Source taken from ‘British Journal of Nursing – At a glance: pressure injuries’

What Pressure Is Pressure Area Care Putting on Your Care Facility?

Pressure Area Care (PAC) is a critical area of care in both hospitals and care homes. Effectively managing it not only protects residents/patients from painful, avoidable injuries, but also reduces the burden on staff, resources, and reputation. In this post, we explore what PAC is, why it matters, how risk is assessed, and what equipment you need to include in your prevention strategy.

What is Pressure Area Care (PAC)?

Pressure Area Care” refers to the set of practices, assessments, equipment, and interventions aimed at preventing or managing pressure ulcers (also called pressure injuries, bedsores) in people who are immobile or have limited mobility. PAC encompasses skin inspection, repositioning regimes, appropriate support surfaces (mattresses, cushions), nutrition, moisture management, and documentation.

In effect, PAC is a proactive safety measure: the aim is to prevent tissue damage by relieving or redistributing pressure, managing shear forces, and supporting overall skin integrity.

Key Statistics on PAC (burden & cost)

Pressure ulcers are among the costliest chronic wounds in the UK’s NHS. In England, treatment costs are estimated at £3.8 million. Wounds International

The incremental cost of treating a pressure ulcer (depending on severity) can reach up to £374 per day in some contexts. Wounds International

In the UK, “over 700,000” people are affected by pressure ulcers annually, with 180,000 newly acquired each year. Incidence | Background information | Pressure ulcers | CKS | NICE

It’s estimated that just under half a million people in the UK will develop at least one pressure ulcer in any given year. Fundamentals of pressure ulcer care – May 2025 – Society of Tissue Viability

These numbers underscore that PAC is not a niche concern — it has real clinical, financial, and reputational impact for care organisations.

Why Does PAC Exist? (The Rationale)

The existence of PAC is justified by a few key principles:

• Prevention is far less costly and harmful than treatment. Once a pressure ulcer has formed particularly at Grade 3 or 4 intervention becomes complex, painful, time-consuming, and expensive.
• Patient quality of life. Pressure injuries can cause severe pain, infection, delayed recovery, longer stays, and even systemic complications.
• Legal, regulatory, reputational risk. Pressure ulcers are often flagged in audits, inspections, or litigation when they are deemed avoidable.
• Resource burden. Managing ulcers consumes nursing time, specialist wound care supplies, dressings, repositioning schedules, additional diagnostics, etc.So PAC is a necessary investment to reduce downstream risks, costs, and harm.

Source ‘British Journal of Community Nursing – Making a difference in pressure injury prevalence: the community nurse’s guide

Grades (Categories) of Pressure Ulcers and Typical Equipment

Using the NHS / EPUAP standard classification, here are the commonly used grades/categories of pressure ulcers:

Risk of the Resident Developing an Ulcer & Equipment Table

It’s helpful to show care staff a simple table relating assessed risk to recommended equipment. You’ve already provided a version; I’d suggest including a short narrative around it, e.g.:

“Once a person is assessed as being at High or Very High risk, the selection of a premium pressure-redistributing mattress (e.g. EC8 or Pressure Guard) becomes essential, combined with more frequent repositioning, skin inspections, and moisture management.”

You may also want to overlay other risk factors (nutrition, incontinence, comorbidities) that could push someone toward needing higher-tier equipment even if their base mobility is moderate.

Risk of the Resident Developing an Ulcer & Equipment Table

Low Risk – Use the EC5 Easycare 5 Overlay Air Mattress (Medium Risk) 

Medium Risk – Use the EC7 Easycare 7 Air Mattress System.

High Risk – Use the EC8 / Pressure Guard Easycare 8 Air Mattress System.

Very High Risk – Use the EC8 / Pressure Guard Easycare 8 Air Mattress System.

Waterlow Score and Equipment Selection

Waterlow Scoring System: How It Works

Scoring Method

Understanding how the Waterlow Score is calculated helps care teams use it effectively. Each factor is given a number of points, and these are added together to give a total Waterlow Score. The higher the total, the greater the risk of developing a pressure ulcer.

Here’s how each part is scored:

• Age: Older individuals score higher, as skin becomes more fragile and healing slows with age.
• BMI (Body Mass Index): A low BMI can suggest frailty or poor nutrition, increasing the risk score.
• Skin Type: Fragile or damaged skin raises the score, as it’s more prone to breakdown.
• Mobility: The less a person can move independently, the higher their score — immobility is a key risk factor.
• Continence: Problems with bladder or bowel control can cause moisture and skin irritation, raising risk levels.
• Nutrition: Poor diet or reduced intake increases the score, highlighting how important nutrition is for skin health.
• Special Risk Factors: Certain conditions or treatments (e.g. diabetes, medication, surgery) add extra points if they make the skin more vulnerable.

Interpreting the Score

Once all factors are scored and added up, the total places an individual into one of three risk levels:

• Low Risk:
  Only standard prevention measures are needed — such as regular checks and basic skin care.
• Moderate Risk:
  The person needs closer monitoring and specific preventive actions, like repositioning and protective equipment.
• High Risk:
  Intensive care is required, including frequent repositioning, specialist mattresses, and thorough daily skin inspections.

Why It Matters

The Waterlow Score helps healthcare teams identify, prevent, and manage pressure ulcer risk early. By understanding the score and what drives it, staff can create personalised care plans that adapt as each person’s condition changes.

When choosing Pressure Area Care

Here is a high-level overview of typical categories and considerations:

• Static foam mattresses and cushions  basic support, useful for low-risk patients.
• High-specification static (viscoelastic, high-density foam)  offer better pressure redistribution, often for medium risk.
• Dynamic/alternating air systems (air mattresses, alternating cell mattresses)  better for high / very high risk, because they change pressure points over time.

• Pressure-relieving overlays (air, gel, low-air-loss overlays)  can supplement existing mattresses if a full replacement is not feasible.
• Heel and limb offloading devices (boots, pillows, splints)  for bony prominence protection.
• Cushions, seat inserts, positioning aids  for chair-bound individuals.
• Accessories and monitoring systems  such as pressure sensors, surface alarms, repositioning reminders, skin inspection devices.
• Support frame / bed features  split frames, profiling beds, tilt/incline features to reduce shear, side supports, gap fillers.

When choosing, consider:

• • Weight capacity / patient dimensions
  • Ease of cleaning / infection control
  • Noise, maintenance, repair
  • Staff training and ease of use
  • Warranty, service support
  • Compatibility with turning / repositioning protocols

Implementing a robust PAC strategy is not optional  it’s essential to safeguard residents, reduce costs, and uphold the reputation of your facility. By combining risk assessment (e.g. Waterlow), clinical judgement, and an appropriate tiered equipment approach, you position your team to prevent avoidable harm.

The 2025 Focus: “What Matters to Me Is…”

This year, the Society of Tissue Viability is shining a spotlight on the patient voice.
The 2025 Stop the Pressure campaign asks a simple but transformative question:

“What matters to you – in this moment, in this place?”

Throughout the year, the Society of Tissue Viability will be sharing stories and perspectives from patients, carers, and clinicians across every corner of care from A&E to community nursing, from care homes to end-of-life settings.

By putting lived experience at the centre, we can rediscover the human heart of evidence-based practice even in a system under strain.

Shop Pressure Area Care Today!