Ask A Magnet Nurse

Certified Wound Nurses Help Prevent And Treat Pressure Injuries

Grecia Luna BSN, RN, CWON
Inpatient Wound Care
St. Joseph’s/Candler  

Smart Living: Pressure injuries, which were more commonly known as pressure ulcers or bedsores, can happen at home to people who have a limited ability to change positions, but they can also happen to patients with longer hospital stays. How do nurses prevent and treat pressure injuries?

Grecia Luna: All of the nurses here are educated on pressure injury risk assessment. It is part of what we call a pressure injury prevention care bundle. Every two hours, nurses will help any patient turn in their bed if they cannot do it themselves.

Any bony prominence can cause a pressure injury, but they commonly occur in places like the heels, ankles and hips. Patients don’t necessarily have to be physically immobile to be at risk. A patient with dementia or with certain medications may not get that signal from their brain to naturally turn and move. Our floor nurses are educated on assessing those situations as well. A great thing about pressure injury prevention at St. Joseph’s/Candler is that it’s a nurse-driven protocol—a bedside nurse can alert us to a potential pressure injury and then we can go to that patient and provide a plan of care.

SL: What do you do for a patient who has a pressure injury or is at high risk for one?

GL: We treat the pressure injury topically, keeping it clean and protecting it with special dressings that protect from friction and shear. But it goes beyond that—we look at the whole person, their nutrition, the kind of bed they’re in, and the various reasons that their skin may be fragile. They may have a chronic illness such as diabetes that affects their ability to heal. We use all of this information to initiate a plan of care. We also educate patients on how they can prevent pressure injuries when they’ve returned home.

There are three of us at SJ/C who have the highest level of certification in wound and ostomy care. It’s rare to have that many at one hospital. During our most recent Magnet designation, we learned the SJ/C exceeded Magnet standards for pressure injury prevention and treatment. We’re proud to be able to always provide a high level of care for this common problem.