Heidi Huddleston Cross – Advanced Pressure Injury Course: Strategies for Prevention, Assessment & Treatment

Outline

Pressure Injury Prevention
Evidence Based Guidelines

• National Pressure Ulcer Advisory Panel
• Wound, Ostomy, and Continence Nurses Society

The Etiology of Pressure Injuries

• Mechanical load: Magnitude and time
• Mechanisms that lead to tissue damage

Risk Factors and Risk Assessment

• Assessing risk using the Braden Scale correctly
• Intrinsic and extrinsic risk factors – you need to know
• Skin and tissue assessment

Practice Tips for Prevention

• Skin care: Moisturization is key
• Repositioning frequency: Is it really every 2 hours?
• Get those heels up!
• The RIGHT surface at the RIGHT time

The Role of Nutrition in Pressure Injury Development

• Lab values
• Avoiding unintentional weight loss

Pressure Injury Assessment
Wound Assessment

• Look at the whole patient, not just the hole in your patient
• Necessary elements of wound assessments
• Decisions, decisions: Is it incontinence associated dermatitis or a pressure ulcer?

Pressure Injury Staging

• Deep tissue injury and medical device related injuries
• Controversies
• STAGING QUIZ!!!

Wound Infection and Complications

• The emerging role of biofilms
• NERDS and STONEES – huh?
• Sepsis
• Osteomyelitis
• Malignancy
• Recurrence

Avoidable vs. Unavoidable Injuries

• Skin failure
• Kennedy Terminal Ulcers

Skin Changes at Life’s End (SCALE)

• F-Tag 314
• WOCN document
• Antibiotic therapy

Pressure Injury Treatment
Wound Bed Preparation

• The principle of TIME
• Importance of cleansing
• Debridement: What works, when and how

Basic Wound Dressings

• The importance of moist wound healing

What needs to be on every formular
Vendor support and caveats
Advanced Wound Dressings and Therapies

• When do we need to step it up and to what?

Antimicrobial dressings

• There are so many……how to choose
• Silver
• Honey
• Hydrofera Blue
• PHMB

Iodosorb

• Dakin’s Solution and vinegar (yes, we still use it)
• Hypochlorous Acid
• Sorbact

Collagen dressings

• Negative pressure wound therapy
• Other modalities

Surgical Repair

• Skin grafts vs. flaps

Documentation Tips

• What you need to know and what MUST be in the record
• Examples of good documentation
• Tips to keep yourself out of court