October 2017 April 2016

Te Puawai As the prevention of pressure injuries is a nursing care indicator, it seems logical to let the nursing profession lead a national pressure injury prevention program. The nursing profession understands as no other health care professional the tension in providing optimal care to the client. Connecting with other similar international pressure injury prevalence programs is another way to move forward. It provides New Zealand with the opportunity to gain insight as to how other countries handle the issue of preventing pressure injuries. New Zealand can learn from these initiatives and other countries can learn from what is done in New Zealand. Good international example of programs that measure pressure injury indicators at structure, process and outcome are the CALNOC study in the US (Stotts, Brown, Donaldson, Aydin, & Fridman, 2013) and the LPZ study of the University of Maastricht in the Netherlands, both programs have existed for over 15 years and have a wealth of data (Halfens et al., 2013). The School of Nursing at Massey University is currently running this program in New Zealand. Another great example of international collaboration is the participation of the New Zealand Wound Care Society in establishing the new International Pressure Injury Guidelines (Haesler (Ed.), 2014). In conclusion, the problem of pressure injuries has been around for some time. Over the last 75 years considerable attention has been given to get a better aetiological understanding of the problem. Despite a better understanding it has become evident that most pressure injuries are caused due to a failure of continuity of care. As such, preventing them requires a system based approach. Currently New Zealand can only estimate the burden of pressure injuries due to inconsistencies and underreporting. Measuring progress using Donabedians quality model (structure process and outcomes) provides an adequate strategy for preventing pressure injuries in New Zealand. The nursing profession should lead this important work and connect with existing international programs to build partnerships and accelerate learning. Bibliography Black, J. M. Edsberg, L. E., Baharestani, M. M., Langemo, D. Goldberg, M. McNichol, L., & Cuddigan, J. (2011). Pressure ulcers: avoidable or unavoidable? Results of the National Pressure Ulcer Advisory Panel Consensus Conference. Ostomy/wound Management, 57(2), 24–37. Blake, S. (2012). A collaborative National Approach to Reducing Preventable Harm. Quality of care indicator mapping: Falls injury prevention and pressure injury prevention. All District Health Boards. Retrieved from https://www.hqsc.govt.nz/assets/Falls/Reducing-preventable-harm-reportOct2012.pdf Bouten, C. (1996). Etiology and pathology of pressure sores: a literature review. Eindhoven: Department of Computational and experimental Mechanics, Eindhoven University of Technology. Defloor, T. (1999). The risk of pressure sores: a conceptual scheme. Journal of Clinical Nursing, 8(2), 206–216. Donabedian, A. (1966). Evaluating the quality of medical care. The Milbank Memorial Fund Quarterly, 44(3), Suppl:166–206. © Te Puawai College of Nurses Aotearoa (NZ) Inc 7

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