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Pressure Ulcers

Pressure ulcers, also called pressure sores, are skin wounds that usually develop on bony parts of the body. They may be painful and take a long time to heal or cause other complications like skin and bone infections. Pressure ulcers occur across health care settings and are often preventable. The elderly are at greater risk of developing pressure ulcers due to age-related skin changes. Some of these factors include immobility, incontinence, inadequate diet, chronic illness, altered level of consciousness, altered sensory perception, and prior history of pressure ulcers. Preventing pressure ulcers is the best treatment.

Current work with pressure ulcers

Stratis Health has worked with nursing homes to improve skin care since 2002. Stratis Health, in partnership with Minnesota Department of Health and others, offers educational training sessions, collaborative learning opportunities, and resources to provide training to all nursing homes in the state. In the most recent data available, there was a 1.7 percent decrease in the pressure ulcer rate for high-risk patients. This is a statistically significant improvement.


Advancing Excellence in America’s Nursing Homes. A coalition-based campaign working to improve the quality of care and quality of life for those living or recuperating in America's nursing homes. The site contains resources on pressure ulcers, including an updated pressure ulcer tracking tool (5-worksheet Excel doc), as well as other topics.

Clinical Web Window. Minnesota Department of Health Compliance Monitoring Division will provide alerts for providers to new clinical issues that may affect survey trends, standards for compliance continue to be based on the existing state and federal regulations.

Coding Suspected Deep Tissue Injury. Recommendation on MDS 3.0 from the National Pressure Ulcer Advisory Panel. (1-page PDF) Nursing Standard of practice protocol: Pressure ulcer and skin tear prevention.

Evidence to Practice. E2P is a online resource designed to provide access to ranked evidence and evidence-based strategies for managing care in a variety of important areas, including pressure ulcers.

Meet Me at the Skin Care Fair training module. A pressure ulcer prevention in-service with hands on activities. Each activity of the in-service covers one of the Braden Scale risk factors for pressure ulcers. The module is designed for nursing assistants and direct care staff and this session is meant to be used as a train-the-trainer activity for nurses.

The New International Guideline: Prevention and Treatment of Pressure Ulcers. Developed by the American National Pressure Ulcer Advisory Panel) and the European Pressure Ulcer Advisory Panel ), has now been released.

Note: Many long-term care providers wonder how the guideline affects F-314 and practice within a long-term care facility. CMS has not made comments or recommendations regarding these guidelines. Long-term care providers should continue to follow and comply with the guidance contained with F-314. This Pressure Ulcer International Guideline (2-page Word doc) document was reprinted and shared with permission from Jeri A. Lundgren and Pathway Health Services.

No More Pressure Ulcers poster. Best practices for pressure ulcer reduction. (1-page PDF)

On-Time Quality Improvement Manual for Long-Term Care Facilities. A clinical decision support intervention. Published by the Agency for Healthcare Research and Quality. (61-page pdf)

Patient Safety: A Disparities Analysis of Quality Measures. The CMS Health Disparities Quality Improvement Organization Support Center report includes summary information regarding Minnesota residents with pressure ulcers and/or physical restraints. (15-page Word doc)

Pressure Ulcer Change Package. A tool for nursing homes to help prevent pressure ulcers. (9-page PDF)

Pressure Ulcer Dashboard (15-worksheet Excel doc). Tools for nursing homes to learn how to do better internal monitoring of issues. They may be useful during the interim without QI/QM reports. Sample Dashboard (15-worksheet Excel doc)

Pressure Ulcer Update for the Medical Director and Long Term Care Provider. By Paul Takahashi, MD, CMD, et al. Topics In Geriatric Medicine and Medical Direction, A Peer Reviewed Journal of the Minnesota Medical Directors Association, April 2012. (5-page PDF)

Pressure Ulcer Quality Resources Kit. This pressure ulcer management tool kit is designed to outline process steps and methodology that leads to improvement in preventing and managing pressure ulcers. (90-page PDF)

Pressure Ulcer Risk Assessment and Prevention: Comparative Effectiveness Review No. 87. Released May 8, 2013. Agency for Healthcare Research & Quality. (358-page PDF)

Pressure Ulcer Staging Guidelines. The National Pressure Ulcer Advisory Panel redefinition of a pressure ulcer and the stages of pressure ulcers. (2-page PDF)

Pressure Ulcer Treatment Strategies: Comparative Effectiveness Review No. 90. Released May 8, 2013. Agency for Healthcare Research & Quality. (488-page PDF)

Prevention of Pressure Ulcers & Management of Urinary Incontinence for Nursing Assistants. Presented by Jeri Lundgren, RN, BSN, PHN, CWS, CWCN, wound care consultant, Pathway Health Services. (48-minute webinar)

Success Stories booklet. This compilation of articles is based on successes of nursing homes in eliminating or reducing pressure ulcers and physical restraints and can serve as inspiration and resources for others.

Webinar: Assessment of Pressure Ulcers. Presented by Jeri Ann Lundgren, RN, BSN, PHN, CWS, CWCN, Pathway Health Services. (26-minute webinar)

Webinar: Assessment and Treatment of Lower Extremity Ulcers. Presented by Jeri Lundgren, RN, CWS, CWCN, wound care consultant, Pathway Health Services. (56-minute webinar)

Webinar: Choosing Appropriate Support Surfaces: Pressure Ulcer Prevention and Treatment. Presented by Betsy Willy, PT, MA, CWS, Pathway Health Services, and Kristi Wergin, BSN, program manager, Stratis Health. (46-minute webinar)

  • Slides (33-slide PowerPoint)

Webinar: Determining the Etiology of Wounds: Pressure Versus Vascular. Presented by Jeri Ann Lundgren, RN, BSN, PHN, CWS, CWCN, Pathway Health Services. (31-minute Webinar)

Webinar: Evidence-Based Topical Treatment Strategies for Pressure Ulcers. Presented by Jeri Lundgren, RN, CWS, CWCN, wound care consultant, Pathway Health Services. (63-minute Webinar)

Webinar: Management of Pain and Depression Related to Pressure Ulcers. Presented by Jane R. Mort, PharmD, FASCP, professor of pharmacy practice, South Dakota University. (55-minute Webinar)

Webinar: Pressure Ulcer Care: Specific Actions for Improvement Prevention and Treatment. Presented by Barbara Bates-Jensen, PhD, professor, School of Nursing, UCLA. (58-minute Webinar)

Webinar: Pressure Ulcer Prevention: Risk Assessment, Interventions, and Care Planning. Presented by Jeri Lundgren, RN, CWS, CWCN, wound care consultant, Pathway Health Services. (52-minute Webinar)


Please contact contact Kristi Wergin or Kathie Nichols for more information on Stratis Health's work and resources available.