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The Role of Nutrition for Pressure Injury Prevention and Healing

Abstract
GENERAL PURPOSE
To review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline with further discussion of nutrition for pressure injury management in the context of the recommendations.

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant should be better able to: 1. Distinguish nutrition and malnutrition, especially as they relate to the development and healing of pressure injuries.
2. Differentiate the tools and techniques that help clinicians assess nutrition status as well as the causes of pressure injuries in specific populations.
3. Identify interventions for improving nutrition status and promoting pressure injury healing.
Macro- and micronutrients are required by each organ system in specific amounts to promote the growth, development, maintenance, and repair of body tissues. Specifically, nutrition plays an important role in the prevention and treatment of pressure injuries. The purpose of this manuscript is to review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. Nutrition for pressure injury management is discussed in the context of the recommendations.

INTRODUCTION
Nutrition plays an important role in the prevention and treatment of pressure injuries (PIs). Macro- and micronutrients are required by each organ system in specific amounts to promote growth, development, maintenance, and repair of body tissues. The 2019 European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Injury Advisory Panel (NPIAP), and Pan Pacific Pressure Injury Alliance (PPPIA) Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline (EPUAP/NPIAP/PPPIA CPG) provides guidance on the prevention and management of PIs.1 This guideline was a collaboration between the EPUAP, NPIAP, and PPPIA with the assistance of 14 associate organizations. The goal of this international collaboration was to provide an updated, comprehensive review of the research literature and develop recommendations reflecting recent evidence. The intent is for health professionals around the world to use the recommendations generated to prevent and treat PI.

The purpose of this article is to review the nutrition-related recommendations presented in the EPUAP/NPIAP/PPPIA CPG, and to discuss nutrition for PI management in the context of the recommendations. The recommendations were developed using a rigorous methodology outlined in the guideline in print and online (internationalguideline.com). Each recommendation includes a list of implementation considerations. Table 1 presents the nutrition-related recommendations from the EPUAP/NPIAP/PPPIA CPG, including the strengths of evidence and assigned recommendations. With the recommendations presented in Table 1 in mind, this article will discuss the underpinning research and the context in which the recommendations are implemented in the nutritional management of individuals with or at risk of PIs.

More information

Type
Journal Article
Author
Munoz N
Posthauer M
Cereda E
Schols J
Haesler E