Reduced mobility
Patients who cannot reposition themselves effectively may experience prolonged pressure over vulnerable areas.
NurseNet Clinical Skills
Pressure Ulcer Prevention for Student Nurses
Learn how pressure ulcers develop, which patients may be at greater risk, what skin changes to look for and how repositioning, skin care, nutrition and early escalation can help prevent avoidable pressure damage.
Prevention starts with
01
Risk assessment
Know which patients need closer monitoring.
02
Skin inspection
Look for early signs of pressure damage.
03
Repositioning
Reduce prolonged pressure on vulnerable areas.
04
Moisture management
Protect skin from excess moisture and irritation.
05
Nutrition and hydration
Support skin integrity and healing capacity.
Understanding pressure damage
What is a pressure ulcer?
A pressure ulcer is an area of localised damage to the skin and/or underlying tissue, usually over a bony prominence or related to a medical device. Pressure, and sometimes pressure combined with shear, can reduce blood flow to vulnerable tissue.
Pressure damage can develop when a patient is unable to reposition themselves effectively, is acutely unwell or has additional factors that make their skin and tissues more vulnerable.
Prevention depends on recognising risk early and consistently carrying out the care needed to reduce that risk.
Pressure ulcer prevention is not one intervention. It is a coordinated
approach involving assessment, movement, skin care, equipment,
nutrition, hydration and communication.
Who may be at risk?
Pressure ulcer risk factors
Risk is individual and can change quickly. Always use the risk assessment process and local guidance used in your clinical area.
Reduced sensation
A patient may not feel discomfort that would normally prompt them to change position.
Poor nutrition or hydration
Inadequate nutritional intake or hydration may affect skin integrity and tissue resilience.
Moisture
Incontinence, perspiration, wound exudate and other moisture can make skin more vulnerable to damage.
Acute illness
Deterioration, poor perfusion and reduced activity can increase risk during acute illness.
Medical devices
Oxygen tubing, masks, catheters, splints and other devices can create pressure on skin if not checked regularly.
Skin assessment
Look for early changes
Early recognition gives the clinical team an opportunity to act before pressure damage progresses.
Colour change
Look for persistent colour change over pressure areas and compare with surrounding skin and the patient's usual skin tone.
Temperature
An area may feel warmer or cooler than nearby tissue.
Texture
Notice changes such as firmness, softness, swelling or altered tissue feel.
Pain or discomfort
Patients may describe tenderness, burning or discomfort before obvious skin breakdown is visible.
Blistering or broken skin
Any blister, open area or visible tissue damage should be reported and assessed promptly.
Device pressure
Inspect skin beneath or around medical devices where safe and clinically appropriate.
Skin changes can look different on different skin tones.
Do not rely on redness alone. Temperature, pain, firmness, swelling, discolouration and comparison with surrounding skin may all be important.
Prevention in practice
A practical pressure ulcer prevention approach
Follow the individual patient's care plan, risk assessment and local pressure-area guidance.
1
Assess risk
Review the patient's mobility, skin condition, nutrition, moisture, clinical status and other relevant risk factors.
2
Inspect the skin
Check vulnerable areas at the frequency required by the care plan and report new changes promptly.
3
Support repositioning
Help the patient change position according to their assessed needs, ability and planned repositioning schedule.
4
Use pressure-relieving equipment correctly
Mattresses, cushions and other equipment should be used according to the patient's care plan and local guidance.
5
Protect the skin
Keep skin clean and appropriately dry, manage moisture and avoid unnecessary friction or shear.
6
Review nutrition and hydration
Report concerns about poor intake, weight loss, dehydration or other factors that may increase pressure ulcer risk.
Repositioning
Movement reduces prolonged pressure
Repositioning plans should be individualised. There is no single position or frequency that is right for every patient.
- Encourage independent movement where the patient can reposition safely.
- Follow the agreed repositioning plan for patients who need assistance.
- Use moving and handling techniques that reduce friction and shear.
- Check pressure areas after repositioning when appropriate.
- Ensure pressure-relieving equipment remains correctly positioned.
- Document repositioning according to local practice.
Repositioning is not simply turning a patient. It should be planned,
safe, comfortable and appropriate to the individual's clinical needs.
Patient safety
When should you escalate?
New skin changes or worsening pressure damage should be communicated promptly so the prevention and treatment plan can be reviewed.
Report suspected pressure damage early.
Escalate new discolouration, persistent skin changes, blistering, broken skin, increasing pain or deterioration around a medical device according to local policy. Do not wait until an open wound develops.
Documentation
Good records support prevention
Clear documentation allows the wider team to understand the patient's risk, current skin condition and the prevention measures in place.
Risk assessment
Record risk assessment information using the approved local tool and documentation system.
Skin findings
Document the site, appearance and relevant characteristics of any skin changes accurately.
Repositioning
Record repositioning and other prevention interventions according to local requirements.
Equipment
Document relevant pressure-relieving equipment and any changes to the prevention plan.
Escalation
Record concerns, who was informed and any subsequent assessment or action.
Review
Update records when the patient's mobility, skin condition or clinical risk changes.
Student nurse focus
How to become confident with pressure-area care
Pressure ulcer prevention becomes easier when you connect skin assessment with mobility, nutrition, continence, equipment and the patient's overall condition.
- Learn the pressure-risk assessment tool used in your placement area.
- Ask which anatomical areas are most vulnerable for each patient.
- Observe how experienced nurses assess different skin tones.
- Learn how pressure-relieving mattresses and cushions are used locally.
- Review repositioning plans rather than relying on memory.
- Escalate early when you notice a new skin change.
Prevention starts before there is a wound. Your observations and
everyday care can make an important difference.
Next clinical skill
Next: Blood Glucose Monitoring.
The next NurseNet guide covers safe blood glucose monitoring, documentation, recognising abnormal results and when to escalate concerns.
Continue to blood glucose monitoring