Module 1
Introduction
What is a pressure injury?
A pressure injury is defined as 'localised damage to the skin and/or underlying tissue, as a result of pressure or pressure in combination with shear.
Pressure injuries usually occur over a bony prominence but may also be related to a medical device or other object'.1
Australian Standard of Care
Pressure injury is a common hospital-acquired complication that can be reduced (although, not necessarily eliminated) by the provision of patient care that mitigates avoidable risks to patients. The delivery of safe patient care in Australia is supported by the National Safety and Quality Health Service (NSQHS) Standards (second edition), in particular the Comprehensive Care Standard.
The Australian Commission on Safety and Quality in Health Care2 recommends the following targeted actions to prevent and manage pressure injury.
- The health service organisations should provide services to patients at risk of pressure injury that are consistent with best-practice guidelines.
- Clinicians should conduct comprehensive skin inspections in accordance with best-practice time frames and frequency.
- The health service organisations should ensure that pressure injury preventive equipment, devices and products are used in line with best-practice guidelines and patients, carers and families are provided with pressure injury information.
Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards (second edition). Sydney 2017.
Australian Commission on Safety and Quality in Health Care. Selected best practices and suggestions for improvement for clinicians and health system managers. Hospital-Acquired Complication 1. Pressure Injury. Factsheet. 2018.
Prevention and Treatment: Clinical Practice Guideline.
In 2019, the European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP), and the Pan Pacific Pressure Injury Alliance (PPIAP) released an updated Clinical Practice Guideline for Prevention and Treatment of Pressure Ulcers/Injuries1. The evidence-based recommendations for the prevention and treatment of pressure injuries were developed using a scientific methodology to identify and critically appraise all available research. These recommendations can be used by health professionals throughout the world. The Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide was designed for busy health professionals and provides a quick summary of the evidence-based recommendations, good practice statements and quality indicators.

European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA: 2019
You may also install the Official NPIAP, EPUAP, and PPPIA Guideline mobile app, InterPIP, which was jointly developed together with app developer Sensorydata Corp.
You may use ‘Stop the Pressure’ educational board game to check your knowledge and skills in pressure injury prevention and management. This educational board game was developed by NHS England to support Stop the Pressure. This game helps frontline staff to recognise and reduce the risk of pressure ulcer formation and is suitable for anyone working in acute, community or social care.
References
1European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan-Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. The International Guideline. Emily Haesler (Ed). EPUAP/NPIAP/PPPIA:2019.
2 Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards (second edition). Sydney 2017. https://www.safetyandquality.gov.au/sites/default/files/2019-04/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf