Pressure injury: localized damage to the skin and/or underlying tissue, usually over a bony prominence or related to a medical or other device.
Only use NPUAP's 6 stages to describe pressure injuries, not other wound etiologies.
|Level of Risk Scoring||Score|
|Very High Risk||9 or less|
Table adapted from NSHA's Pressure Ulcer Risk Assessment and Documentation Tool (Braden).
NPUAP has many resources to support clinical practice for preventing and managing Pressure Injuries:
Pressure Injury management includes a comprehensive client and wound assessment to guide the creation of an individualized care plan, with the appropriate referrals to the multidisciplinary team.3-9,11-14
Care plans need to encompass the principles of wound healing:
This resource binder was developed as part of a quality improvement initiative led by the Department of Health and Wellness Continuing Care branch in partnership with Nova Scotia Health Authority Provincial Wound Prevention and Management Program. It is a compilation of best-practice recommendations for the prevention and management of pressure injuries. The purpose of this resource is to support continuity of care, enhance knowledge, and build capacity to address pressure injury prevention and management in long-term care facilities.
This presentation covers assessment of pressure injuries, grading using the Braden Scale, and prevention strategies.
Questions? Email email@example.com.
1. National Pressure Ulcer Advisory Panel (NPUAP) website. www.npuap.org; Accessed July 2018
2. Braden, B.; Bergstrom, N. (2017) Permission to Use Braden Scale in Nova Scotia Health Authority and the Long Term Care Sector; Prevention Plus Omaha, NE.
3. British Columbia Provincial Nursing Skin and Wound Committee. Braden Scale Intervention Guide-Adults 2017. [cited 2018 July 11]. Available from: https://www.clwk.ca/communities-of-practice/skin-wound-community-of-practice/buddydrive/
4. British Columbia Provincial Nursing Skin and Wound Committee. Prevention of pressure injury in adults & children: guideline 2017 november. [cited 2018 July 11]. Available from: https://www.clwk.ca/communities-of-practice/skin-wound-community-of-practice/buddydrive/
5. National Pressure Advisory Panel, European Pressure Ulcer Advisor Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Emilt Haesler (Ed.). Cambridge Media: Perth, Australia; 2014.
6. Norton L, Parslow N, Johnston D, Ho C, Afalavi A, Mark M, O’Sullivan-Drombolis D, Moffat S. Best practice recommendations for the prevention and management of pressure injuries. In: Foundations of Best Practice for Skin and Wound Management. A supplement of Wound Care Canada; 2017 [cited 2018 July 11]. Available from: https://www.woundscanada.ca/health-care-professional/education-health-care-professional/advanced-education/12-healthcare-professional/110-supplements
7. Sibbald, G., et al. (2011). Special considerations in wound bed preparation 2011: An update. Advances in Skin and Wound Care, 24(9), 415-436
8. Registered Nurses’ Association of Ontario (2005). Risk assessment and prevention of pressure ulcers. (Revised). Toronto, Canada: Registered Nurses’ Association of Ontario
9. Registered Nurses’ Association of Ontario (2016). Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition. Toronto, ON: Registered Nurses’ Association of Ontario.
10. Posthauer ME, Banks M, Dorner B, Schols JM. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper. Advances in skin & wound care. 2015 Apr 1;28(4):175-88.
11. Orsted HL, Keast DH, Forest-Lelande L, Kuhnke JL, O’Sullivan-Drombolis D, Jin S, et al. Best practice recommendations for the prevention and management of wounds. In: Foundations of Best Practice for Skin and Wound Management. A supplement of Wound Care Canada; 2017 [cited 2018 Jan 23]. 73p. Available from:https://www.woundscanada.ca/health-care-professional/education-health-care-professional/advanced-education/12-healthcare-professional/110-supplements.
12. British Columbia Provincial Nursing Skin and Wound Committee. Guideline: wound bed preparation for healable and non-healable wounds in adults and children. June 2015. [cited 2018 Jan 23]. Available from: https://www.clwk.ca/communities-of-practice/skin-wound-community-of-practice/buddydrive/
13. . Sibbald RG, Elliott JA, Ayello EA, Somayaji R. Optimizing the moisture management tightrope with wound bed preparation 2015. Adv Skin Wound Care. 2015; (10):466-76
14. British Columbia Provincial Nursing Skin and Wound Committee. (2018). Guideline: Wound Management for Adults & Children. [cited 2018 Nov 7]. Available from https://www.clwk.ca/buddydrive/file/guideline-wound-management-2018-august/
15. Colwell JC. Pressure injury prevention and care. In: Clinical Nursing Skills and Techniques, 9th Edition. Perry AG, Potter PA, Ostendorf WR (Eds.). Elsevier: St. Louis, Missouri; 2018; 994.