In This Corner: The Unavoidable Pressure Ulcer

Laura A. Stokowski, RN, MS

Disclosures

February 05, 2010

In This Article

Prevention of Pressure Ulcers: What's Next?

A new international guideline regarding the prevention of pressure ulcers was released in 2009.[11] A collaboration between the National Pressure Ulcer Advisory Panel and the European Pressure Ulcer Advisory Panel, the guideline cover the latest evidence-based recommendations for all patients in all healthcare settings. Clinical practice recommendations regarding prevention will include:

  • Current definitions and classification of pressure ulcers;

  • Risk assessment, including the role of nutrition;

  • Skin inspection and skin care;

  • Positioning and repositioning patients;

  • Evidence for use of various support surfaces (air fluidized beds; alternating air mattresses and cushions; foam-, gel-, or fluid-filled mattresses; overlays for operating tables; turning beds; and other aids for pressure-redistribution);

  • Protective devices used for pressure ulcer prevention; and

  • Education and training for healthcare providers.

The complete new International Pressure Ulcer Guidelines are available for purchase, and 2 free quick reference guidelines derived from these guidelines are also available: the Pressure Ulcer Treatment Quick Reference Guide and the Pressure Ulcer Prevention Quick Reference Guide.

The National Quality Forum has been working on an evidence-based framework for the prevention and management of pressure ulcers across the continuum of care.[12] This framework will be a road map of preferred practices and performance measures for a pressure ulcer management program. The draft framework contains specific recommendations, such as requiring a pressure ulcer risk assessment within 8 hours of admission and moving from a staging system to a grading system to classify pressure ulcer severity upon admission. The document will also help facilities determine accountability as the patient moves across settings of care.

Conclusion

At the end of the day, all healthcare workers want to believe that they have done a good job. When a patient develops a pressure ulcer "on your watch," even if you realize intellectually that it wasn't preventable, you may still wonder what you might have done differently. The best that nurses can do is understand their roles in surveillance and risk assessment, use of evidence-based preventive measures, accurate documentation, and focused patient and family education. Nurses are also encouraged to read the 'WOCN Society's position paper for a different perspective on pressure ulcer prevention.

About the Wound, Ostomy, and Continence Nurses Society

Founded in 1968, the Wound, Ostomy and Continence Nurses (WOCN) Society is a professional, international nursing society of more than 4200 healthcare professionals who are experts in the care of patients with wound, ostomy, and incontinence.

The WOCN Society supports its members by promoting educational, clinical and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wounds, ostomies and incontinence. Visit the WOCN at http://www.wocn.org/index.php.

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