Search

Aim: The European Pressure Ulcer Advisory Panel, the Pan Pacific Pressure Injury Alliance, and the National Pressure Ulcer Advisory Panel are updating the 'Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline' (CPG) in 2019. The aim of this contribution is to summarize and to discuss the guideline development protocol for the 2019 update., Methods: A guideline governance group determines and monitors all steps of the CPG development. An international survey of consumers will be undertaken to establish consumer needs and interests. Systematic evidence searches in relevant electronic databases cover the period from July 2013 through August 2018. Risk of bias of included studies will be assessed by two reviewers using established checklists and an overall strength of evidence assigned to the cumulative body of evidence. Small working groups review the evidence available for each topic, review and/or draft the guideline chapters and recommendations and/or good practice statements. Finally, strength of recommendation grades are assigned. The recommendations are rated based on their importance and their potential to improve individual patient outcomes using an international formal consensus process., Discussion: Major methodological advantages of the current revision are a clear distinction between evidence-based recommendations and good practice statements and strong consumer involvement., Conclusion: The 2019 guideline update builds on the previous 2014 version to ensure consistency and comparability. Methodology changes will improve the guideline quality to increase clarity and to enhance implementation and compliance. The full guideline development protocol can be accessed from the guideline website (http://www.internationalguideline.com/)., (Copyright © 2019. Published by Elsevier Ltd.)

Aims and Objectives: The aim of this study was to examine interrater reliability and agreement of the diagnosis of moisture lesions as defined by the European Pressure Ulcer Advisory Panel., Background: Differentiation between superficial pressure ulcers and moisture-related skin damages is difficult. To enhance the precision of the identification of moisture lesions, the European Pressure Ulcer Advisory Panel provided wound- and patient-related characteristics. Empirical evidence regarding interrater reliability and agreement among nurses for the detection of moisture-related skin damages in clinical practice is lacking., Design: Observational., Methods: Home care clients (n = 339) were independently assessed twice by trained nurses. A head to toe skin inspection was conducted., Results: For the diagnosis of moisture lesion (yes/no), nurses exactly agreed in 95% of all assessed clients. Interrater reliability was intraclass correlation coefficient (1,1) = 0.67 (95% CI 0.61-0.73)., Conclusions: Nurses were able to differentiate between home care clients with and without moisture lesions but assessment results contained a high degree of measurement error. It seems that the descriptions for the identification of moisture lesions provided by the European Pressure Ulcer Advisory Panel do support the diagnostic process but reliability must be enhanced., Relevance to Clinical Practice: Because of low interrater reliability, it is questionable whether the diagnosis of moisture lesions in clinical practice is valid. Measurement error is too high to make adequate inferences for individuals. Definitions and descriptions provided by the European Pressure Ulcer Advisory Panel, provisions of a single training and images are not sufficient to achieve acceptable interrater reliability in clinical practice.