Standard 8

Preventing and Managing Pressure Injuries

NSQHS Standards Standard 8 - Preventing and Managing Pressure Injuries

Advisory

This page contains information about the first edition of the NSQHS standards. This edition has been superseded by the second edition that was endorsed by the Health Ministers in June 2017 and released in November 2017.

This latest edition addresses the gaps that were identified in the first edition, including mental health and cognitive impairment, health literacy, end-of-life care, and Aboriginal and Torres Strait Islander health.

Health service organisations will be assessed to the second edition from January 2019.

To find information and resources for the second edition, visit the Australian Commission on Safety and Quality in Health Care's new NSQHS Standards microsite.

Key messages

  1. Pressure injuries can occur in any patient and are often preventable.
  2. There is increased risk of pressure injury associated with immobility during hospital admission.
  3. All clinicians are responsible for pressure injury prevention and management.
  4. A pressure injury prevention and management plan should be developed in partnership with the patient and carer.

Introduction

Pressure injuries are localised areas of damage to the skin or underlying tissue, caused by unrelieved pressure or friction. They occur most commonly over bony prominences such as the sacral area (the area at the base or bottom of the spine) and heel, but they can develop anywhere on the body.

While pressure injuries are generally considered to be preventable, research shows that pressure injuries are a major contributor to the care needs of patients within healthcare facilities.

Pressure injuries may impact significantly on the length of stay in health services, the cost of care, health outcomes and the comfort and quality of life of the individuals affected. In the majority of cases pressure injuries are preventable.

Pressure injuries occur most commonly in the elderly but they can occur in any patient. Immobility, such as that associated with extended bed rest, can cause pressure injuries. In addition, factors such as poor nutrition, poor skin integrity and lack of available oxygen to tissues have been associated with pressure injuries. A pressure injury can commence in any setting, including acute areas such as operating theatres, during transportation to a health service and in intensive care units.

National and international bodies are currently discussing the correct terminology for pressure-induced wounds, often known as bed sores or ulcers. This Standard adopts the alternate term ‘pressure injury’ in line with national and international moves to recognise that ulcers are only one form of a pressure injury

Implementing best practice strategies for the prevention and management of pressure injuries occurs through multiple evidence based resources including screening and assessment tools, skin protection strategies training, and education in wound management for the awareness of all associated risk factors.

The aim of this Standard is to prevent patients developing pressure injuries and effectively manage pressure injuries when they do occur.

In brief, this Standard requires that:

  • Health service organisations have governance structures and systems in place for the prevention and management of pressure injuries.
  • Patients are screened on presentation and pressure injury prevention strategies are implemented when clinically indicated.
  • Patients who have pressure injuries are managed according to best practice guidelines.
  • Patients and carers are informed of the risks, prevention strategies and management of pressure injuries.

Information above is taken directly from the Safety and Quality Improvement Guide Standard 8: Preventing and Managing Pressure Injuries, October 2012 document published in the Australian Commission on Safety and Quality in Health Care website.

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Responsibilities under Standard 8 include:

  • screen patients for risk of pressure injury using a validated screening tool on:
    • all presenting patients within timeframes set by best practice guidelines
    • change of condition.
  • complete a daily comprehensive skin assessment for patients at high risk of developing pressure injuries
  • communicate and document risk status and prevention plans during handover, transfer and discharge
  • implement pressure injury prevention strategies
  • assess and monitor any pressure injury
  • implement and evaluate strategies to promote effective wound healing
  • ensure that patients and carers are engaged in the development of pressure injury prevention and management plans.

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Further information

Below is a full copy of the Preventing and Managing Pressure Injuries contained in the National Safety and Quality Health Service Standards. It includes the criteria, items and actions required for health services to meet this Standard and is available on the Commission’s website at www.safetyandquality.gov.au.

  • Download Safety and Quality Improvement Guide Standard 8: Preventing and Managing Pressure Injuries, October 2012