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The National Pressure Ulcer Advisory Panel (NPUAP) published a manuscript documenting the proceedings at the consensus conference held in April 2016, announcing terminology and staging changes that will affect how clinicians classify pressure injuries. NPUAP used a methodical and collaborative approach to examine the available evidence and incorporated current interdisciplinary clinical expertise to better define the important phenomenon of pressure injury etiology and development.

Key Changes:

  • The term "pressure injury" is replacing "pressure ulcer" to more accurately describe injuries with intact skin and reduce confusion when referring to injuries in Stage 1 and Deep Tissue Injury.
  • Arabic numbers are replacing Roman numeral staging numbers.
  • The Deep Tissue Injury diagnostic label no longer contains the term "suspected."
  • The Stage 2 pressure injury definition was revised to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear.
  • Each definition now describes the extent of tissue loss and anatomical features that may or may not be present in the stage.
  • Two pressure injury definitions were added:
    • Medical Device Related Pressure Injury — (This describes an etiology.) Medical device related pressure injuries result from the use of devices designed and applied for diagnostic or therapeutic purposes. The resultant pressure injury generally conforms to the pattern or shape of the device. The injury should be staged using the staging system.
    • Mucosal Membrane Pressure Injury — Mucosal membrane pressure injury is found on mucous membranes with a history of a medical device in use at the location of the injury. Due to the anatomy of the tissue, these injuries cannot be staged.
The first major change in the staging system in nine years, the stages were revised based on questions received by the NPUAP from clinicians attempting to diagnose and identify the stage of pressure injuries. These updates will affect health care providers across the continuum, and the manuscript outlining the revisions can be downloaded here.

Joerns Healthcare, a Corporate Advisory Council member of the NPUAP, can help clarify these changes and their implications to clinical practice, and provide education to your staff. Our team of wound-certified clinicians is available to provide engaging in-services and address any questions you have about these new definitions.

Contact your Joerns Healthcare clinician or account representative today to schedule an in-service or consultation. If you are not a Joerns customer or you are not sure who your account representative is, please call 800-826-0270.

Click here to request an updated guide to the pressure injury stages complete with photographs.