In this issue:   

NPUAP Bi-Annual Conference 2017 in NOLA
New Year. New President. New Healthcare?
Incidence of Pressure Injuries in the Emergency Department
In the Know - March Awareness Dates
Quote of the Day:
 "We have to be active about kindness and about peace. I've always fantasized that it would be great if there was a Department of Peace."
 
   ~ David Matthews
 
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NPUAP Bi-Annual Conference 2017
March 10-12, 2017 New Orleans, LA

   

The 2017 National Pressure Ulcer Advisory Panel (NPUAP) Biennial Conference in New Orleans will be held March 10-11, 2017.  The Biennial Conference will describe the new changes in the Pressure Injury Staging system identify best practices for the management of complex pressure injury, discuss the challenges in describing unavoidable pressure injuries and examine components of a sustainable pressure injury program.  Please join the NPUAP community as we share and expand our knowledge together.


What's New in our Healthcare?
New Year. New President. New Healthcare?
An in-depth look into healthcare reform in 2017
 
ON JANUARY 20TH, PRESIDENT
Elect Donald J. Trump will take the oath of office as the next president of the United States, making him the 45th person to hold this title. After a grueling campaign, three debates and an election year that will go down in history, America is anxious to see what will come next.
  
In the healthcare realm, the federal Patient Protection and Affordable Care Act (ACA) remains the hot topic at large. During President Barack Obama's administration, the ACA was developed to provide universal healthcare in America. Since its inception, the ACA, popularly coined "Obamacare," has seen over 50 repeal attempts from the house and senate. 1
  
During the 2016 campaign, the president-elect's feelings and policies on the ACA were clear: "Obamacare is a total disaster... Doesn't work. I will REPEAL AND REPLACE," he tweeted on November 3rd. 2 Many pressing topics like immigration, job security, the state of the economy and more were presented during campaigning and the national debates throughout the election process. Healthcare-addressed in one question during the town meeting debate on October 9, 2016-did not receive much attention during the months leading up to Trump's presidency. However, Trump's website, www.donaldjtrump.com, outlines a detailed plan for the future of the ACA-that is, if the ACA will still exist.

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Articles of Interest

The Incidence of Pressure Injuries in the Emergency Department: A Meta-analysis


Author(s): Peng Liu, MD; Wang-Qin Shen, MD; and Hong-Lin Chen, MD
Index: Wounds 2017;29(1):14-19. Epub 2016 October 24.
Abstract: Objective. The aim of this meta-analysis was to estimate the incidence of pressure ulcers (PUs) in the emergency department (ED).

Methods. The authors searched PubMed, Web of Science, and CINAHL databases for all time leading up to February 2016. The incidence of PUs in the ED were collected, and the pooled incidence with 95% confidence interval (CI) was calculated by meta-analysis. Results. Six studies with 8 cohorts were included in this study. The incidence of PUs in the ED ranged from 0.38% to 19.1%. The pooled incidence was 6.310% (95% CI 4.658%-7.962%; Z = 7.49, P = 0.000) by the random-effects model (I 2 = 98.2%, P = 0.000). Funnel plot, Begg's test (z = 0.37, P = 0.711) and Egger's test ( t = 2.73, P = 0.034) suggested there was significant publication bias. Sensitivity analysis that included prospective studies showed the pooled incidence was 11.992% (95% CI 5.569%-18.415%; Z = 3.66, P = 0.000) by the random-effects model (I 2 = 93.9%, P = 0.000). Conclusion. Even for a short stay in the ED, developing a PU is a common complication. The figures of this meta-analysis may be useful in the estimation of the PU burden in the ED.

Although much progress has been made in the prevention and the treatment of pressure ulcers (PUs), 1 they are still a common problem for patients. Pressure ulcers are more likely to occur in patients who are critically ill; patients who have had a prolonged surgery, a stroke, or a spinal injury; and frail elderly patients and individuals using wheelchairs in long-term care settings. In intensive care settings over the past 10 years, PU prevalence ranged from 4% to 49%. 2 Also in the past decade, patients with surgery-related PUs had an incidence of 15%, with 95% confidence intervals (CI) 14%-16%. 3 For patients who had a stroke over the past 10 years, the PU prevalence ranged from 17% to 28%. 4 In long-term care settings, again over the past decade, the prevalence of PUs ranged from 3.5% to 16.9%. 5-7

In the authors' clinical practice, they found that PUs were also common in the emergency department (ED), and the incidence had increased in recent years. Pressure ulcers in the ED were also reported by other researchers. 8-10 Santamaria and colleagues 8 reported the incidence of PUs in critically ill patients and those with trauma in the ED ranged from 3.1% to 13.1%. Dugaret and coauhthors 9 reported 12.8% of patients (77/602) in the ED had prevalent PUs at admission and 19.1% (115/602) at discharge, while Denby and Rowlands 10 reported the PU incidence was 0.38% in another ED. Although PUs have always been assessed in critically ill patients, prolonged surgery patients, patients who have had a stroke, and elderly patients, there is an increasing focus on PUs in the ED in recent years due to the increased PU incidence. However, the authors still did not find any meta-analysis to investigate the incidence of PUs in the ED worldwide. 

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In the Know - March Awareness Dates
Monthly Awareness:
  • National Colorectal Cancer Awareness Month
  • National Endometriosis Awareness Month
  • National Kidney Month
  • Multiple Sclerosis Education Month (promoted by the Multiple Sclerosis Foundation and others)
  • National Nutrition Month
  • Save Your Vision Month
  • Sleep Awareness Month (promoted by the National Sleep Foundation)
  • Trisomy Awareness Month
  • Workplace Eye Wellness Month
  • National Athletic Training Month
  • Patient Safety Awareness Week (March 13-19)
  • National Sleep Awareness Week (March 6-13)
  • Brain Awareness Week (March 14-20)
  • National Poison Prevention Week (March 15-21)
  • Purple Day for Epilepsy Awareness (March 26)
  • National Bleeding Disorders Awareness Month
  • National Cheerleader Safety Month
  • Problem Gambling Awareness Month
  • National School Breakfast Week (March 7-11)
  • National Women and Girls HIV/AIDS Awareness Day (March 10)
  • World Kidney Day (March 10)
  • National Native American HIV/AIDS Awareness Day (March 20)
  • American Diabetes Alert Day (March 24)
  • World Tuberculosis Day (March 24)
  • Tsunami Preparedness Week (March 27-April 2)
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    Prevention is Key!
    Pressure injuries can often be prevented through evidence-based practice and interdisciplinary care.  Prevention is always the best way to avoid unnecessary risk, pain and threat that pressure injuries pose to our patients.  
     
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