Pressure Ulcers: Even the Grading of Facilities Fails
Authors: Barbara Pieper, Robert S. Kirsner
Journal: Annals of Internal Medicine (2013)

Editorials15 October 2013Pressure Ulcers: Even the Grading of Facilities FailsBarbara Pieper, PhD, RN and Robert S. Kirsner, MD, PhDBarbara Pieper, PhD, RNFrom Wayne State University, Detroit, Michigan; and University of Miami Miller School of Medicine, Miami, Florida.Search for more papers by this author and Robert S. Kirsner, MD, PhDFrom Wayne State University, Detroit, Michigan; and University of Miami Miller School of Medicine, Miami, Florida.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-8-201310150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A pressure ulcer is a serious, painful, and costly problem for patients, with grave implications for families, clinicians, and health care institutions. Estimated to affect more than 7.5 million persons worldwide each year, pressure ulcers are a serious public health concern and a patient safety issue (1). They affect elderly patients, infirm patients, and those with mobility issues, and their estimated annual cost is $11 billion (2). To reduce the problem, the Centers for Medicare & Medicaid Services plans public reporting of institutional rates and financial penalties for poor performers (3). But what is a poor performer, and why? The ...References1. MedMarket Diligence. Worldwide Wound Management, 2007–2016: Established and Emerging Products, Technologies and Markets in the U.S., Europe, Japan and Rest of World. Report S245. Foothill Ranch, CA: MedMarket Diligence; 2007. Accessed at www.mediligence.com/rpt/rpt-s245.htm on 9 September 2013. Google Scholar2. Sen CK, Gordillo GM, Roy S, Kirsner R, Lambert L, Hunt TK, et al. Human skin wounds: a major and snowballing threat to public health and the economy [Editorial]. Wound Repair Regen. 2009;17:763-71. [PMID: 19903300] CrossrefMedlineGoogle Scholar3. Ayello EA and Lyder CH. Research and public policy context.. In: Pieper B, eds. Pressure Ulcers: Prevalence, Incidence, and Implications for the Future. 2nd ed. Washington, DC National Pressure Ulcer Advisory Panel 2012 15-8. Google Scholar4. Meddings JA, Reichert H, Hofer T, and McMahon LF. Hospital report cards for hospital-acquired pressure ulcers: how good are the grades? Ann Intern Med. 2013;159:505-13. LinkGoogle Scholar5. Levine JM, Ayello EA, Zulkowski KM, and Fogel J. Pressure ulcer knowledge in medical residents: an opportunity for improvement. Adv Skin Wound Care. 2012;25:115-7. [PMID: 22343598] CrossrefMedlineGoogle Scholar6. Zulkowski K and Ayello EA. Urban and rural nurses' knowledge of pressure ulcers in the USA. World Council of Enterostomal Therapists Journal. 2005;25:24-30. Google Scholar7. National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Pressure Ulcer Prevention and Treatment Clinical Practice Guideline. Washington, DC National Pressure Ulcer Advisory Panel 2009. Google Scholar8. Mahoney M, Rozenboom B, and Doughty D. Challenges in classification of gluteal cleft and buttocks wounds: consensus session reports. J Wound Ostomy Continence Nurs. 2013;40:239-45. [PMID: 23652696] CrossrefMedlineGoogle Scholar9. Jesada EC, Warren JI, Goodman D, Iliuta RW, Thurkauf G, McLaughlin MK, et al. Staging and defining characteristics of pressure ulcers using photographs by staff nurses in acute care settings. J Wound Ostomy Continence Nurs. 2013;40:150-6. [PMID: 23466719] CrossrefMedlineGoogle Scholar10. McNichol LL and Ratliff CR. Risk assessment, staff education, and interventions for pressure ulcer prevention programs. Pressure ulcer incidence and prevalence by clinical setting: General acute care.. In: Pieper B, eds. Pressure Ulcers: Prevalence, Incidence, and Implications for the Future. 2nd ed. Washington, DC National Pressure Ulcer Advisory Panel 2012 197-226. Google Scholar Author, Article, and Disclosure InformationAuthors: Barbara Pieper, PhD, RN; Robert S. Kirsner, MD, PhDAffiliations: From Wayne State University, Detroit, Michigan; and University of Miami Miller School of Medicine, Miami, Florida.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2077.Corresponding Author: Barbara Pieper, PhD, RN, College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, MI 48202; e-mail, [email protected].Current Author Addresses: Dr. Pieper: College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, MI 48202.Dr. Kirsner: Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Avenue, RMSB, Room 2023-A, Miami, FL 33136. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHospital Report Cards for Hospital-Acquired Pressure Ulcers: How Good Are the Grades? Jennifer A. Meddings , Heidi Reichert , Tim Hofer , and Laurence F. McMahon Jr. Metrics 15 October 2013Volume 159, Issue 8Page: 571-572 ePublished: 15 October 2013 Issue Published: 15 October 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...