Pressure Area Assessment: OSCE Station Checklist

Pressure damage is the harm the NHS measures wards by, and this station imports that seriousness. It’s an inspection-plus-planning station: find the risk, find any damage already present, and leave a prevention plan behind.

The sequence:

1. Risk score first: Waterlow or the local tool, built from mobility, continence, nutrition, age, skin condition, and special risks. Say the factors as you score; each is an assessment mark.
2. Consent, privacy, and a dignified systematic skin inspection over the bony prominences: sacrum, heels, hips, elbows, shoulders, back of head, ears.
3. Device check: under and around oxygen tubing, masks, casts, stockings, catheters. Devices are the growing cause of hospital pressure damage and a favourite exam probe.
4. Any redness gets the blanch test: light pressure, release, watch. Blanching redness with quick refill is intact circulation; keep watching it. Non-blanching redness is category 1 pressure damage: offload now, report, document.
5. Plan prevention with SSKIN: Surface, Skin inspection, Keep moving, Incontinence/moisture, Nutrition.
6. Document: score, sites inspected, findings per site, actions and repositioning schedule.

The category 1 moment

The scripted finding is nearly always a red sacrum or heel. The mark hinges on the blanch test and on knowing what non-blanching means: not “at risk of a pressure ulcer” but “this is a pressure ulcer, category 1”. The response is concrete: position the patient off the area, check the surface (does this patient need a higher-spec mattress?), report it as the incident local policy considers it, and shorten the repositioning interval. Vague vigilance (“I’d keep an eye on it”) is the marked fail.

Prevention as a plan, not a sentiment

SSKIN gives the station’s closing structure, and the examiner wants specifics under the letters: a pressure-redistributing mattress and heel offloading (Surface), inspection at every reposition (Skin), a written turn schedule the patient has agreed to (Keep moving), barrier products and prompt changes for moisture (Incontinence), and a MUST-informed food and fluid plan (Nutrition), which connects directly to the nutritional assessment station.

Involve the patient audibly: can they reposition themselves, do they understand why the ask matters, what’s their pain doing to their movement? Pressure care done to a patient fails; done with them, it collects the communication marks this station holds.

Five questions below, then pain assessment.