Defi ning unstageable pressure ulcers as full-thickness wounds are these wounds being misclassified?

Journal of Wound, Ostomy and Continence Nursing

Volumn 42, Issue 6, 2015, Pages 583-588

  Zaratkiewicz, Sunniva ^a   Whitney, Jo Anne D ^b   Baker, Margaret W ^c   Lowe, Jeanne R ^b  

^a UNIVERSITY OF WASHINGTON   (United States)

^b UNIVERSITY OF WASHINGTON   (United States)

^c UNIVERSITY OF WASHINGTON   (United States)

Author keywords

Eschar; Full thickness wound; Partial thickness wound; Pressure ulcer; Pressure ulcer staging; Slough; Unstageable .

Indexed keywords

ADULT; CLASSIFICATION; DECUBITUS; HUMAN; PHYSIOLOGY; RETROSPECTIVE STUDY; WOUND HEALING;

ADULT; HUMANS; PRESSURE ULCER; RETROSPECTIVE STUDIES; WOUND HEALING;

EID: 84946724245     PISSN: 10715754     EISSN: None     Source Type: Journal    
DOI: 10.1097/WON.0000000000000175     Document Type: Article

References (25)

1. National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Washington, DC : National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel ; 2009
2. Fife C , Yankowsky K , Ayello E , et al. Legal issues in the care of pressure ulcer patients: key concepts for healthcare providers-A consensus paper from the international expert wound care advisory panel. Adv Skin Wound Care. 2010 ; 23(11 ): 493-507
3. Campbell K , Woodbury G , Labate T , Lmesurier A , Houghton P. Heel ulcer incidence following orthopedic surgery: a prospective observational study. Ostomy Wound Manage. 2010 ; 56(8 ): 24-31
4. Aronovitch S , Wilber M , Slezak S , Martin T , Utter D. A comparative study of an alternating air mattress for the prevention of pressure ulcers in surgical patients. Ostomy Wound Manage. 1999 ; 45(3 ): 24-44
5. VanGilder C , MacFarlane G , Harrison P , Lachenbruch C , Meyer S. The demographics of suspected deep tissue injury in the United States: an analysis of the International Pressure Ulcer Prevalence Survey 2006-2009. Adv Skin Wound Care. 2010 ; 23(6 ): 254-261
6. Medrano S , Beneke M. Acoustic pressure wound therapy to debride unstageable pressure ulcers in the acute care setting: a case series. Ostomy Wound Manage. 2008 ; 54(12 ): 54-58
7. Gajewski B , Hart S , Baergquist-Beringer S , Dunton N. Interrater reliability of pressure ulcer staging: ordinal probit Bayesian hierarchical model that allows for uncertain rater response. Stat Med. 2007 ; 26 : 4602-4618
8. Fishman T. Wound assessment and evaluation. Dermatol Nurs. 1999 ; 11(3 ): 201-202
9. Alvey B , Hennen N , Heard H. Improving accuracy of pressure ulcer staging and documentation using a computerized clinical decision support system. J Wound Ostomy Continence Nurs. 2012 ; 39(6 ): 607-612
10. Maida V , Ennis M , Corban J. Wound outcomes in patients with advanced illness. Int Wound J. 2012 ; 9 : 683-692
11. Richbourg L , Smith J , Dunzweiler S. Suspected deep tissue injury evaluated by North Carolina WOC nurses. J Wound Ostomy Continence Nurs. 2011 ; 38(6 ): 655-660
12. Levine J , Ayello E , Zulkowski K , Fogel J. Pressure ulcer knowledge in medical residents: an opportunity for improvement. Adv Skin Wound Care. 2012 ; 25(3 ): 115-117
13. Kelleher A , Moorer A , Makic M. Peer-to-peer nursing rounds and hospital-Acquired pressure ulcer prevalence in a surgical intensive care unit: a quality improvement project. J Wound Ostomy Continence Nurs. 2012 ; 39(2 ): 152-157
14. Lewis G , Pham T , Robinson E , et al. Pressure ulcer and risk assessment in severe burns. J Burn Care Res. 2012 ; 33(5 ): 619-623
15. Bruce T , Shever L , Tschannen D , Gombert J. Reliability of pressure ulcer staging: a review of literature and 1 institutions strategy. Crit Care Nurs Q. 2012 ; 35(1 ): 85-101
16. Jesada E , Warren J , Goodman D , et al. Staging and defi ning characteristics of pressure ulcers using photographs by staff nurses in acute care settings. J Wound Ostomy Continence Nurs. 2013 ; 40(2 ): 150-156
17. Hart S , Berquist S , Gajewski B , Dunton N. Reliability testing in the National Database of Nursing Quality Indicators pressure ulcer indicator. J Nurs Care Qual. 2006 ; 21(3 ): 256-265
18. Maklebust J. Pressure ulcer staging systems. Adv Wound Care. 1995 ; 8(4 ): 28-11-28-14
19. Centers for Medicare &Medicaid Services. Proposed changes to the hospital inpatient prospective payment systems and fi scal year 2009 rates; proposed additions to hospital acquired conditions for fi scal year 2009. http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3042&intNumPerPage=1 0&checkDate=&checkKey=&srchType=1&numDays=3500&sr chOpt=0&srchData=&keywordType=All&chkNewsType=6&in tPage=&showAll=&pYear=&year=&desc=false&cboOrder=d ate#-ftn1. Accessed May 24, 2013.
20. McHugh M , Martin T , Orwat J , Van Dyke K. Medicares policy to limit payment for hospital acquired conditions: the impact on safety net providers. J Health Care Poor Underserved. 2011 ; 22 : 638-647
21. National Quality Forum. Serious reportable events. http://www.qualityforum.org/Topics/SREs/List-of-SREs.aspx. Accessed May 24, 2013.
22. Bilimoria N. CMS Never Events" and other new trends in quality health care standards for hospitals. Health Care Law Mon. 2008 ; 12 : 2-10
23. Mattie A , Webster B. Centers for Medicare and Medicaid Services Never Events": an analysis and recommendations to hospitals. Health Care Manag. 2008 ; 4 : 338-349
24. Nixon J , Thorpe H , Barrow H , et al. Reliability of pressure ulcer classifi cation and diagnosis. J Adv Nurs. 2005 ; 50(6 ): 613-623
25. Buckley K , Tran B , Adelson L , Agazio J , Halstead L. The use of digital images in evaluating home care nurses knowledge of wound assessment. J Wound Ostomy Continence Nurs. 2005 ; 32(5 ): 307-316