The Role of Nutrition for Pressure Injury Prevention and Healing (White Paper): The 2019 International Clinical Practice Guideline Recommendations

European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Injury Advisory Panel (NPIAP), and Pan Pacific Pressure Injury Alliance (PPPIA) Prevention and Treatment of Pressure Ulcers/Injuries.

Nutrition plays an important role in the prevention and treatment of pressure injuries (PIs). Macro- and micronutrients are required by each organ system in specific amounts to promote growth, development, maintenance, and repair of body tissues. The 2019 European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Injury Advisory Panel (NPIAP), and Pan Pacific Pressure Injury Alliance (PPPIA) Prevention and Treatment of Pressure Ulcers/Injuries:
Clinical Practice Guideline (EPUAP/NPIAP/PPPIA CPG) provides guidance on the prevention and management of PIs. This guideline was a collaboration between the EPUAP, NPIAP, and PPPIA with the assistance of 14 associate organizations. The goal of this international collaboration was to provide an updated, comprehensive review of the research literature and develop recommendations
reflecting recent evidence. The intent is for health professionals around the world to use the recommendations generated to prevent and treat PI.

NUTRITION & IMMUNITY PODCAST SERIES: Pressure Injury

Abbott Nutrition Health Institute (ANHI)

Panel of world-renowned experts discuss nutrition guidelines for caring for COVID-19 patients.

  • NUTRITION CARE FOR PRESSURE INJURIES: GUIDELINES TO OPTIMIZE OUTCOMES
  • THE ROLE OF HYDRATION IN ACUTE INFLAMMATORY PROCESS & RECOVERY
  • NATIONAL BLUEPRINT: ACHIEVING QUALITY MALNUTRITION CARE FOR OLDER ADULTS, 2020 UPDATE
  • NUTRITION SUPPORT OF THE COVID-19 ICU PATIENT
  • A REVIEW OF THE SCCM/ASPEN COVID-19 RECOMMENDATIONS
  • NUTRITIONAL NEEDS OF COVID-19 PATIENTS IN-HOSPITAL & POST-DISCHARGE

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.

Skin Manifestations with COVID-19

National Pressure Injury Advisory Panel (NPAIP)

Many reports are occurring concerning areas of purpuric/purple skin and purple toe lesions in patients diagnosed with COVID-19 (SARS-CoV-2). Wound care providers are being asked if these skin lesions are forms of Deep Tissue Pressure Injury and/or “skin failure”. Early reports of COVID-19 related
skin changes included rashes, acral areas of erythema with vesicles or pustules (pseudo-chilblain), other vesicular eruptions, urticarial lesions, maculopapular eruptions, and livedo or necrosis. The pattern and presentation of skin manifestations with COVID-19 is more than rashes. The purpose of this paper is to guide the wound care clinician in determining if the “purple skin” being seen is a deep tissue pressure injury or a cutaneous manifestation of COVID-19.

Preventing Pressure Ulcers in Hospitals

Agency for Healthcare Research and Quality (AHRQ)

This tool is an example of a clinical pathway, detailing the relationship among the different components of pressure ulcer prevention. This tool can be used by the hospital unit team in designing a new system, as a training tool for frontline staff, and as an ongoing clinical reference tool on the units. This tool can be modified or a new one created to meet the needs of your particular setting. If you prepared a process map describing your current practices, you can compare that to desired practices outlined on the clinical pathway.