Pressure ulcers. Are you doing enough to prevent them?

Margaret is a 72 year old female with a history of coronary artery disease, diabetes and CPOD.  She underwent a CABG 7 days ago.  She was on the operating table for 11 hours due to post-operative bleeding.  While in the ICU, Margaret was on a ventilator for 5 days due to complications with her COPD and new onset CHF. She was on a pressure redistribution mattress but was unable to turn herself. She has been weaned off the ventilator and has been transferred to your unit on day 7 post-op.

Upon review of her records from the ICU, you note that an open area on her coccyx was documented in her EHR on day 4, but no measurements were recorded. No treatment is in place and there has been no further documentation of the wound.  You perform an assessment of Margaret's wound.   You find the wound to be covered with black eschar measuring 6cm x 4cm, with a sloughy edge. Yellowish exudate with erythema surrounds the wound.

You will refer back to this scenario as you make your way through this Webquest.