Pressure Ulcers: What Clinicians Need to Know

Pressure Ulcers: What Clinicians Need to Know

Pressure ulcers are localized areas of tissue damage or necrosis that develop because of pressure over a bony prominence. They have previously been called pressure sores, bedsores, and decubitus ulcers, terms that imply that only bed-bound, nonambulatory patients develop pressure ulcers. It is important to recognize that patients who are ambulatory can also develop pressure ulcers, although reduced mobility is still a major risk factor.

The purpose of this article is to familiarize physicians and other clinicians who provide care to hospitalized patients, such as physician assistants, certified nurse midwives, and nurse practitioners, with some of the terminology associated with pressure ulcers, so that they can better assess patients at risk for the development of pressure ulcers and properly identify and describe pressure ulcers.

Pressure ulcer treatment is one of many aspects of patient care in which nursing care interfaces directly with clinician-provided medical services. Traditionally, the treatment of pressure ulcers has been left to nurses. No less an authority than Florence Nightingale said in 1859, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing.”1 Physicians have tended to be passive participants, routinely cosigning orders written by hospital-based wound-care nurses or home health nurses. Realization of the costs associated with the treatment of pressure ulcers and recent requirements by third-party payers have prompted physicians to become more actively engaged in the prevention, identification, and treatment of pressure ulcers.
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