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Pressure Ulcer Prevention and Treatment Guideline at a Glance (Nursing Practice Guideline)

Pressure Ulcer Prevention and Treatment Guideline at a Glance (Nursing Practice Guideline) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Nursing Practice Guidelines


Guideline Title: Pressure Ulcer Prevention and Treatment
Effective Date: March 2016
Approved By: Nursing Practice Guidelines Committee; Nursing Practice Council

I. Guideline Overview

This content is extracted from the adopted source document: National Pressure Ulcer Advisory
Panel (NPUAP), European Pressure Ulcer Advisory Panel (EPUAP), and Pan Pacific Pressure Injury
Alliance. (2014). Prevention and treatment of pressure ulcers: clinical practice guideline. Emily
Haesler (Ed.). Cambirdge Media: Perth, Australia. Please refer to the source guideline for complete
Purpose and Scope:

The goal of this guideline is to provide evidence based recommendations for the prevention and
treatment of pressure ulcers that can be used by health professionals throughout the world. The
purpose of the prevention recommendations is to guide evidence based care to prevent the
development of pressure ulcers and the purpose of the treatment focused recommendations is to
provide evidence-based guidance on the most effective strategies to promote pressure ulcer
The guideline is intended for the use of all health professionals, regardless of clinical discipline,
who are involved in the care of individuals who are at risk of developing pressure ulcers, or those
with an existing pressure ulcer. The guideline is intended to apply to all clinical settings, including
hospitals, rehabilitation care, long term care, assisted living at home, and unless specifically
stated, can be considered appropriate for all individuals, regardless of their diagnosis or other
health care needs. The sections of the guideline for Special Populations add further guidance for
population groups with additional needs, including those in palliative care, critical care, paediatric
and operating room settings; bariatric individuals; individuals with spinal cord injury; and older
adults. Additionally, the guideline may be used as a resource for individuals who are at risk of, or
have an existing pressure ulcer, to guide awareness of the range of preventive and treatment
strategies that are available. Prevention and treatment of mucosal membrane pressure ulcers are
beyond the scope of this guideline.

II. Practice Recommendations

The recommendations in this guideline are a general guide to appropriate clinical practice, to be
implemented by qualified health professionals subject to their clinical judgment of each individual case
and in consideration of the patient consumer’s personal preferences and available resources. The
guideline should be implemented in a culturally aware and respectful manner in accordance with the
principles of protection, participation and partnership.

Due to the length of the source guideline recommendations, only the topic areas are listed below. The
complete recommendations for each topic can be found here. To quickly navigate this pdf, use the
“find” function: Ctrl+F; enter the text/topic that you are searching for.

Prevention of Pressure Ulcers:
• Risk Factors and Risk Assessment
• Skin and Tissue Assessment
• Preventive Skin Care
• Emerging Therapies for Prevention of Pressure Ulcers

University of Wisconsin Hospitals and Clinics
Nursing Practice Guideline At-a-Glance

Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Last Revised: 03/201 6EArsenaultknudsen@uwhealth.org
Interventions for Prevention & Treatment of Pressure Ulcers:
• Nutrition in Pressure Ulcer Prevention and Treatment
• Repositioning and Early Mobilization
• Repositioning to Prevent and Treat Heel Pressure Ulcers
• Support Surfaces
• Medical Device Related Pressure Ulcers
Treatment of Pressure Ulcers:
• Classification of Pressure Ulcers
• Assessment of Pressure Ulcers and Monitoring of Healing
• Pain Assessment and Treatment
• Wound Bed Preparation
• Wound Care: Cleansing
• Wound Care: Debridement
• Assessment and Treatment of Infection and Biofilms
• Wound Dressings for Treatment of Pressure Ulcers
• Biological Dressings for the Treatment of Pressure Ulcers
• Growth Factors for the Treatment of Pressure Ulcers
• Biophysical Agents in Pressure Ulcer Treatment
• Surgery for Pressure Ulcers
Special Populations:
• Bariatric (Obese) Individuals
• Critically Ill Individuals
• Older Adults
• Individuals in the Operating Room
• Individuals in Palliative Care
• Pediatric Individuals
• Individuals with Spinal Cord Injury
III. Pertinent Resources
A. UWHC Policy
• Policy 4.22, Negative Pressure Wound Therapy Vacuum Assisted Closure (VAC) Ulta
Dressing Maintenance (Inpatient)
• Policy 4.23AP, Changing Sterile and Clean Dressings
• Policy 8.17AP, Therapeutic Support Surfaces and Frames (Specialty Beds)
• Policy 13.12A, Basic Care Standards (Adult)
B. Patient Education Resources
• Health Facts For You (HFFY):
o Performing Pressure Relief (7616)
o Treating Pressure Sores (6616)
o Negative Pressure Wound Therapy (NPWT or Wound VAC) (6075)
C. Clinical Tools
• American Family Children’s Hospital Modified Braden Q Pressure Ulcer Risk Assessment
• American Family Children’s Hospital Pressure Ulcer Prevention and Treatment Protocol
• American Family Children’s Hospital Pressure Ulcer Prevention for High Risk Pediatric
Perioperative Patients
• Braden Scale for Predicting Pressure Sore Risk
• Guidelines for Dressing Selection Based on Wound Characteristics and Goal of
• Selection of Therapeutic Pressure Redistribution Support Surfaces Algorithms
IV. References
See full guideline document for list of references.

Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Last Revised: 03/201 6EArsenaultknudsen@uwhealth.org
V. Levels of Evidence, Strengths of Evidence and Strengths of Recommendations
Full explanation of the methodology is available in the full Clinical Practice Guideline. Individual studies
were assigned a ‘level of evidence’ based on study design and quality, using a classification system
adapted from Sackett (1989)
The full body of evidence supporting each recommendation was given a ‘strength of evidence’. A
consensus voting process (GRADE) involving all the experts formally engaged in the guideline
development was used to assign a ‘strength of recommendation’ that indicates the confidence the
health professional can have that the recommended practice will improve patient outcomes (i.e., do
more good than harm). The overall aim of the ‘strength of recommendation’ is to help health
professionals to prioritize interventions.