Research Priorities Identified for Pressure Ulcer Prevention, Treatment & Policy

The National Pressure Ulcer Advisory Panel (NPUAP) has identified Research Priorities for Pressure Ulcer Prevention, Treatment & Policy. The Research Committee compiled this list to help guide researchers and stakeholders in the advancement of science for the prevention and treatment of pressure ulcers and to guide policy development.  To review the priorities please see below:

HIGH RESEARCH PRIORITY – Cost of Pressure Ulcer Care in the United States

Prevention

  1. Co-morbidities,  age (neonate, children, adults, older adults), disparities, genetic influences and  other risk factors related to the incidence and prevalence of  pressure ulcers and DTI across settings (acute, OR, community acquired)
  2. Effects of nutritional interventions in the prevention of pressure ulcers and DTI
  3. Effects of microenvironment (sanitation, microclimate, microbiology) on incidence and prevalence of pressure ulcers and DTI
  4. Effects of compressive and shear stress and deformation on soft tissue injury associated with DTI and pressure ulcers
  5. Effect of turning and repositioning schedules on pressure ulcer and DTI prevention outcomes
  6. Prevalence and incidence of pressure ulcers and DTI associated with the use of medical devices
  7. Generation of fundamental knowledge on the etiology of pressure ulcer formation and deep tissue injury
  8. Patient literacy and teaching about prevention or treatment

Treatment

  1. Surgical solutions for treatment of pressure ulcers
  2. Selection of support surfaces based on assessment of patient clinical characteristics and support surface characteristics
  3. Effects of wound dressings on outcome of pressure ulcers
  4. Role of bioburden and biofilms in the treatment and healing of pressure ulcers
  5. Effects of nutritional interventions on outcomes of pressure ulcers
  6. Disparities, co-morbidities, age, genetics and risk factors related to outcomes of pressure ulcers
  7. Assessment and management of pain associated with pressure ulcers
  8. Time to healing in pressure ulcers (is there a time frame such as exists with diabetic foot ulcers and venous ulcers? i.e. 50% closure in 4 weeks?)

Policy

  1. Standardization of patient records and documentation to support research
  2. Impact of government regulations on pressure ulcer management
  3. Standardization of terminology, tools, and outcomes, ie health care quality metrics
  4. Effective implementation of prevention and treatment guidelines
  5. Effective dissemination of implementation of prevention and treatment guidelines
  6. Skills to design research studies with adequate power and controls to generate data that can be rigorously interpreted
  7. Skills to design case/outcome studies as a decision aid for further research
  8. Caregivers (physicians, nurses, family etc.) knowledge and interest in pressure ulcer prevention and treatment
  9. Nurse and physician communication linked to quality measures, patient teaching/literacy as well as disparity/racial groups
  10. Pressure ulcer recurrence rates; consistency in what to call ulcers that recur at the same location/site, how to stage, when is it a new ulcer? When is it just remodeling gone astray?
  11. Research into methods of cost/benefit calculations to be applied to compare efficacy of preventative measures