Pressure Ulcer Prevention

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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Mary Ellen Posthauer's picture
health care quality measures

By Mary Ellen Posthauer RDN, CD, LD, FAND

The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT) amends Title XVIII of the Social Security Act by adding a new section –Standardized Post-Acute Care (PAC) Assessment Data for Quality, Payment, and Discharge Planning. The goal of the IMPACT Act is to reform PAC payments and reimbursement while ensuring continued beneficiary access to the most appropriate setting of care. The act requires the submission of standardized and interoperable PAC assessment and quality measurement data by Long-Term Care Hospitals (LTCH), Skilled Nursing Facilities (SNF), Home Health Agencies (HHA) and Inpatient Rehabilitation Facilities (IRF).

Cheryl Carver's picture
patient repositioning for pressure injury prevention

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

I am very passionate about wound care, but pressure injury (pressure ulcer) prevention and awareness is at the top of my list for many reasons. My mother passed away in my arms at the young age of 47 due to complications of diabetes, amputation, and three pressure injuries. My mother's hospital-acquired pressure injuries were avoidable.

Aletha Tippett MD's picture
dry skin and pressure ulcers

By Aletha Tippett MD

The other day I received a phone call from a dear physician friend of mine who works tirelessly in the field of pressure support and pressure ulcer prevention. He had been talking to some older nurses who told him that "in their day" they kept their patients lubed up and never had a skin problem. He knows that I advocate vigorous skin lubrication and sought guidance.

WoundSource Editors's picture

By the WoundSource Editors

Decubitus ulcers are an open skin wound sometimes known as a pressure ulcer, bed sore, or pressure sore. A decubitus ulcer forms where the pressure from body the body's weight presses the skin against a firm surface, such as a bed or wheelchair. Pressure cuts off the blood supply to the skin and injures tissue cells. Initially, the skin usually looks red or a bit discolored. Eventually, if the pressure isn't relieved, the skin breaks down and the tissue dies (necrosis). With proper diagnostic care and treatment, most people with a decubitus ulcer have a good prognosis for recovery

Rick Hall's picture
documenting wounds

By Rick Hall, BA, RN, CWON

Wound care documentation is a hot topic with overseeing agencies dealing with the medical industry. Good documentation is imperative to protect all those giving care to patients. Documentation should be Legible, Accurate, Whole, Substantiated, Unaltered, Intelligible and Timely. If these components are not incorporated into your wound care documentation, you could end up in a LAWSUIT.

Margaret Heale's picture
delivery of high quality bedside care

By Margaret Heale, RN, MSc, CWOCN

Stepping forward into a model of care that is quantitative and objective is essential and most definitely the way we are headed in wound care and beyond. Using the word "care" in the same sentence with "quantitative" and "objective" may sound like an oxymoron, but care does not have to be fluffy and old-fashioned. What it must be is kind, gentle and authentic. My question is: how can the care we provide be kind, gentle, and authentic when the emphasis is so obviously on cold, hard measures and stark black and white comparisons with little value placed on the people who are the care providers?

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Margaret Heale's picture
nurse transporting patient in wheelchair

By Margaret Heale, RN, MSc, CWOCN

It has become quite easy to look at pressure ulcer prevention in most health care settings. From acute care, through the ED and on to the OR and ITU, then to the various floors of med surg, orthopedic, not forgetting rehab and community nursing. Pediatric and neonatal units have better defined pressure ulcer risk assessment tools to utilize that have made assessment and planning care much less haphazard for those patients than in the past.

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Cheryl Carver's picture

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

It's November, and most people are thinking about turkey, stuffing, pumpkin spice, and the fall colors. But I think of Worldwide Pressure Ulcer Prevention and Awareness Day (November 19, 2015), National Caregivers Month, and how I can help. I have shared a holding sign video and personal photos on social media to share my story in hopes of educating others. My passion for wound care is driven by my mother dying in my arms at the young age of 47, due to complications of diabetes and stage IV pressure ulcers.

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Mary Ellen Posthauer's picture
Pressure ulcer prevention

by Mary Ellen Posthauer RDN, CD, LD, FAND

Despite all of the advances in risk assessment, prevention and treatment guidelines, support surfaces, nutritional products and vigorous educational efforts, pressure ulcers continue to be a major health care problem worldwide.

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