Clinical insights
Pressure Care: Why Preventing Pressure Injuries Is Everyday OT Work
Pressure injury prevention is a daily, individualised plan — combining skin checks, movement, support surfaces and routines that fit the person's life.
Key points
- Pressure injury prevention is a daily, individualised plan — combining skin checks, movement, support surfaces and routines that fit the person's life.
What a pressure injury actually is
A pressure injury is damage to the skin and underlying tissue, commonly over a bony area or beneath a medical device. Sustained pressure, or pressure combined with shear, can contribute. Risk varies with mobility, sensation, skin condition and overall health.
Early changes can include persistent discolouration, pain, swelling or a change in skin temperature or firmness. Redness may be harder to see on darker skin tones, so colour alone is not a reliable check. Damage can involve deeper tissue even when the skin surface looks relatively intact.
Pressure care is a system, not a cushion
A suitable cushion or mattress can help redistribute pressure, but equipment alone does not eliminate risk. Prevention may include individualised repositioning or pressure relief, skin and tissue checks, moisture management, nutrition and transfers that reduce shear. The frequency and method of repositioning need to be agreed with the treating team rather than taken from a universal timetable.
When I assess pressure care needs, I look at the whole 24-hour picture: what someone sits on, sleeps on, how they transfer, who helps them and whether that help is sustainable. Occupational therapy contributes equipment, positioning and functional advice alongside medical, nursing and other relevant care.
- Support surfaces matched to assessed needs — including wheelchair, bed, commode and shower seating
- Repositioning routines suited to the person's ability, comfort, skin response and available support
- Skin and tissue checks, with review after illness or equipment changes
- Transfer methods that reduce dragging and shear where possible
When to ask for a review
Seek prompt advice from an appropriate health professional for new or persistent skin changes, pain, warmth, swelling or a wound. Do not wait for a fixed number of minutes or for broken skin before seeking help. Reduce pressure on the affected area where safely possible and follow your treating team's instructions. Fever or rapidly worsening symptoms require urgent medical assessment.
Changes in sitting tolerance, weight, health, support arrangements or equipment are also reasons to review the prevention plan. No product or routine guarantees prevention.
I complete seating and pressure care assessments in person across the Gold Coast, Brisbane, Logan, Scenic Rim and Northern Rivers, during regional visits to Adelaide, the Riverland and Mackay, with planning and follow-up available by Telehealth Australia-wide.
References and further reading
- Australian Commission on Safety and Quality in Health Care — Pressure injuries
- International Pressure Injury Guideline — Repositioning
This article provides general information only. NDIS rules and individual circumstances can change; check current official guidance or seek advice about your situation.
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