ulcers.
Lewis et al. (2003) provide a practical model of preventing and treating pressure ulcers. Lewis et al. (2003) provide a model that encompasses risk assessment, nutritional care, skin assessment and inspection, pressure relieving, redistributing devices and other management strategies, seating, pressure ulcer care, infection strategies and education and training. This model offers risk assessment that is conducted within one hour of facility admission, involving both ôformal and informal assessment proceduresö that addresses the following aspects: level of mobility, incontinence, nutritional status, sensory impairment, level of consciousness and neurological status, complete history, and physical and psychosocial examination measuring mental status and cognitive ability (Lewis, et al. 2003, p. 96). Lewis et al. (2003) recommend the use of risk assessment scales but only as a guide to augment clinical judgment.
The Lewis et al. (2003) model also encompasses daily systematic skin inspections for all patients with particular attention given to problematic regions of the body. Skin changes should be documented, skin should be cleansed with an appropriate cleanser with a pH range of 4.5-6.5, moisturizer should be used on dry skin, and recurrent soiling should be prevented through examining diet and medication augmented by appropriate continence aids (Lewis et al. 2003). Skin inspection in this writerÆs view should be vigilant for skin changes. The Lewis et al. (2003, p. 97) advocates such vigilance, maintaining the following skin changes are indicative of potential pressure ulcer development:
The Lewis et al. (2003) model provides a number of strategies for pressure relieving, redistributing devices and other management aimed at prevention and treatment of pressure ulcers. Shearing, pressure and friction are factors this writer finds contribute to the development of ulcers, and should be eliminated or minimized. ...