National Pressure Ulcer Advisory Panel
In this month's Guest Editorial on page 198, our Clinical Editors, Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, ETN, MAPWCA, FAAN, and R. Gary Sibbald, BSc, MD, MEd, DSc (Hon), FRCPC (Med)(Derm), FAAD, MAPWCA, report on the National Pressure Ulcer Advisory Panel's recent biennial meeting. During the session, Untangling the Terminology: Unavoidable Pressure Injuries, Terminal Ulcers & Skin Failure," Dr Sibbald was among the presenters, and Dr Ayello was the session moderator.
In addition to discussing "Skin Changes at Life's End (SCALE)," Dr Sibbald illuminated levels of vascular compromise to the skin. Cutaneous vascular compromise can arise from large arteries and veins of the peripheral vascular system or from local perfusion of the superficial, deep, and subcutaneous networks of arterioles venules and their connecting capillary networks. The skin can also become fragile from external and internal insults, including pressure on bony prominences. These factors may help explain the etiology of unavoidable skin compromises.
Dr Ayello presented a checklist based on the F-Tag 314 definition of unavoidable pressure injuries from the 2004 guidance to surveyors (Figure). The unavoidable pressure injury is characterized by reviewing the process used by the clinicians within an organization. The criteria evaluated reflect the nursing process:
* assessment, goal setting, creation of a plan of care;
* implementation of the care plan based on recognized guidelines and evidence;
* assessment/evaluation of the individual's response to the implemented plan of care; and
* revisions of the care plan based on the individuals response to care rendered.
Also see the "Commentary" on skin failure on page 200 of this issue.
[black up pointing small triangle]Information:http://www.npuap.org