Too often pressure injuries are thought of as an inpatient problem, an issue that’s highly unlikely to occur during the shorter procedures performed in outpatient facilities on relatively healthy patients. But that mindset fosters a one-size-fits-all approach to the problem, which is a critical flaw in effective pressure injury prevention practices.
“The complexity and dynamics associated with the development of a pressure injury, especially among surgical patients, make it difficult for nurses to take a blanket approach to preventing pressure injuries,” says Dana Tschannen, PhD, RN, a clinical professor at the University of Michigan School of Nursing in Ann Arbor. “We need to focus on ways to individualize care.”
It was the desire to individualize patient care that drove Dr. Tschannen and her colleague Christine Anderson, PhD, RN, a clinical associate professor at the University of Michigan School of Nursing, to pore over pressure injury risk data to identify gaps in assessment capabilities and create a more comprehensive model for predicting when the issues are likely to occur. Their research eventually led to the creation of the Pressure Injury Predictive Model (PIPM), which provides a more accurate picture of the complexity of contextual and process factors associated with pressure injury development. The PIPM uses six factors to determine a patient’s risk for developing a skin injury: pressure, tissue tolerance, friction and shear, patient characteristics, episode of care, and environment.