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Updated NPUAP Staging Illustrations for Pressure Ulcers

November 5, 2017 5 Comments

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The National Pressure Ulcer Advisory Panel redefined the definition of pressure injuries during the NPUAP 2016 Staging Consensus Conference. 

The updated staging definitions were presented at a meeting of over 400 professionals.  Dr. Mikel Gray from the University of Virginia guided the Staging Task Force and conference participants to an agreement on the updated definitions through an interactive discussion and voting process.  During the meeting, the participants also validated the new terminology using photographs.

NPUAP Staging Illustrations:

NPUAP-stagingThe National Pressure Ulcer Advisory Panel (NPUAP)  has published NEW illustrations of pressure ulcer stages.

According to the NPUAP website these There is also a normal Caucasian and Non-Caucasian skin illustration for reference.

There is no cost to use these NPUAP Staging illustrations; however, donations to support the work of NPUAP are graciously accepted.  

**Use of drawings is permitted for educational purposes only. 

The use of NPUAP material does not imply endorsement of products or programs associated with the use of the material.

Original Press Release

Washington, DC – April 13, 2016 – The term “pressure injury” replaces “pressure ulcer” in the National Pressure Ulcer Advisory Panel Pressure Injury Staging System according to the NPUAP. The change in terminology more accurately describes pressure injuries to both intact and ulcerated skin. In the previous staging system Stage 1 and Deep Tissue Injury described injured intact skin, while the other stages described open ulcers. This led to confusion because the definitions for each of the stages referred to the injuries as “pressure ulcers”.

In addition to the change in terminology, Arabic numbers are now used in the names of the stages instead of Roman numerals. The term “suspected” has been removed from the Deep Tissue Injury diagnostic label. Additional pressure injury definitions agreed upon at the meeting included Medical Device Related Pressure Injury and Mucosal Membrane Pressure Injury.

The updated staging definitions were presented at a meeting of over 400 professionals held in Chicago on April 8-9, 2016. Using a consensus format, Dr. Mikel Gray from the University of Virginia adeptly guided the Staging Task Force and meeting participants to consensus on the updated definitions through an interactive discussion and voting process. During the meeting, the participants also validated the new terminology using photographs.

Dr. Laura Edsberg from Daemen College in Buffalo, NY and Dr. Joyce Black from the University of Nebraska Medical Center in Omaha served as co-chairs of the Staging Task Force appointed by the NPUAP Board of Directors. Task force members included Margaret Goldberg, MSN, RN, CWOCN from Delray Wound Center, Florida, Laurie McNichol, MSN, RN, CWOCN, CWON-AP, from Cone Health in Greensboro, NC, Lynn Moore, RDN, from Nutrition Systems, Mississippi and Mary Sieggreen, MSN, CNS, NP, CVN, from Detroit Medical Center.

Pressure injuries are staged to indicate the extent of tissue damage. The stages were revised based on questions received by NPUAP from clinicians attempting to diagnose and identify the stage of pressure injuries. Schematic artwork for each of the stages of pressure injury was also revised and will be available for use at no cost through the NPUAP website. 

Editors Note:  This post was originally published in July 2016 and has been revamped and updated for accuracy and comprehensiveness. (NPUAP Position Statement on Staging – 2017 Clarifications). For-profit uses of the drawings are subject to a charge, please contact Jen Bank for more information.

 

Tags: Pressure ulcer Categories: Pressure ulcers

About the Author

Laurie Swezey's avatar

Laurie Swezey, founder and president of WoundEducators.com, has been a Registered Nurse for more than a quarter century, with most of those years dedicated to wound treatment. Ms. Swezey is a Certified Wound Care Nurse and a Certified Wound Specialist.

Reader Interactions

Comments

  1. Laurene Elauria-Johnson says

    September 23, 2016 at 5:20 am

    Thank you Laurie Swezey.

    Reply
    • Lori says

      November 6, 2017 at 10:40 am

      Why change from Roman numerals To Arabic ? I️ can understand the reasoning from ulcer to injury , however I️ really don’t see the reasoning behind changing the numeral practice . Please advise

      Reply
      • Laurie Swezey says

        November 6, 2017 at 11:55 am

        Hi Lori, I recommend that you contact NPUAP with your question: http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/

        Reply
  2. Lisa E. Frye says

    April 28, 2018 at 1:17 am

    These are excellent illustrations of the different stages. I would like to share this to educate my staff. Would you be able to send this to my email? I am having trouble downloading this with attachment which includes all in succession. Thank you.

    Reply
    • Laurie Swezey says

      April 30, 2018 at 10:05 am

      Please visit the NPUAP to download the illustrations: http://www.npuap.org

      Reply

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