Nursing Intervention: Pressure Sore and Nutrition

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It is important for nurses to assist in the healing of pressure ulcers. Apart from providing appropriate wound dressing, various nursing interventions are needed such as relieving pressure by providing special pads or air mattresses and turning or repositioning the patient at least every two hours. Arranging pillows under the ankles, back, head and arms, regular cleansing and drying of the skin, and providing good nutrition to support the healing process are also important (Cohen, 2009).

Optimal nutrition helps pressure ulcer healing, keeps immune competence and reduces risk of infection. On the other hand, when patients are in a poor nutritional state wound healing is impaired and more likely to be complicated by infection (Edmonds, 2007; Gillman, 2008).
The treatment of pressure ulcers from NICE (National Institute for Health and Clinical Excellence) clinical guideline indicates that nutritional supplementation is recommended for all patients, especially those who have an identified deficiency. Nutritional support of patients with pressure ulcers should be based on nutritional assessment using a recognised tool, general health status, patient preference, expert dietitian and/or specialist input to support in the decision-making process (ANJ, 2008; NICE, 2005; Rafferty, 2007).
The Waterlow screening tool includes Malnutrition Screening Tool (MST), as evidence suggests that dehydration and malnutrition are related to pressure ulcers (Chamanga, 2010). However, NICE recommends that nutritional screening should only be carried out by healthcare professionals with appropriate skill and the Malnutrition Universal Screening Tool (MUST) should be taken for all patients including those who already have pressure ulcers (NICE, 2005).

The healing process of pressure ulcer demands an increase in the energy intake of nutrients due to an increase in metabolic need. Elderly or disabled people like Mrs. X probably have diminished dietary intake. Patients with highly

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