International Guidelines for Prevention and Treatment of Pressure Injuries

Written by Mary Litchford

February 14, 2020

Is your clinical practice up-to-date on the latest nutrition recommendations for the prevention and treatment of pressure injuries?  The European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) have released the new Clinical Practice Guideline for Prevention and Treatment of Pressure Injuries (CPG). EPUAP, NPIAP and PPPIA partnered with 14 international Associate Partner Organizations in the development of the 2019 CPG.

The CPG covers all aspects of preventive care and treatment of pressure injuries including:

  • evidence-based recommendations and good practice statements
  • implementation considerations
  • evidence summaries and evidence discussion
  • guidance for how to implement the recommendations
  • 20 quality indicators for auditing best practice in pressure injury prevention and treatment
  • over 70 figures and tables as a resource for users
  • updated Nutrition Chapter

What is the difference between a Recommendation and a Good Practice Statement?

  • Recommendations were written based on a body of supporting evidence and given a strength of evidence and strength of recommendation rating
  • Good Practice Statements (GPS) are based a very limited body of evidence, reliance on expert opinion or inconclusive evidence. The GPS were not rated by a strength of evidence or strength of recommendation rating.

RDNs familiar with the nutrition recommendations from previous editions of the CPG will note that there are fewer recommendations in new edition. There are 29 recommendations in 2014 CPG vs 10 recommendations and 5 good practice statements in 2019 CPG. Remember that not all clinical nutrition questions can be ethically examined in random controlled trials. Nutrition science research has demonstrated the value of meeting nutrient needs for overall health and recovery from illness, injury or surgery. The GPS and implementation considerations are important to incorporate into clinical practice and should not be considered of lesser value than the recommendations to achieve patient care goals.

Essential Resources

Electronic or hard copies of the CPG are available for purchased at http://internationalguideline.com/guideline

The Quick Reference Guide (QRG) includes a list of the evidenced based recommendations and good practice statements, quality indicators and the commonly used classifications systems. Electronic copies of the QRG are available for free download and hard copies of the QRG are available for purchase at http://internationalguideline.com/guideline

Advanced Level CE course: Litchford,MD. Nutrition & Pressure Injuries: Putting the Guidelines into Practice. 2016 with 2020 updates.

References

 1.European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Injuries:     Clinical Practice Guideline. The International Guideline. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA; 2019.

 2. National Pressure Injury Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Injuries:     Clinical Practice Guideline. The International Guideline. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA; 2014.

3. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Injuries:    Quick Reference Guide. Emily Haesler (Ed.). Cambridge Media: Osborne Park, Western Australia; 2019.

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