Bed Sores - Prevention

To properly prevent pressure ulcers, it is necessary for nursing homes to adopt systematic strategies to reduce risk factors by assessing the physical and mental conditions of a resident, including activity level, mobility, incontinence, nutrition, risk for friction and shear, and skin condition. Only a comprehensive assessment of each resident, which leads to a specific plan designed for the needs of that particular resident, can lead to effective prevention of pressure ulcers.

Movement and Position Changes

Maintaining the ability to move around and position changes are the most effective ways to prevent pressure sores. Those who are not confined to a bed or wheelchair should be encouraged to stand and walk. Appropriate daily exercise that helps circulation and builds up vital muscle tissue is an important step in maintaining healthy skin.

People who are wheelchair-bound should shift their weight every 15 to 20 minutes and should be assisted to reposition every hour to increase blood flow and take pressure off certain areas. Bedbound nursing home residents should be repositioned, changing from the back to their right and left sides, at least every 2 hours to relieve pressure over bony areas. Caregivers should pay extra attention to the areas where pressure sores often form, such as heels, ankles, knees, hips, spine, tailbone area, elbows, shoulders, back of the head, and ears. When repositioning, the body should not be dragged to get in or out of bed because dragging causes skin breakdown. Nursing Assistants should use proper repositioning, transferring, and turning techniques to minimize friction.

Soft cushions can also help place the body in an appropriate position, can relieve pressure, and can protect vulnerable areas from damage. For example, when lying on the side, they can be placed between the knees and ankles. When lying on the back, they can be placed under the heels, tailbone area, shoulders, shoulder blades, and elbows. The head of the bed should be elevated as little as possible and should be raised no more than 30 degrees to prevent shearing.

Skin Care

A thorough daily skin inspection, with particular attention to all bony areas, is important for identifying vulnerable areas of skin or early signs of pressure sores. Excessive dampness or dryness of the skin increases the risk of pressure sores. To minimize irritation and dryness, the skin should be washed with warm water and mild soap or a no-rinse cleanser and then gently dried with a towel. Moisturizers, talcum powder and disposable underpads can be used to control moisture and to protect the skin. Caregivers should also pay attention to prevention of dampness and bacterial exposure to skin.


A good diet with adequate fluids, protein, vitamins, and minerals is important for prevention of pressure sores. People with limited mobility or significant weakness should be assisted with eating and drinking so that they get adequate hydration and calories that are necessary for maintaining healthy skin.

Adequate Nursing Staff Levels for Pressure Ulcer Prevention Care

It has been shown that adequate staffing levels can help reduce the incidence of pressure ulcers in skilled nursing facilities. A nursing home must provide evidence-based quality incontinence care, a pressure relief plan, and meet nutritional needs in order to reverse any underlying conditions that may increase the risk of pressure ulcers in the first place. Such preventive care, as well as the necessary treatment care, requires adequate staffing levels at nursing homes for daily preventive measures such as frequent repositioning of residents throughout the day, cleaning and drying each resident, and use of nutritional supplements to maintain good nutrition. (For more information on necessary preventative care, please go to California Nursing Home Abuse Lawyer Blog.)

If your loved one has suffered from pressure ulcers developed in a nursing home in California, or if you believe a nursing home failed to provide adequate care to prevent or treat pressure ulcers, please contact us today. We will evaluate your case with our team of experts to determine whether you or your loved one has been subjected to elder neglect, which is a form of Elder Abuse.