Implementing an evidence-based best practice system for pressure injury prevention and management can reduce the potential for pressure injury development and promote healing of existing pressure injuries.
Each person should be assessed for pressure injury risk factors on admission and receive an in-depth assessment of any existing pressure injuries. The assessment process drives the development of person-centered goals and interventions to prevent or heal pressure injuries.
The care plan should reflect the person’s preferences, values and needs and identify the interventions necessary to meet his/her goals for treatment. The care plan should also include guidelines for reassessment to evaluate the effectiveness of the care provided and to prompt changes in treatment as needed. The use of any particular intervention should be based on the strength of the evidence provided by existing clinical trials or literature reviews.
Evaluation and monitoring outcomes are vital components of any program for managing pressure injury risk and treating existing pressure injuries. An effective system includes reassessment of the person’s risk for developing a pressure injury. The frequency of reassessment will depend on a variety of factors, with more frequent assessments for people with existing pressure injuries, those who are at high risk for developing pressure injuries, or those who have experienced a significant change of condition.
The toolkit below includes evidence-based resources that will assist facility staff in developing effective systems for pressure injury prevention and management.
Resources Created by HHSC
- Evidence-based Best Practice for Pressure Injury Prevention and Management (PDF) summarizes the key elements of an effective pressure ulcer prevention and management program.
- Pressure Injury Prevention and Management: Resources (PDF) includes of collection of evidence-based best practice resources for the prevention and management of pressure injuries.
- Pressure Injury Prevention and Management: Care Plan Highlights (PDF) can assist NF staff in developing person-centered care plans for preventing and managing pressure injuries.
Resources from Other Organizations
- Braden Scale II: Predicting Pressure Injuries provides services and products related to the Braden Scale for Predicting Pressure Ulcer Risk and evidence-based programs for pressure ulcer prevention. Note: annual license is required.
- The Bates-Jensen Wound Assessment Tool (BWAT) is a validated and reliable tool for conducting in-depth evaluations of wound status. The BWAT is available on this website, along with concise instructions for using the tool.
- The National Pressure Injury Advisory Panel is a professional organization dedicated to the preventing and managing pressure ulcers.
- The Pressure Ulcer Scale for Healing (PUSH) is a validated and reliable tool that is used to collect data and monitor the healing of pressure ulcers. Note: A licensing fee is required for commercial use.
- Pressure Ulcers with Exposed Cartilage Are Stage IV Pressure Ulcers (PDF) is an NPIAP position statement on pressure ulcers.
- Pressure Ulcers/Injury Reduction is a collection of resources that can assist nursing facilities with pressure injury prevention. Note: You may need to complete a registration to access some resources on this website.
- Indiana State Department of Health: Pressure Ulcer Resource Center offers information, tools, educational modules and other resources for pressure ulcer prevention and management.
- Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention was developed by the Agency for Healthcare Research and Quality (AHRQ) to help nursing facilities prevent adverse events, such as pressure injuries.
- Medline Plus: Pressure Ulcers includes multimedia presentations, photographs and patient handouts addressing pressure ulcer prevention and management. The information also is available in Spanish.
- Registered Nurses’ Association of Ontario (2016): Assessment and Management of Pressure Injuries for the Interprofessional Team provides evidence-based best practice recommendations for assessing and managing the pressure injuries.
- Registered Nurses’ Association of Ontario (2004): Assessment and Management of Venous Leg Ulcers provides recommendations for assessment and management of venous leg ulcers, using evidence gathered through systematic literature review and analysis.
- Registered Nurses’ Association of Ontario (2013): Assessment and Management of Foot Ulcers for People with Diabetes, 2nd Edition(link is external) provides recommendations for assessment and management of foot ulcers in people with diabetes, using evidence gathered through systematic literature review and analysis.