Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline​

This guideline is a collaborative effort from Partner Organizations, the European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Injury Advisory Panel (NPIAP), and Pan Pacific Pressure Injury Alliance (PPPIA), and 14 additional wound organizations around the world. A comprehensive literature review was conducted on pressure injury prevention and treatment and a rigorous methodology was used to appraise the research and make evidence based recommendations. This work builds on the work of the previous two editions of this guideline (2009 and 2014).

Further, an international survey of patient consumers and their informal caregivers was undertaken to capture the perspectives of these individuals in the prevention and treatment of pressure injuries. The research evidence was summarized and evaluated using evidence-to-decision frameworks. Where sufficient research evidence was available, recommendations to guide clinical practice were developed. In areas without sufficient research, good practice statements were developed to promote comprehensive care. Both the recommendations and good practice statements are accompanied by implementation considerations supported by the research and/or expert opinion. The draft recommendations were made available to stakeholders for feedback.

There were 699 health professionals, industry representatives, peak body organizations, researchers, policy makers, patient consumers and informal caregivers who reviewed and/or commented on the document. After refining the content, the final stage of the guideline development consisted of a consensus voting process to assign strengths of recommendations. Strength of recommendations indicate the extent to which one can be confident that adherence to a recommendation will do more good than harm, and are intended to assist health professionals to prioritize interventions.

The guideline includes discussion of the science, followed by 115 recommendations and 61 good practice statements to guide practice in risk assessment, pressure injury prevention and treatment, and issues in implementing best practice. The needs of specific population groups are discussed, including individuals with obesity, critically ill individuals, older adults, neonates and children, and individuals in palliative care, operating room and community settings. The guideline also discusses the patient perspective of pressure injuries, and covers topics of importance to individuals, including pain and quality of life. Recommendations on supporting and engaging the patient consumer in their care are made. Finally, 20 quality indicators are provided to assist in monitoring implementation of the guideline.

European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific

Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice

Guideline. The International Guideline. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA: 2019.