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Pressure-injury prevention starts with a daily plan for the person
Skin checks, movement and support
When illness makes movement difficult, skin care becomes part of the daily care plan. Pressure injuries can begin before there is an obvious open wound, and prevention depends on noticing changes early and reducing avoidable pressure. A mattress or cushion can help, but it works within a wider plan involving movement, observation, nutrition and clear communication.
Start with the person's risk
Pressure ulcers, also called pressure sores or pressure injuries, affect skin and the tissue beneath it. Long-lasting pressure and shear can contribute to damage. Risk is greater when someone cannot change position easily, has reduced sensation or has other factors affecting skin health. Previous pressure injuries also matter when planning care.
A risk assessment should lead to specific actions. Explain how the person usually moves, where they spend the day and what help is available at night. A plan for someone who can reposition independently will differ from a plan for someone needing assistance. Ask for review when illness, surgery or a change in mobility alters those circumstances.
Look for changes before a wound develops
The NHS lists persistent discolouration, changes in skin feel and pain or itchiness among possible early signs. Appearance varies with skin tone. On darker skin, changes may look purple or blue rather than the redness often shown in teaching photographs. A visual check alone may therefore miss useful information about discomfort, warmth or firmness.
Heels, hips and the base of the spine are common pressure areas. Medical devices can also create local pressure. Agree with the care team which areas need checking and how the person can participate. Respect privacy, explain what is being examined and report a change promptly rather than waiting for the next routine appointment.
Movement and equipment need to work together
Health New Zealand's prevention advice combines a supportive surface with skin inspection, movement, continence care and nutrition. This is a helpful way to organise a conversation because it keeps several practical needs visible at once. It also makes clear that buying equipment does not complete the prevention work.
The clinical team should recommend how often and how safely to change position. Ask for help and suitable equipment if the person cannot move independently. Avoid assuming that one turning schedule fits everyone. A written plan should explain the assistance required and who will provide it, including when usual carers are unavailable.
Mattresses and seating cushions need to suit the person's needs and environment. NICE recommends assessing seating for people who sit for prolonged periods and considering pressure-redistributing support. Ask how the equipment should be used and checked. An illustrative photograph of a cushion is not a recommendation to purchase that particular design.
Protect the skin without adding harm
Moisture, friction and movement during transfers deserve attention alongside pressure. Ask the team about continence support, skin cleansing and any recommended barrier preparation. These decisions should reflect the person's skin assessment. A product suggested for one type of skin problem may not be appropriate for another.
NICE advises against massaging or rubbing skin to prevent pressure ulcers. MedlinePlus similarly cautions against massage near an ulcer and against ring-shaped cushions. If there is already a wound, follow professional advice on dressings and cleaning rather than selecting treatments from a general list. Report deterioration or a new sore to the treating team.
Make nutrition and comfort practical
Prevention includes paying attention to whether a person can eat and drink adequately. That may require help with meals, an assessment of poor intake or discussion of individual fluid restrictions. More supplements or extra fluids are not automatically beneficial when intake and hydration are already adequate; NICE recommends tailoring support to assessed needs.
Comfort can influence whether a plan is achievable. Tell clinicians if pain makes movement difficult or if an item of equipment is hard to tolerate. The aim is to find a workable approach that reduces pressure while taking the person's wider health and preferences seriously. Repeated instructions are less useful than resolving the reason they cannot be followed.
Know when to seek help
Contact a healthcare professional if you think a pressure injury has developed. The NHS advises urgent assessment when symptoms include hot or swollen skin, pus, fever or severe or worsening pain. Use local urgent-care arrangements, and seek emergency help if the person is seriously unwell. Do not wait for a wound to become large before reporting concern.
Graymedy's practical interpretation is to make prevention visible in everyday care: a clear plan, appropriate equipment, regular review and someone who knows what to do when skin changes. That turns a general warning into shared actions that can be checked and adjusted.
Sources: NHS: pressure ulcers; NICE: pressure-ulcer prevention and management; Health New Zealand: pressure injuries; MedlinePlus: caring for pressure sores.
Photo: Sanchors62 / Wikimedia Commons, CC BY-SA 4.0. Resized for display.
Editorial review: 29 October 2026. Adult care information, not an individual treatment plan or product endorsement.
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