Updated evidence-based recommendations for managing pressure injuries

To mark World Pressure Injury Prevention Day, the Registered Nurses’ Association of Ontario (RNAO) is proud to release a new edition of its best practice guideline (BPG), Pressure injury management: Risk assessment, prevention and treatment (Fourth edition).

This clinical guideline provides nurses, members of the interprofessional team and other collaborators around the world with up-to-date evidence-based recommendations to support and care for persons at risk of or living with pressure injuries.

“Pressure injuries are a common health concern with research showing a relatively stable number of incidences from 1990 to 2017, highlighting a need for improvement,” says RNAO CEO Dr. Doris Grinspun. “When nurses and other health professionals follow the recommendations outlined in this BPG, they can be confident the care they’re providing is supported by evidence and is best practice for managing pressure injuries. We look forward to interprofessional teams – locally and internationally – adopting the recommendations to improve health outcomes.”

The 16-member expert panel was co-chaired by Dr. Dimitri Beeckman, professor of nursing science at Ghent University (Belgium) and Örebro University (Sweden), and Corey Heerschap, wound and ostomy clinical nurse specialist at Barrie’s Royal Victoria Regional Health Centre (Canada). The panel included nurses, persons with lived experience, occupational therapists, physiotherapists and dietitians with expertise and experience in all domains of practice.

“The interprofessional approach taken in the development of this guideline highlights the unique contributions and shared commitment by a diverse group of professionals to the advancement of caring for those living with wounds,” says Heerschap. “Through the integration of current research findings, new technologies and relevant clinical strategies, this guideline provides a resource for health-care providers to deliver high quality care, leading to the reduction of incidence and severity of pressure injuries.”

The guideline outlines good practice statements and recommendations related to:

• repositioning persons at risk of pressure injuries every two to four hours
• implementing preventative care bundles for persons at risk of pressure injuries
• individualized support surfaces and technology use
• crucial prevention and treatment strategies

“By embedding the latest evidence into real clinical settings, it bridges the gap between research, practice and policy,” says Beeckman. “The recommendations enable all partners to make effective decisions to prevent pressure injuries, enhance treatment and improve patient outcomes. Given the significant impact of pressure injuries on patient comfort, disability and health-care costs, integrating these practices into routine care can greatly enhance patient quality of life and health-care efficiency.”

This BPG is available for free download on RNAO’s website. It replaces two previous RNAO BPGs: Assessment and Management of Pressure Injuries for the Interprofessional Team (2016), and Risk Assessment and Prevention of Pressure Ulcers (2005, revised in 2011).

RNAO’s Best Practice Guideline (BPG) Program is funded by Ontario’s Ministry of Health. It was envisioned by CEO Dr. Doris Grinspun in 1998 and launched in 1999 to provide the best available evidence for patient care across all health sectors and settings, with more than 50 guidelines developed to date. The Best Practice Spotlight Organization® (BPSO®) program supports health service and academic institutions that have formally agreed to implement multiple RNAO BPGs over a three-year period, and evaluate their impact on patients, organizations and health system outcomes. Launched in 2003, the BPSO program now has more than 1,500 BPSOs in Ontario, Canada and internationally.

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system, and influenced decisions that affect nurses and the public we serve. For more information about RNAO, visit RNAO.ca or follow us on X (formerly Twitter), Facebook, Instagram and LinkedIn.

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