Two wound ostomy nurses have proposed a scale that distinguishes between end-of-life skin failure and pressure injuries (PIs), a tool that could lead to better interventions and decrease reimbursement penalties.
Kennedy terminal ulcers may look like PIs, but the breakdown is typically caused by a chronic illness or the dying process. Rapid onset, acute progression, poorly defined borders and full thickness of such wounds may help clinicians differentiate them.
Their Skin Failure Clinical Indicator Scale correctly identified 83.7% of cases in the charts of 52 deceased wound patients. The researchers tracked serum albumin level, primary diagnosis, presence of sepsis/multiple organ dysfunction syndrome, vasopressor/inotrope use and mechanical ventilation use.
“With the development of the SFCIS, identification of skin failure and a higher awareness could increase,” wrote lead author Richard Hill, RN, a wound ostomy nurse at Louisiana’s Natchitoches Regional Medical Center. “Documentation could lead to inherent changes that include increased regulatory reimbursement, decreased pressure injury-related litigation, and decreased costs among facilities.”
Sharing their results in the October issue of Wounds, Hill and co-author Amy Petersen, RN, said the scale also could help educate patients, families and post-discharge caregivers on realistic treatment goals.
From the November 2020 Issue of McKnight's Long-Term Care News
