Todd J. Kowalski, MD; Michelle L. Tilson, CWOCN; Sonya A. Brickner, CWOCN, CFCN
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0423.
Kowalski T., Tilson M., Brickner S.; Risk Assessment and Prevention of Pressure Ulcers. Ann Intern Med. 2015;163:645-646. doi: 10.7326/L15-5147-2
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Published: Ann Intern Med. 2015;163(8):645-646.
TO THE EDITOR:
Qaseem and colleagues' clinical practice guidelines for prevention, assessment, and treatment of pressure ulcers (1, 2) highlight the dearth of evidence available to guide clinicians and health systems. This is salient because pressure ulcers have been coined “never events.” Since 2008, the Centers for Medicare & Medicaid Services has withheld reimbursement for treatment of hospital-acquired stage 3 and 4 pressure ulcers, but—in contrast to other disease states for which evidence strongly suggests that better processes yield better outcomes—pressure ulcer rates have not decreased (3). Furthermore, 100% of expert voting attendees at a recent NPUAP consensus conference believe that patient situations may render pressure ulcers unavoidable (4).
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