Pressure Ulcers

Aletha Tippett MD's picture
Braden Scale

By Aletha Tippett MD

I was recently asked to speak on best practices for prevention of pressure ulcers for a group of state surveyors. This is an excellent subject and here is how I would address it:

Lindsay Andronaco's picture
depression

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

I have been in wound care my entire nursing career. I have been in a variety of positions, but it always involved wound management. It wasn't until recently that I became more interested in pressure ulcers than I ever thought possible. A close friend of mine, "Karla", was diagnosed with a rare condition that left her basically paralyzed from the waist down. Karla is an extremely intelligent, independent, successful young woman who woke up one day and couldn't feel her feet due to her condition. The progression of the paralysis was rapid, but luckily seemed to have stopped about waist high.

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Mary Ellen Posthauer's picture
medical records

By Mary Ellen Posthauer RDN, CD, LD, FAND

As Dr. Aletha Tippett noted in her December blog, following wound documentation standards can help clinicians avoid legal issues. Pressure ulcer litigation often involves pressure ulcers and weight loss.

WoundSource Editors's picture

By the WoundSource Editors

Litigation over hospital-acquired pressure ulcers represents a significant fraction of a medical malpractice attorney's caseload. The liability issues have shifted since October 1, 2008 when the Centers for Medicare and Medicaid Services and several private payers began denying reimbursement for care related to hospital-acquired stage III and IV pressure ulcer. Prior to October 2008, the experts battled over whether a pressure ulcer was avoidable. Now, they still do, but plaintiff attorneys and their experts can point to the government's stance that pressure ulcers are avoidable, "never events". Defense experts must assert that everything possible was done to avoid the ulcer, or it was not really caused by pressure.

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Cheryl Carver's picture

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

As a traveling wound care educator for physicians, I am observing many changes within the state survey process for long-term care. Wound care physicians working in long-term care are feeling the same anxiety that facility leaders and staff members are, as the time nears the window for an annual state survey.

WoundSource Editors's picture

By the WoundSource Editors

Over the course of a wound’s existence, several tissue types can be identified. In order to properly stage a pressure ulcer (injury) and determine the best treatment option, it is important for the clinician to be able to determine the tissue type that is present. The following represent the most commonly identified tissue types seen in pressure ulcers, and also in other open wounds:

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

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

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

This article is designed to provide a review of cellulitis, an infection affecting the skin which can be life-threatening if not treated.

Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

For the past two years I have been involved in the research and development of the second edition of the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Members of the Pan Pacific Pressure Injury Alliance joined National Pressure Ulcer Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel (EPUAP) in producing a document that could be used by health professionals around the world.

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Cheryl Carver's picture

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

Deciding on a blog topic for this month was simple. August 12th marked 18 years since my 47-year-old mother passed away due to pressure ulcer complications. A flood of memories came rushing through, realizing just how much wound care has evolved throughout the years. A feeling of "if I only knew then, what I know now" type emotions. I cannot help but have a great deal of heartfelt empathy for caregivers and their loved ones with chronic wounds. My personal experiences have led me to my sense of gratification in what I do every day.