Not All Pressure Sores Are Avoidable
The National Pressure Ulcer Advisory Panel's recent consensus conference panelists
agreed that patients who choose not to participate in their own pressure ulcer prevention
could develop unavoidable pressure ulcers. They also agreed that there are clinical
situations in which the development of pressure ulcers can be unavoidable. The
conference was held at Johns Hopkins Medical Center in Baltimore, Maryland.
Twenty-four multidisciplinary experts in pressure ulcer prevention and treatment
comprised the voting panelists. Specialties included medicine, geriatrics, surgery, specialty
nursing, physical therapy and dieticians. The international panel represented professional
wound organizations, accrediting bodies, hospitals, rehabilitation agencies, long-term care,
hospice, and home care.
The panelists agreed that the current definition of unavoidable pressure ulcers developed
by the Federal Government for long term care settings captured the spirit of pressure
ulcer avoidability but could not be used in all settings. A revised definition was developed
and agreed upon by the panelists
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Unavoidable - means that the individual developed a pressure ulcer
even though the provider had evaluated the individual's clinical
condition and pressure ulcer risk factors; defined and implemented
interventions that are consistent with individual needs goals and
recognized standards of practice; monitored and evaluated the
impact of the interventions; and revised the approaches as
appropriate.
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The panelists unanimously agreed there are patient situations that create unavoidable
pressure ulcers. A condition seen in patients in critical care, hemodynamic instability may
preclude turning or repositioning and lead to unavoidable pressure ulcers. Patients who
refuse to be repositioned may also develop unavoidable pressure ulcers. The panelists
agreed that the condition of skin failure exists.
The full report of the consensus conference including a report on the methodology used
will be forthcoming.
The National Pressure Ulcer Advisory Panel serves as the authoritative voice for improved
patient outcomes in pressure ulcer prevention and treatment through public policy,
education and research.
Contact Information: Jen Bank, NPUAP Executive Assistant at jbank@npuap.org
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March 3, 2010
National Pressure Ulcer Advisory Panel
Washington, DC
