Ask the Treatment Expert about ... what NPUAP's new "pressure ulcer" definition means for providers?

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

What does NPUAP's new “pressure ulcer” definition mean for providers?

The National Pressure Ulcer Advisory Panel announced a number of changes in April, including replacing the term “pressure ulcer” with “pressure injury” and modifying stage definitions. 

The term pressure injury is now defined in this manner:

“A pressure injury is localized damage to the skin and/or underlying soft tissue usually over a bony prominence or related to a medical or other device. The injury can present as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, comorbidities and condition of the soft tissue.”

Changes include changing stage numbering from Roman numerals (I, II, III) to Arabic (1, 2, 3) and removing the word “suspected” from “deep tissue injury.”

The changes to terminology were developed among researchers, clinicians and pressure ulcer specialists. Providers need a transition plan and should identify how the new terms will affect — and improve — wound care.  

Examine policies and procedures to include the new terminology, update assessment protocols as needed, and provide staff education.  

Next, look at abuse policies to ensure that the medical causes of a pressure injury are accurately described and that pressure injuries are differentiated from other types of injuries.  

Updates from the Centers for Medicare & Medicaid Services may address when “pressure ulcer” and “pressure injury” will no longer be interchangeable. 

The impact of one change in terminology is a reminder of how important specificity and accuracy are in long-term care assessment.