Monday, June 5, 2023
This activity is intended for nurses, nurse practitioners, and other healthcare professionals providing care to patients at risk for pressure ulcers.
The goal of this activity is to improve understanding of risk factors for pressure ulcers with the goal of minimizing incidence.
Upon completion of this activity, participants will be able to:
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Medscape, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
Awarded 0.5 contact hour(s) of continuing nursing education for RNs and APNs; none of these credits is in the area of pharmacology.
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and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page.
Follow these steps to earn CME/CE credit*:
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CE Released: 3/11/2010
Valid for credit through: 3/11/2011
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Controversy is usually considered undesirable -- in the same category as conflict, discord, and disagreement. However, when it takes the form of respectful dialogue rather than debate, controversy can transform opinion and even give rise to unexpected progress. One hopes, for the benefit of all concerned, that the current controversy surrounding pressure ulcers might bring about a similarly positive outcome.
About a year ago, the Centers for Medicare & Medicaid Services (CMS) halted additional payments to hospitals for selected conditions that were acquired in the hospital (in other words, not present when the patient was admitted). One of these conditions was the pressure ulcer, which CMS asserted "could reasonably have been prevented through the application of evidence-based guidelines." This regulation was known as the Inpatient Prospective Payment System Fiscal Year 2009 Final Rule (IPPS FY 2009 Final Rule).[1] In the IPPS FY 2009 Final Rule, CMS hedges a bit with language. The rule does not state unequivocally that pressure ulcers are always or entirely preventable -- only that they are reasonably preventable. However, no recourse exists for hospitals to receive any additional reimbursement for the treatment of hospital-acquired pressure ulcers, even if clinicians deem them unavoidable.
A reduction in reimbursement is not the only consequence of the CMS ruling. The assertion by CMS that pressure ulcers can be prevented raises the legal stakes for nurses because the ruling essentially implies that if a pressure ulcer occurs during hospitalization, it must be the result of inadequate nursing care. Patients, families, attorneys, the courts, juries, and the public will now believe that pressure ulcers can be always be prevented with adequate vigilance and care, leaving nurses and hospitals open to lawsuits every time a pressure ulcer appears to have its onset during hospitalization.[2]
