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1. Accuracy of pressure ulcer events in US nursing home ratings. | PSNet
   psnet.ahrq.gov/issue/accuracy-pressure-ulcer-events-us-nursing-home-ratings
   August 09, 2023 - Accuracy of pressure ulcer events in US nursing home ratings. Med Care. … ulcer-related hospital admissions. … Accuracy of pressure ulcer events in US nursing home ratings. Med Care. … September 7, 2005 Barriers and facilitators to reporting medical device-related pressure ulcers … See More About The Topic Long-Term Care Geriatrics Nurse Care Pressure Ulcers

2. The Forgotten Turn | PSNet
   psnet.ahrq.gov/web-mm/forgotten-turn
   August 01, 2018 - Definitions and Staging The National Pressure Ulcer Advisory Panel defines a pressure ulcer as "a localized … Not all pressure ulcers are avoidable, but every pressure ulcer occurring in hospitals today should provide … Take-Home Points Pressure ulcers continue to occur despite national focus on pressure ulcer prevention … Hip fracture and pressure ulcers – the Pan-European Pressure Ulcer Study – intrinsic and extrinsic risk … Pressure Ulcer Stages: National Pressure Ulcer Advisory Panel—2007.( 8 ) Stage Description

3. Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey. | PSNet
   psnet.ahrq.gov/issue/organisational-strategies-implement-hospital-pressure-ulcer-prevention-programmes-findings
   December 07, 2022 - Study Organisational strategies to implement hospital pressure ulcer prevention programmes … Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a … Hospital-acquired pressure ulcers are considered a never event and can result in loss of payment … Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a … May 30, 2018 A comprehensive program to reduce rates of hospital-acquired pressure ulcers

4. Spotlight Case July 2008 (ppt file)
   psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.230_slideshow.ppt
   December 01, 2010 - Hip fracture and pressure ulcers–the Pan-European Pressure Ulcer Study–intrinsic and extrinsic risk factors … Pressure ulcer prevention and management. … Definition National Pressure Ulcer Advisory Panel (APUP) defines a pressure ulcer as: “A localized … Available at http://www.npuap.org/pr2.htm * Pressure Ulcer Stages Pressure Ulcer Stages: National … focus on pressure ulcer prevention.

5. Success in hospital-acquired pressure ulcer prevention: a tale in two data sets. | PSNet
   psnet.ahrq.gov/issue/success-hospital-acquired-pressure-ulcer-prevention-tale-two-data-sets
   October 18, 2017 - Study Success in hospital-acquired pressure ulcer prevention: a tale in two data … Success In Hospital-Acquired Pressure Ulcer Prevention: A Tale In Two Data Sets. … Hospital-acquired pressure ulcers (HAPUs) are considered a never event , represent a significant source … administrative data was almost entirely due to a decrease in the incidence of lower stage pressure ulcers … Success In Hospital-Acquired Pressure Ulcer Prevention: A Tale In Two Data Sets.

6. Preventing pressure ulcers: the goal is zero. | PSNet
   psnet.ahrq.gov/issue/preventing-pressure-ulcers-goal-zero
   January 25, 2012 - Commentary Preventing pressure ulcers: the goal is zero. … Preventing pressure ulcers: the goal is zero. Jt Comm J Qual Patient Saf. 2007;33(10):605-10. … background and motivation behind the 5 Million Lives Campaign goal to prevent and eliminate pressure ulcers … Preventing pressure ulcers: the goal is zero. Jt Comm J Qual Patient Saf. 2007;33(10):605-10. … October 18, 2017 Organisational strategies to implement hospital pressure ulcer prevention

7. Spotlight Case July 2008 (ppt file)
   psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.248_slideshow.ppt
   September 01, 2011 - Case: Safety of Long-Term Care (4) At the hospital, a full examination revealed a very deep pressure ulcer … in her sacrum (stage IV full thickness ulcer), which had developed at the long-term care facility after … Unfortunately, likely secondary to an infection of the pressure ulcer, she developed septic shock and … Pressure Ulcers in America: Prevalence, Incidence, and Implications for the Future. … Reston, VA: National Pressure Ulcer Advisory Panel; 2001.

8. The Safety and Quality of Long Term Care | PSNet
   psnet.ahrq.gov/web-mm/safety-and-quality-long-term-care
   January 01, 2016 - understanding of adverse events in nursing homes is primarily based on research exploring pressure ulcers … For example, the rate of pressure ulcers in nursing homes has been shown to range between 2.2% to 23.9% … Pressure Ulcers in America: Prevalence, Incidence, and Implications for the Future. … Reston, VA: National Pressure Ulcer Advisory Panel; 2001. 6. … RN staffing time and outcomes of long-stay nursing home residents: pressure ulcers and other adverse

9. Wound-care teams for preventing and treating pressure ulcers. | PSNet
   psnet.ahrq.gov/issue/wound-care-teams-preventing-and-treating-pressure-ulcers
   June 05, 2019 - Review Wound-care teams for preventing and treating pressure ulcers. … Wound-care teams for preventing and treating pressure ulcers. … Pressure ulcers are considered a never event for hospitals. … review, researchers sought to examine the impact of wound care teams in preventing and treating pressure ulcers … Wound-care teams for preventing and treating pressure ulcers.

10. Preventing in-facility pressure ulcers as a patient safety strategy: a systematic review. | PSNet
    psnet.ahrq.gov/issue/preventing-facility-pressure-ulcers-patient-safety-strategy-systematic-review
    March 13, 2013 - Review Preventing in-facility pressure ulcers as a patient safety strategy: a systematic … Preventing in-facility pressure ulcers as a patient safety strategy: a systematic review. … simplification and standardization of safety strategies, and regular audit and feedback of pressure ulcer … Preventing in-facility pressure ulcers as a patient safety strategy: a systematic review. … Never Events September 7, 2019 Success in hospital-acquired pressure ulcer

11. A comprehensive program to reduce rates of hospital-acquired pressure ulcers in a system of community hospitals. | PSNet
    psnet.ahrq.gov/issue/comprehensive-program-reduce-rates-hospital-acquired-pressure-ulcers-system-community
    May 12, 2021 - Study A comprehensive program to reduce rates of hospital-acquired pressure ulcers … A Comprehensive Program to Reduce Rates of Hospital-Acquired Pressure Ulcers in a System of Community … Rates of severe (stages III and IV) ulcers declined in participating facilities, demonstrating that a … December 14, 2022 Accuracy of pressure ulcer events in US nursing home ratings. … May 23, 2018 Organisational strategies to implement hospital pressure ulcer prevention

12. Medical device-related pressure ulcers: a systematic review and meta-analysis. | PSNet
    psnet.ahrq.gov/issue/medical-device-related-pressure-ulcers-systematic-review-and-meta-analysis
    September 12, 2018 - Review Classic Medical device-related pressure ulcers: … Medical device-related pressure ulcers: A systematic review and meta-analysis. … Hospital-acquired pressure ulcers are considered never events and represent a significant source of … Medical device-related pressure ulcers: A systematic review and meta-analysis.

13. Barriers and facilitators to reporting medical device-related pressure ulcers: a qualitative exploration of international practice. | PSNet
    psnet.ahrq.gov/issue/barriers-and-facilitators-reporting-medical-device-related-pressure-ulcers-qualitative
    January 25, 2023 - Study Barriers and facilitators to reporting medical device-related pressure ulcers … Barriers and facilitators to reporting medical device-related pressure ulcers: A qualitative exploration … Hospital-acquired pressure ulcers, categorized as a never event, are underreported , particularly when … Interviews with experts in hospital-acquired pressure ulcers revealed four domains related to reporting … April 19, 2017 Accuracy of pressure ulcer events in US nursing home ratings.

14. Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers? | PSNet
    psnet.ahrq.gov/issue/are-evidence-based-practices-associated-effective-prevention-hospital-acquired-pressure
    May 28, 2008 - Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers … Are Evidence-based Practices Associated With Effective Prevention of Hospital-acquired Pressure Ulcers … Severe hospital-acquired pressure ulcers are considered a never event , and they result in loss of payment … Are Evidence-based Practices Associated With Effective Prevention of Hospital-acquired Pressure Ulcers … September 14, 2022 Accuracy of pressure ulcer events in US nursing home ratings.

15. Evaluation of the suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers: a systematic review and documentary analysis. | PSNet
    psnet.ahrq.gov/issue/evaluation-suitability-root-cause-analysis-frameworks-investigation-community-acquired
    January 11, 2012 - suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers … suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers … discusses how root cause analysis methods can be used to understand community-acquired pressure ulcers … In hospital and long-term care settings, pressure ulcers are considered preventable complications, but … March 6, 2019 Success in hospital-acquired pressure ulcer prevention: a tale in two data

16. Enhancing Patient Safety and Outcomes: The Safe Patient Handling Connection. | PSNet
    psnet.ahrq.gov/issue/enhancing-patient-safety-and-outcomes-safe-patient-handling-connection
    September 23, 2021 - Patient handling can affect the safety of patient mobility , development of pressure ulcers and worker … More See More About Online Education Nursing Latent Errors Pressure Ulcers

17. Towards international consensus on patient harm: perspectives on pressure injury policy. | PSNet
    psnet.ahrq.gov/issue/towards-international-consensus-patient-harm-perspectives-pressure-injury-policy
    August 07, 2019 - Pressure ulcers are never events that continue to occur, despite potential repercussions on reimbursement … February 8, 2017 Medical device-related pressure ulcers: a systematic review and meta-analysis … June 19, 2019 Medical device-related pressure ulcers: a systematic review and meta-analysis … January 23, 2019 Success in hospital-acquired pressure ulcer prevention: a tale in two … Hospitals Nurses Health Care Executives and Administrators Hospital Medicine Pressure Ulcers

18. Don't Pick the PICC | PSNet
    psnet.ahrq.gov/web-mm/dont-pick-picc
    December 01, 2011 - and nephropathy; glaucoma; and stage IV chronic kidney disease was admitted to the hospital with an ulcer … Physical examination revealed a 2 cm clean-based ulcer below the fifth metatarsal head of the right foot … No surrounding swelling or erythema was present, but the ulcer could be probed to the underlying bone … discharged and completed 6 weeks of antibiotics and wound care, with healing of the osteomyelitis and ulcer

19. Bandemia as a Harbinger of Stercoral Colitis and Impending Perforation. | PSNet
    psnet.ahrq.gov/web-mm/bandemia-harbinger-stercoral-colitis-and-impending-perforation
    November 25, 2020 - In the operating room, the surgeon found stercoral colitis and a large perforated “stercoral ulcer” of … Stercoral ulcer.

20. Root cause analysis for hospital-acquired pressure injury. | PSNet
    psnet.ahrq.gov/issue/root-cause-analysis-hospital-acquired-pressure-injury
    June 02, 2021 - method to utilize root cause analysis results to determine latent weaknesses that facilitate pressure ulcer … April 13, 2022 Accuracy of pressure ulcer events in US nursing home ratings. … June 5, 2019 Medical device-related pressure ulcers: a systematic review and meta-analysis … May 16, 2018 A comprehensive program to reduce rates of hospital-acquired pressure ulcers