IV 
115TH CONGRESS 
2D SESSION 
H. RES. 1133 
Expressing support for the designation of the third Thursday in November 
as ‘‘National Pressure Ulcer/Injury Prevention Day’’ and promoting en-
hanced care coordination and prevention resources to reduce the develop-
ment of pressure ulcers/injuries. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 26, 2018 
Mr. EMMER (for himself, Mrs. HANDEL, Mr. WOODALL, and Mr. POLIQUIN) 
submitted the following resolution; which was referred to the Committee 
on Energy and Commerce 
RESOLUTION 
Expressing support for the designation of the third Thursday 
in November as ‘‘National Pressure Ulcer/Injury Preven-
tion Day’’ and promoting enhanced care coordination 
and prevention resources to reduce the development of 
pressure ulcers/injuries. 
Whereas hospital-acquired pressure ulcers/injuries are a sig-
nificant problem that cause harm in terms of morbidity, 
mortality, and cost for Americans covered through Medi-
care or Medicaid, those covered by private commercial 
health insurance, and the uninsured; 
Whereas the prevalence and impact of pressure ulcers/injuries 
and their associated complications and expenses kill over 
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60,000 patients per year while impacting over 2,000,000 
Americans; 
Whereas these complications cost the United States at least 
$9,000,000,000 to $11,000,000,000 per year based on 
data from the Centers for Medicare & Medicaid Services 
(CMS) and the Agency for Healthcare Research and 
Quality, and economists project that this issue could sur-
pass $25,000,000,000 by 2020; 
Whereas the physiologic process describing pressure ulcer/in-
jury formation is not completely understood, and there 
are multiple factors that contribute to their development 
including decreased mobility, moisture, nutrition deficits, 
friction, obstructed lymph flow, dehydration, and im-
paired tissue perfusion; 
Whereas these complications may be indicative of the end of 
life or organ failure; 
Whereas pressure ulcers/injuries may develop despite the 
caregiver’s diligent use of currently known and accessible 
prevention methods; 
Whereas there is adequate evidence that multiple factors are 
involved in the formation of a pressure ulcer/injury that 
require additional research to effectively understand the 
protocols necessary to relieve the pressure ulcer/injury 
burden to the patient, health care provider, and govern-
ment; 
Whereas information provided by the CMS Office of Enter-
prise Data and Analytics in October 2017 identified that 
hospital-acquired pressure ulcer/injury incidence rates 
have increased by 58.4 percent between the first quarter 
of 2016 and the first quarter of 2017; 
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Whereas the data demonstrate a need to work together to de-
termine how we can improve our Nation’s health care 
outcomes by reducing the occurrence of pressure ulcers/ 
injuries and their significant morbidity and mortality 
consequences; 
Whereas the term ‘‘pressure ulcer’’ has been widely known as 
pressure injury, decubitus ulcer, bedsore, pressure in-
duced skin damage, skin failure, and pressure sore; 
Whereas there are approximately 17,000 additional lawsuits 
each year as a result of pressure ulcers/injuries; 
Whereas pressure ulcers/injuries are one of the five most 
prevalent harms experienced by patients; 
Whereas in long-term acute care settings, 28.2 percent of pa-
tients have pressure ulcers/injuries; 
Whereas in nursing homes and rehabilitation centers, ap-
proximately 11 percent of patients have documented pres-
sure ulcers/injuries; 
Whereas for hospital settings, 4.5 percent of Medicare bene-
ficiaries develop hospital-acquired pressure ulcers/injuries; 
Whereas more than 1⁄3 of veterans with a spinal cord injury 
report pressure ulcers/injuries each year, and those vet-
erans face more than $70,000 in inpatient costs com-
pared to those without; 
Whereas patients with hospital-acquired pressure ulcers/inju-
ries increase their length of stay from 4.9 to 11.6 days, 
adding additional health care costs; 
Whereas these patients are more likely to be discharged to an 
extended care facility rather than home, and readmitted 
to a hospital; 
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Whereas the pathology of pressure ulcer/injury formation in-
dicates multiple contributing factors; and 
Whereas effecting positive change in the prevention and man-
agement of patients will require multiple areas of focus 
including the public, patients, health care professionals, 
providers, and government: Now, therefore, be it 
Resolved, That the House of Representatives— 
(1) affirms that pressure ulcers/injuries and 
their resulting costs in human suffering and strain 
on the health care system require a coordinated and 
systemic plan to address; 
(2) supports the designation of ‘‘National Pres-
sure Ulcer/Injury Prevention Day’’; 
(3) encourages the Secretary of the Department 
of Health and Human Services (HHS) to review 
current pressure ulcer/injury prevention and man-
agement protocols and develop a plan to use peer- 
reviewed science to test, revise, and continually re-
duce pressure ulcer/injury development; 
(4) encourages the Secretary of HHS to host a 
Federal interagency conference with academia, in-
dustry stakeholders, health care providers, commu-
nity caregivers, patients, families, patient and vet-
eran advocacy groups, and other stakeholders to 
publicly review and discuss the state of pressure 
ulcer/injury prevention research, protocols, scope and 
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magnitude of the problem, and related topics each 
year; 
(5) encourages the Centers for Medicare & 
Medicaid Services (CMS) to review its authorities 
and programs to reduce pressure ulcers/injuries, in-
cluding focus on early detection and prevention; and 
(6) encourages HHS to coordinate with the De-
partment of Veterans Affairs and State health agen-
cies and boards to deliver best practices on the pre-
vention and reduction of pressure injury/ulcer rates. 
Æ 
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