Week 6 | Pressure Injury Scope, Etiology and Staging (17170-SP)

Illustration showing the coccyx area of the human body.

Content Outline

  • Pressure Ulcer Scope 
    • Overview 
      • Significance       
      • Scope of the problem 
      • Prevalence: Number of patients with at least one pressure ulcer who exist in a given population at a given point in time. 
      • Incidence: Number of patients who were initially ulcer free who develop a pressure ulcer within a particular time period in a defined population. 
    • Pressure Ulcer Etiology
      • Pressure Ulcer: A localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. A number of contributing or confounding factors are also associated with pressure ulcers; then significance of these factors is yet  to be elucidated. 
      • Pressure from devices. 
      • Mucosal pressure ulcers: pressure ulcers found on the mucous membrane with a history of a medical device in use at the location of the ulcer. 
      • Causative factor is pressure which is dependent upon: 
        • Intensity of pressure. 
        • Duration of pressure. 
        • Tissue tolerance: the condition or integrity of the skin and supporting structures that influences the skin's ability to redistribute pressure.  
      • Factors affecting tissue tolerance 
        • Intrinsic 
          • Nutritional debilitation 
          • advanced age 
          • Low blood pressure 
          • Stress
          • Smoking 
          • Elevated body temperature 
        • Extrinsic 
          • Friction 
          • Shear 
          • Moisture
      • Pathophysiologic theories of pressure ulcer development 
        • Ischemia caused by occlusion of capillaries. 
        • Reperfusion injury. 
        • Impaired lymphatic function. 
        • Mechanical deformation of tissue cells.
      • Common pressure ulcer locations 
      • Heel pressure ulcers 
    • National Pressure Ulcer Advisory Panel Staging System: used only classify pressure ulcers based on the depth of tissue destruction.  
      • Suspected Deep Tissue Injury (DTI) 
      • Stage I 
      • Stage II 
      • Stage III 
      • Stage IV 
      • Unstagable 
    • Practice classifying tissue damage.

Objectives for Learning Outcomes

At the end of this course work the learner will be able to:

  1. Discuss the significance of pressure ulcers as a health care problem. 
  2. Differentiate between prevalence and incidence of pressure ulcers. 
  3. Describe the etiology of a pressure ulcer. 
  4. Define the NPUAP classification system for staging pressure ulcers.

Additional Information

Course summary

Renee Anderson, MSN, RN, CWON
Certified Wound and Ostomy Care Nurse; Co‐Director, Wound Management Education Program, University of Washington School of Nursing , Seattle; Clinical Faculty, Biobehavioral Nursing & Health Systems University of Washington School of Nursing; President, Rainier Clinical Consultants, Inc., Seattle, WA


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