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The National Pressure Ulcer Advisory Panel (NPUAP) has published a Position Statement clarifying its 2016 pressure injury terminology and staging changes. The document was designed to expand upon the NPUAP's position and to respond to requests for further explanation.

The seven clarification statements include:
  1. The diagnosis of a "pressure injury" does not mean that the health care provider(s) "caused" the injury.
  2. Some pressure injuries are unavoidable despite provision of evidence-based care by the health care team.
  3. The numerical staging system does NOT imply linear progression of pressure injuries from Stage 1 through Stage 4, nor does it imply healing from Stage 4 through Stage 1.
  4. The NPUAP Staging System classifies pressure injuries based on the type of tissue loss that can be visualized or directly palpated.
  5. The pressure injury may be more extensive than initially apparent. The wound base and surrounding tissue should be assessed for variations in sensation, temperature, firmness, color and any expression of drainage from surrounding tissues when palpated.
  6. Deep Tissue Pressure Injury (DTPI) may evolve into a full thickness wound despite optimal care.
  7. Any pressure injury should be treated in accordance with current evidence-based practices and monitored closely for changes that require re-evaluation of treatment strategies.

The NPUAP explained the consensus process used in adoption of the 2016 revisions and cited specific professional bodies like the Wound Ostomy and Continence Nurses Society (WOCN®) that support the revised staging system. It also referenced initiatives that are in process, including ongoing discussions between NPUAP and the Centers for Medicare and Medicaid Services "to facilitate implementation for documentation, quality monitoring and reimbursement."

"The overall impact of the revised NPUAP Staging System is better patient care, improved health, and less patient pain and suffering," said Joerns Healthcare's National Clinical Director, Julia Melendez, RN, BSN, JD, CWOCN.

Melendez encouraged providers to request support with terminology implementation and staff training. "Implementation will only be successful if the new terminology is truly understood and woven into a facility's standards of care. That can be difficult, and that is why Joerns provides a highly credentialed clinical staff for assistance. Our team of experts can provide wound care resources and educational programs through a number of training venues including on-site education and webinars."

To learn how you and your team can receive training on the new pressure injury terminology and staging, contact your Joerns Healthcare representative or call 800-826-0270 today.

To download A Quick Guide to the NPUAP Position Statements on Pressure Injury Staging – 2017 Clarifications, click here.

Reference: NPUAP Position Statement on Staging – 2017 Clarifications. National Pressure Ulcer Advisory Panel. (2017). Available at Accessed April 19, 2017.