Ask the treatment expert ... about unavoidable pressure ulcers

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Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC
Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC

Have you heard that most clinicians are in agreement that there are unavoidable pressure ulcers?

I had the privilege to represent the American Association for Long Term Care Nursing at the National Pressure Ulcer Advisory Panel Consensus Conference to formulate consensus statements regarding “Unavoidable Pressure Ulcers.”

In a previous NPUAP consensus conference, an unavoidable pressure ulcer was defined as a pressure ulcer that occurs even when the clinical condition of the patient and risk factors have been identified and appropriate interventions initiated, provided and documented. 

After an extensive literature review of evidence that related to healthcare conditions that put a patient “at risk” of developing an unavoidable pressure ulcer, discussion statements were developed by NPUAP. More than 250 articles were reviewed and consensus statements were developed and discussed at the conference. 

 AALTCN, along with 14 other stakeholder organizations that provide care for individuals “at risk” or requiring treatment for pressure ulcers, comprised the panel; the Centers for Medicare & Medicaid Services participated as a non-voting panel member.

Both the conference attendees and panel members voted on each statement presented and the votes were electronically tabulated. Consensus was considered present when there was an 80% agreement of the panel and attendees. 

The group did reach consensus that there indeed are specific medical diagnoses and conditions that frequently resulted in unavoidable pressure ulcer development. Among the conditions that obtained the consensus vote: cardiac status, pulmonary function, hemodynamic stability, elevation of the head of the bed, septic shock, generalized edema, burns and immobility.