Pressure injury in emergency departments | The problem, statistics, and solutions
Pressure injury prevention is often a low priority for staff in an emergency department, however, as the time patients are spending in ED increases across the country it is becoming an important issue which needs a concerted effort to manage and prevent.
The problem
As hospitals across the UK remain under significant pressure, the number of patients waiting in emergency departments is also increasing, leading to greater risks of pressure injuries developing in emergency departments.
A study carried out in 2021 by Al Nhdi N found that 26.5% of patients stay in emergency departments for longer than 4 hours1. When you consider that patients can develop pressure damage in as little as two hours through immobility or by being cared for on the incorrect mattress type2, we can start to understand the scale of the problem.
What actually causes pressure injuries to develop?
Put simply, pressure ulcers are caused by a particular part of the body being placed under pressure for a period of time. This pressure interrupts the blood supply to the affected skin area, causing it to break down over time.
In emergency departments, patients with reduced mobility will often be kept on patient stretchers whilst waiting to be seen and treated. If immobile patients aren’t being frequently repositioned, or if they are on unsuitable stretchers or mattresses, they are likely to start developing pressure injuries.
3 solutions to help reduce the risk of pressure injuries in ED
Carry out risk assessments on vulnerable patients
One of the best ways to identify the risks and prevent pressure injuries from occurring in the first place is to risk-assess vulnerable patients as they come into the emergency department. An effective pressure injury risk assessment considers factors including but not limited to mobility, existing pressure injuries, co-morbidities such as diabetes, circulatory status, body temperature and nutrition3.
Risk assessments should also be regularly reviewed and updated when necessary.
Increase education & training on pressure injury management
As mentioned at the beginning of this article, pressure injury prevention is often a low priority for staff in an emergency department, particularly with the intense pressure they are under to keep patients flowing through the hospital and treated on time.
However, with this becoming more and more of an issue, by educating staff about the issues and by including it in staff training the risk of pressure injuries developing in ED is likely to decrease.
Implement appropriate equipment
The risk of patients developing pressure injuries in emergency departments can also be reduced by implementing equipment specifically designed to improve pressure distribution, such as specialist mattresses and stretchers.
Stretchers such as the MultiFlow feature dual auto-regression, which allows for the natural lengthening of a patient’s body during profiling, significantly reducing shear and friction and improving pressure distribution. This reduces the risk of patients developing pressure injuries.
Citations
[1] Al Nhdi N, Al Asmari H, Al Thobaity A. 2021. Investigating Indicators of Waiting Time and Length of Stay in Emergency Departments. Open Access Emerg Med. 16;13:311-318. [Online] 2021. https://pubmed.ncbi.nlm.nih.gov/34295196/
[2] Kirman, 2022
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Why are NHS Emergency Departments under so much pressure? – 4 problems they’re currently facing
How does the MultiFlow Stretcher help prevent pressure injury in emergency departments?
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