Q:
What is the difference between avoidable and unavoidable pressure injuries?
A:
The determination of whether a pressure injury is avoidable versus unavoidable depends on the facility meeting the following criteria. The facility must ensure the following:
- Evaluation of the resident’s clinical condition and risk factors
- Determination and implementation of interventions that are consistent with resident needs, goals, and professional standards of practice
- Monitoring and evaluating the impact of the interventions and revising the interventions as when necessary
If pressure injuries or ulcers develop despite these efforts, the area could be considered unavoidable. It is imperative to review and monitor treatments and interventions routinely and adjust, as appropriate. Facilities should also remember to address when residents choose not to adhere to wound treatment interventions. Resident “refusals” can play in important role in determining if the facility meets the unavoidable pressure injury criteria. Documentation should reflect the specific interventions the resident is choosing not to allow, education of risks and benefits posed by the refusal(s), and the alternative interventions offered by the facility with resident response. Documentation of efforts, interventions, and supportive documentation from providers are all required to validate the final determination.
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Written By:
Liz Wheeler, BSN, RN, CHPN, IPCO, QCP, CDP
Clinical Consultant
Proactive LTC Consulting
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