A pressure injury also referred to as a pressure ulcer or wound is localized injury to the skin and/or underlying tissue usually over a bony prominence. Unrelieved pressure, friction, sheer forces, and moisture contribute to development of a pressure injury. Other conditions, such as ambulation difficulty, malnutrition, and bed-bound status/limited mobility are risk factors for the development of pressure injuries. Because of these risk factors, pressure injuries occur primarily in debilitated, bed-bound patients and are recognized as a major cause of morbidity and mortality in nursing homes. Therefore, nursing homes must ensure that (1) residents do not develop unavoidable pressure injuries; and (2) residents who have pressure injuries receive necessary treatment and services to promote healing, prevent infection and prevent new pressure injuries from developing.

In fact, federal regulations create specific rules regarding pressure injuries:

(1)Pressure ulcers. Based on the comprehensive assessment of a resident, the facility must ensure that –

(i) A resident receives care, consistent with professional standards of practice, to prevent pressure ulcers and does not develop pressure ulcers unless the individual’s clinical condition demonstrates that they were unavoidable; and

(ii) A resident with pressure ulcers receives necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing.