Skip to main content

Evidence to Improve Care

Pressure Injuries

Care for Patients in All Settings

Click below to see a list of brief quality statements and scroll down for more information.​​


Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence. ​

See below for the quality statements and click for more detail.​


Quality Statement 1: Risk and Skin Assessment
People with at least one risk factor for developing a pressure injury undergo a comprehensive risk assessment, including a skin assessment, to determine their level of risk. Those at risk are reassessed on an ongoing basis.


Quality Statement 2: Patient Education and Self-Management
People who have developed or are at risk of developing a pressure injury and their families and caregivers are offered education about pressure injuries, including an overview of the condition; the importance of mobilization and repositioning for pressure redistribution; and who to contact in the event of a concerning change.


Quality Statement 3: Comprehensive Assessment
People with a pressure injury undergo a comprehensive assessment, including an evaluation of risk factors that affect healing to determine the healing potential of the wound.


Quality Statement 4: Individualized Care Plan
People who have developed or are at risk of developing a pressure injury have a mutually agreed-upon individualized care plan that identifies patient-centred concerns and is reviewed and updated regularly.


Quality Statement 5: Support Surfaces
People who have developed or are at risk of developing a pressure injury are provided with appropriate support surfaces based on their assessment.


Quality Statement 6: Repositioning
People who have developed or are at risk of developing a pressure injury receive interventions that enable repositioning at regular intervals, encouraging people to reposition themselves if they are mobile or helping them to do so if they cannot reposition themselves.


Quality Statement 7: Wound Debridement
People with a pressure injury have their wound debrided if it is determined as necessary in their assessment, and if it is not contraindicated. Debridement is carried out by a trained health care professional using an appropriate method.


Quality Statement 8: Local Infection Management
People with a pressure injury and a local infection receive appropriate treatment, including antimicrobial and non-antimicrobial interventions.


Quality Statement 9: Deep/Surrounding Tissue Infection or Systemic Infection Management
People with a pressure injury and suspected deep/surrounding tissue infection or systemic infection receive urgent assessment (within 24 hours of initiation of care) and systemic antimicrobial treatment.


Quality Statement 10: Wound Moisture Management
People with a pressure injury receive wound care that maintains the appropriate moisture balance or moisture reduction in the wound bed.


Quality Statement 11: Surgical Consultation
People who are adherent to treatment and have a stage 3 or 4 healable pressure injury that is not responding to optimal care are referred for a surgical consultation to determine their eligibility for surgical intervention.


Quality Statement 12: Health Care Provider Training and Education
People who have developed or are at risk of developing a pressure injury receive care from health care providers with training and education on the assessment and treatment of pressure injuries.


Quality Statement 13: Transitions in Care
People with a pressure injury who transition between care settings have a team or provider who is accountable for coordination and communication to ensure the effective transfer of information related to their care.

12

Health Care Provider Training and Education

People who have developed or are at risk of developing a pressure injury receive care from health care providers with training and education on the assessment and treatment of pressure injuries.


People who have developed or are at risk of developing a pressure injury benefit from improved outcomes from individualized care by health care professionals who have specific, comprehensive training and education in the appropriate assessment and management of these types of wounds. Training and education materials or programs are additional to entry-level programs and should be tailored to providers’ roles and responsibilities.

For Patients

You should receive care from a team of health care professionals who have been trained to care for people who have a pressure injury or are at risk for one.


For Clinicians

Ensure that you have the training and education required to effectively provide care (including assessments, strategies for prevention, and treatments) for people who have developed or are at risk of developing a pressure injury, in accordance with your professional role.


For Health Services

Ensure that health care providers caring for people who have developed or are at risk of developing a pressure injury have training and education in how to carry out comprehensive assessments and provide appropriate prevention strategies and treatments.

Structural Indicator

Local availability of providers trained in the assessment and management of pressure injuries

Risk factors

These include:

  • Admission to a health care facility (such as acute care, complex continuing care, rehabilitation, or long-term care)

  • Impaired or limited mobility

  • Use of an assistive device, such as a wheelchair

  • Use of medical devices, such as tubes

  • Inability to reposition oneself

  • Limited ability or inability to feel pain or pressure

  • Nutritional deficiency

  • Being underweight

  • Cognitive impairment

  • Past or current pressure injuries


Provider training and education

These should include the following skills and information, at a minimum:

  • Techniques for providing effective patient education (Quality Statement 2)

  • Information for all health care providers (for prevention of initial ulceration and recurrence) on:

    • How to identify people at risk and complete a skin assessment (Quality Statement 1)

    • How to identify pressure damage (Quality Statement 1)

    • Methods and actions for preventing new or further damage

    • Who to contact for further information

  • Assessment and treatment information for health care providers who care for people who have developed or are at high risk for developing a pressure injury, including:

    • How to carry out a comprehensive assessment, including risk and skin assessment (Quality Statements 1 and 3), and individualized care planning (Quality Statement 4)

    • How to support regular repositioning and encouraging people to reposition themselves if they are mobile or helping them to do so if they cannot reposition themselves (Quality Statement 6), and information on support surfaces (Quality Statement 5)

    • Who to contact for advice and support

    • Treatment, including local wound care (Quality Statements 7, 8, 9, and 10)

    • Preventing recurrence

Let’s make our health system healthier

Join Our Patient, Family and Public Advisors Program

Patients, families and the public are central to improving health quality.


Claude Lurette and Kowsiya Vijayartnam, Health Quality Ontario Patient, Family and Caregiver Advisors Council Co-Chairs

Sign up for our newsletter

Are you passionate about quality health care for all Ontarians? Stay in-the-know about our newest programs, reports and news.

Health Quality Connect - Health Quality Ontario's newsletter - on an iPad and a cell phone