A New Perspective on Pressure Injury Prevention

When the NPIAP came out with its guidelines in 2019, no one would have guessed we’d find ourselves amid a global pandemic that would make the guidelines that much more critical and relevant just a few months later. With a whole new perspective on the healthcare industry and the future that ensues, it will be crucial for clinicians to keep best practices in mind when it comes to pressure injury prevention and treatment. As we move from reacting to the pandemic to stable practices, the NPIAP guidelines can serve as a foundation to arm clinicians with the knowledge they need to keep the most vulnerable patients – and even themselves – safe from undue devastation.

Top 3 Takaways

To bring awareness to the important work that the NPIAP has compiled, here are the top three takeaways: The Good Practice Statements, Covid-19 impact, and early assessment and personalized prevention.

1. GPS – Good Practice Statements

   A new feature for the guidelines, Good Practice Statements have been formulated to assist practitioners in taking appropriate steps in areas not supported by a body of evidence. Although “evidence-based” practice is touted – and rightfully so – it’s important to take into account common sense and years of experience for prevention and treatment practices. The new guidelines, along with the Good Practices Statements provide a way to “bridge the gap” between practice and research, making it applicable and effective in a timely manner.

2. COVID-19 Impact

   Although COVID-19 was not taken into consideration when developing the NPIAP guidelines (because it hadn’t yet been discovered), the organization has added supplemental resources in regards to prone positioning and N95 masks. With the capacity of proper hospital beds and support surfaces potentially at stake, the probability increases to see more pressure injuries – making the guidelines more important to follow than ever.

3. Early assessment and personalized prevention

   The sooner a patient is able to be assessed, the sooner prevention or treatment methods can be implemented – but how soon is “soon?” At many hospitals, a patient is assessed upon admission; but the NPIAP guidelines suggest it be done sooner than that. For at-risk individuals, an ER assessment or even support surfaces in transportation – like an ambulance – should be considered to avoid deep tissue injuries. The guidelines also stress the need for personalized prevention practices. While it sounds rudimentary, there are now evidence-based findings to support individualized repositioning frequency and nutritional requirements—such as energy intake.

Summary of other enhancements

Prevention, assessment and treatment

These three takeaways just barely scratch the surface when it comes to other additions and enhancements to the 2019 Guidelines. New evidence-based treatments and ample resources, like surgical positioning diagrams, are just some of the features available. Not only does the guide provide recommendations on nutrition, education delivery models, and psychosocial support – but also strategies on how to implement and advocate for best practices.

Negative Pressure Wound Therapy for Pressure Injuries

According to the guidelines, there is a positive recommendation and evidence to support the use of NPWT to:

1. Decrease the wound size of pressure injuries
2. Reduce cost compared to moist gauze dressings
3. Be used as an adjunct therapy when combined with debridement, nutrition and pressure redistribution

Additionally, the NPIAP has a robust library of resources for the prevention and treatment of pressure injuries which can be found here: Pressure Injury Resources. Click below to download a copy of the 2019 Clinical Guidelines.