Prevention and Management of Pressure Ulcers

This policy provides a strategy for pressure ulcer prevention and management across NHS Lothian services to ensure that all NHS Lothian clinical staff are aware of, and adhere to, the standards expected of them to provide safe and effective care. This will optimize pressure ulcer prevention, support wound healing, and enhance comfort and dignity.

Developed with reference to national guidelines and local best practice, it aims to optimize pressure ulcer prevention and management by ensuring accurate assessment, timely interventions, and consistent documentation to improve outcomes.

Pressure ulcers (also called pressure sores, pressure injuries, bed sores and decubitus ulcers) are defined as localised damage to the skin and/or underlying soft tissue, which usually occur over a bony prominence or related to a medical or other device. The injury occurs because of intense and/or prolonged pressure or friction, or pressure in combination with shear. This can occur in any person. It is more likely to occur in people who have reduced sensation or movement, who, for example, cannot reposition themselves, have limited mobility, cognitive impairment, palliative, and end-of-life care needs, or who are acutely ill. Other contributory factors include poorly controlled diabetes, poor bladder or bowel function, and poor nutrition and hydration (NPIAP/EPUAP/PPPIA 2025).

This policy should be read in conjunction with the associated guidelines and policies such as the Wound Assessment and Management for Adults Policy.