PUSH Tool 3.0 (web version)

Patient Name:____________________________________ Patient ID#:_______________
Ulcer Location: _________________________________ Date:_____________________

Directions:

Observe and measure the pressure ulcer. Categorize the ulcer with respect to surface area, exudate, and type of wound tissue. Record a sub-score for each of these ulcer characteristics. Add the sub-scores to obtain the total score. A comparison of total scores measured over time provides an indication of the improvement or deterioration in pressure ulcer healing.

Length
x
Width
00 cm2 1< 0.3 cm2 20.3-0.6 cm2 30.7-1.0 cm2 41.1-2.0 cm2 52.1-3.0 cm Sub-score
 63.1-4.0 cm2 74.1-8.0 cm2 88.1-12.0 cm2 912.1-24.0 cm2 10 >24.0 cm2
Exudate
Amount
0
None
1
Light
2
Moderate
3
Heavy
Sub-score
Tissue
Type
0Closed 1Epithelial
Tissue
2Granulation
Tissue
3Slough 4Necrotic
Tissue
Sub-score
Total Score

Length x Width:

Measure the greatest length (head to toe) and the greatest width (side to side) using a centimeter ruler. Multiply these two measurements (length x width) to obtain an estimate of surface area in square centimeters (cm2). Caveat: Do not guess! Always use a centimeter ruler and always use the same method each time the ulcer is measured.

Exudate Amount:

Estimate the amount of exudate (drainage) present after removal of the dressing and before applying any topical agent to the ulcer. Estimate the exudate (drainage) as none, light, moderate, or heavy.

Tissue Type:

This refers to the types of tissue that are present in the wound (ulcer) bed. Score as a “4″ if there is any necrotic tissue present. Score as a “3″ if there is any amount of slough present and necrotic tissue is absent. Score as a “2″ if the wound is clean and contains granulation tissue. A superficial wound that is reepithelializing is scored as a “1″. When the wound is closed, score as a “0″.

4 – Necrotic Tissue (Eschar):black, brown, or tan tissue that adheres firmly to the wound bed or ulcer edges and may be either firmer or softer than surrounding skin.

3 – Slough:yellow or white tissue that adheres to the ulcer bed in strings or thick clumps, or is mucinous.

2 – Granulation Tissue:pink or beefy red tissue with a shiny, moist, granular appearance.

1 – Epithelial Tissue:for superficial ulcers, new pink or shiny tissue (skin) that grows in from the edges or as islands on the ulcer surface.

0 – Closed/Resurfaced:the wound is completely covered with epithelium (new skin).

Version 3.0: 9/15/98
©National Pressure Ulcer Advisory Panel

Pressure Ulcer Healing Chart


(To Monitor Trends in PUSH Scores Over Time)
(use a separate page for each pressure ulcer)

Patient Name:_____________________________________ Patient ID#:______________

Ulcer Location: ___________________________________ Date:____________________

Directions:

Observe and measure pressure ulcers at regular intervals using the PUSH Tool. Date and record PUSH Sub-scale and Total Scores on the Pressure Ulcer Healing Record below.

PRESSURE ULCER HEALING RECORD
Date
Length
x
Width
Exudate
Amount
Tissue
Type
Total Score

Graph the PUSH Total Score on the Pressure Ulcer Healing Graph below. PUSH Tool Version 3.0: 9/15/98

PUSH
Total Score
PRESSURE ULCER HEALING GRAPH
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Date