[CG] Tissue viability: pressure ulcer prevention, obstetrics


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  1. On admission to each maternity area, complete BadgerNet Tab PRESSURE ULCER RISK ASSESSMENT for every woman.
    Under “Additional Notes”, document if woman has any medical devices, e.g. CTG transducers and belts, Urinary Catheter, Fetal Scalp Electrode, Epidural Catheter etc., which are in persistent contact with their skin. These devices can cause pressure damage. Also note any pre-existing skin conditions e.g. psoriasis, dermatitis, etc.

  2. 4 hourly care rounding assessments and skin checks must be documented in PRESSURE ULCER RISK ASSESSMENT.
    If risk factors increase and/or any redness is noted during care rounding, PRESSURE ULCER INTERVENTIONAL PLAN Tab must be opened and completed.
    If any redness or areas of concern, such as blanching erythema (grade 1) are present then care rounding should be increased to 2 hourly with positional changes and documented skin checks.

  3. In the event of a PRESSURE ULCER being suspected/identified, a referral to TISSUE VIABILITY must be made immediately via TRAKCARE.
    [CLICK ‘OTHER’ TAB, SUB-CATEGORY > tissue viability, ITEM > search magnifying glass {requested
    option}, UPDATE]

In the event of a hospital acquired pressure damage with review by Tissue Viability, the TV team will complete a Datix form.

No Datix is required to be submitted by Maternity staff.

Further information can be obtained by contacting Tissue Viability Service 0141 300 6317 and from the tissue viability website on Staffnet.

Last reviewed: 28 February 2022

Next review: 28 February 2024

Author(s): Karen Taylor, QEUH Midwife and Katrina McGown, Tissue Viability Clinical Nurse Specialist

Version: 1

Approved By: Obstetrics Guideline Group