NPUAP

Article Title: Pressure Injury Progression and Factors Associated With Different End-Points in a Home Palliative Care Setting: A Retrospective Chart Review Study
Authors: Artico M, D’Angelo D, Piredda M, et al
Journal: J Pain Symptom Manage 2018;56(1):23-31
Reviewed by: Arden Harada, class of 2021, Temple University School of Podiatric Medicine

by the National Pressure Ulcer Advisory Panel

Washington, DC – April 12, 2019 – On March 25-27, Dr. William Padula visited Washington, D.C. to advocate for policy solutions surrounding pressure injury prevention at the highest levels of government and health care. His independent advocacy for improving patient safety was provided as a researcher on behalf of NPUAP and its panel members. Dr. Padula is Treasurer on the Board of Directors for NPUAP, as well as an Assistant Professor of Health Economics at the University of Southern California Schaeffer Center for Health Policy & Economics in Los Angeles, along with a secondary appointment at the Johns Hopkins School of Nursing in Baltimore.

by Heidi H. Cross, MSN, RN, FNP-BC, CWON

According to the Agency for Healthcare Research and Quality, more than 17,000 lawsuits related to pressure ulcers (PUs) are filed annually in the United States, second only to wrongful death lawsuits. One of the greatest gifts to defense attorneys was when the Centers for Medicare & Medicaid Services (CMS) published F-Tag 314, finally acknowledging that some ulcers can occur despite best care. The facility essentially can maintain, “Hey, we did everything we were supposed to, and despite that, the patient developed that pressure ulcer”—that is, the ulcer was unavoidable. To prove unavoidability, proper documentation (proof) of best care needs to be in place, as well as documentation that all proper prevention and treatment measures were implemented.

by the National Pressure Ulcer Advisory Panel

Washington, DC. – March 7, 2019 – On February 15, 2019, the American National Standard Institute (ANSI) approved a revision to the ANSI/RESNA SS-1-2014 standard. The revision includes 4 new test methods to evaluate important performance characteristics of support surfaces, including mattresses, mattress overlays, and integrated bed systems related to the prevention and treatment of pressure injuries. This National standard has been developed by the National Pressure Ulcer Advisory Panel (NPUAP) Support Surface Standards Initiate (S3I) and is available through RESNA (https://www.resna.org/standards/support-surfaces/support-surfaces).

by Heidi H. Cross, MSN, RN, FNP-BC, CWON

"If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed sore, it is generally the fault not of the disease, but of the nursing." —Florence Nightingale

Ouch! What an indictment of nursing and, by extension, the facility in which the nurse works. We have a lot to thank Florence Nightingale for—a brilliant woman considered to be the founder of nursing and nursing standards and the first to ever put statistics to health care, among other valuable contributions.

by Heidi H. Cross, MSN, RN, FNP-BC, CWON

When looking at medical charts from a legal perspective, one of the areas closely scrutinized is the risk assessment for skin breakdown and pressure ulcer development. Completing a risk assessment is considered a standard of care. Was the patient adequately assessed, and was this done in a timely fashion? Was it repeated at regular intervals, with a change in condition, or on readmission? Do scores seem appropriate for the patient's condition? Is there consistency among health practitioners? Were the results used to institute evidence-based and appropriate prevention and treatment measures and care plans? Or do the results seem to simply languish in the chart? What are the standards of care related to this?

By Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP

What does your facility do to raise awareness regarding pressure injury prevention? We have lots of educational opportunities throughout the year, but one of our most important and prepared for days is the third Thursday in November – World Wide Pressure Injury Prevention Day! This is a day to raise awareness that has been promoted by the National Pressure Ulcer Advisory Panel (NPUAP). Every year, the NPUAP puts out a press release and lots of good information in terms of ways to educate and engage staff on such an important topic, on a national level.

by Heidi H. Cross, MSN, RN, FNP-BC, CWON

Failure to T&P (turn and position) is always part and parcel of a pressure ulcer lawsuit and a key element of a complaint related to pressure ulcers, as illustrated in the opening quotation. T&P documentation is a dominant focus in chart analysis and is usually one of the first things that an attorney and the expert witness look for. If T&P documentation is satisfactory, the defendant is likely to prevail; if not, then the plaintiff may have a pretty rock-solid case. But as I have opined in previous blogs, is there such a thing as perfect documentation? Alas...NO! (Or at least, rarely.)

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

It is 2018, and health care professionals around the world are still debating what to call skin damage. I totally immersed myself in wound care because of losing my 47-year-old mother to what was then called "decubitus ulcers." I was young when my mother died, and I wanted to know why and how this could happen. My perspective is different from that of most clinicians because of my personal experience.

by Dr. Nancy Munoz, DCN, MHA, RDN, FAND

The presence of diabetes can have a negative impact on wound healing rates. Increased glucose levels can stiffen the arteries and contribute to narrowing of the blood vessels. This can influence pressure injury development and is a risk factor for impaired wound healing.