Pressure Ulcer Prevention

Cheryl Carver's picture
fat grafting for pressure injuries


This month's blog topic idea came about from a recent conversation with a middle-aged patient with paraplegia. She had a stage 4 pressure injury due to being in her wheelchair long hours, along with a low BMI. I made the comment, "I wish I could give you a fat transplant." She laughed. She then asked, "Well, why not?" Later that day the topic of fat grafting popped up on social media in a spinal cord injury group I follow. I ended up chatting with a few spinal cord injury folks that were serious about coming up with funds to get fat grafting done. They all had a fear of, or a previous history of pressure injuries. These folks with past pressure injuries had used advanced wound care dressings, support surfaces, high-end cushions, supplements, negative pressure wound therapy, a slew of antibiotics, and even flap closures.

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Holly Hovan's picture
wound care education


As a wound, ostomy, and continence nurse in long-term care, education is a huge part of my role working in our Community Living Center (CLC), Hospice, and Transitional Care Unit (TCU). Unit specific, evidence-based training and continued follow-up are integral to the success of our pressure injury prevention program. The unit-based skin care nurses (UBSCNs) are at the frontline of prevention, along with all nursing staff, especially nursing assistants (NAs).

Janet Wolfson's picture

By Janet Wolfson PT, CLWT, CWS, CLT-LANA

As I read through wound care articles on pressure injuries and treatments, I keep going back to one thought: why are they still occurring? They are preventable! Staff are educated, have certifications and equipment, and have been oriented on policy to prevent pressure injuries. I think it comes down to opportunities and choices.

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Cheryl Carver's picture
Managing shear and pressure in preventing pressure injuries


Let us start off this post with a typical scenario. You walk into any facility or institution and you see a patient slouched in their wheelchair, with no wheelchair cushion. You notice part of their brief hanging out of the top of their pants, so you assume the patient may be incontinent. So let’s think about this for a minute. We most likely have friction, shear, and moisture going on with this patient.

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Mary Ellen Posthauer's picture
World Wide Pressure Injury Prevention Day

By Mary Ellen Posthauer RDN, CD, LD, FAND

The National Pressure Ulcer Advisory Panel (NPUAP) has designated November 17, 2016 as World Wide Pressure Injury Prevention Day and is urging states to join the effort and raise awareness about the need to prevent pressure injuries. As of October 1st, North Carolina, New Jersey, Nevada, and the District of Columbia have issued State Proclamations for Pressure Injury Prevention Awareness Day. The NPUAP is working through Congressional channels to seek a Federal Declaration from the President for a Pressure Injury Prevention Awareness Day to occur each year on the 3rd Thursday of November. This would then coincide with their worldwide partners.

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Terri Kolenich's picture
long-term care facility pressure injury staging at admission

By Terri Kolenich, RN, CWCA, AAPWCA

Question: What are Quality Measures, how does my long-term care facility measure up, and how can we improve?

Jeffrey M. Levine's picture
documentation of pressure injury never event

By Jeffrey M. Levine MD, AGSF, CWS-P

Editor's Note: The views expressed in Dr. Levine’s posts are solely those of the author, and do not represent the views of any medical school or national organization.

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Aletha Tippett MD's picture
support surface technology and pressure injury prevention

Bby Aletha Tippett MD

The idea that pressure injuries (ulcers) can be prevented through equipment or device technology is one we must challenge as clinicians. A manufacturer of support surfaces, for example, may try to tell us that their beds, technologically superior, will prevent pressure injuries from forming.

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Cheryl Carver's picture
Stage 1 Pressure Injury - Darkly Pigmented Skin


I have worked all over the country as an educator. The same gaps in education arise everywhere. A few years ago, I began teaching skin color awareness as part of my course curriculum. I feel strongly about it being a part of my inservices and course education. Understanding skin color as it relates to assessment is critical in the prevention of pressure injuries.

Margaret Heale's picture
advancing wound care nursing skills

By Margaret Heale, RN, MSc, CWOCN

I was not at the April National Pressure Ulcer Advisory Panel (NPUAP) meeting, but I do think some of critical commentary that has followed the announcement of the pressure injury staging system changes is flawed. Clearly designating the thickness of an injury to a defined wound stage makes sense and communicates a severity. All the NPUAP have done is clarify some detail that clinicians have had to manage previously, within a gray area. It is not the responsibility of the NPUAP, researchers or clinicians at the bedside to make up definitions to fit coding or legislators. It is important that researchers and bedside clinicians provide the Centers for Medicare & Medicaid Services (CMS) and legislators with research demonstrating how and why pressure ulcers occur.

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