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A descriptive comparison study was carried out to determine whether there was a difference between a staff nurse's single-item pressure ulcer risk assessment and a risk assessment using the Braden Scale. Seventy-two medical patients participated in the study. Statistical analysis of the data indicated nurses were accurate in predicting pressure ulcer risk with a simple YES/NO answer. The mean Braden Score for those patients indicated at risk by the nurse was 14.45, and 20.24 for those assessed to be not at risk. This study indicates that nurses' good judgement is as reliable as more complicated tools in determining pressure ulcer risk. Further studies comparing risk assessment tools are recommended.

The Agency for Health Care Policy and Research (AHCPR) guidelines for pain management, urinary incontinence, and pressure ulcers emphasize the importance of patient and family education. Patient teaching strategies are discussed by using the example of pressure ulcer management. The family is invited into an educational partnership through needs assessment and mutual goal setting. Teaching strategies that involve the learner and are adapted for the home setting are most effective. Evaluation of teaching should be in terms of patient outcomes.

Complete and careful observation, description and documentation of pressure ulcers is an essential component of practice when caring for people with pressure ulcers. Photographing pressure ulcers and including the photo as part of the patient's chart provides a useful adjunct to the written record. While a "picture is worth a thousand words," photographs can be misleading unless they are consistently taken according to specific guidelines. Techniques to enhance photographic results and avoid common errors are discussed.

Teaching assessment of patients with pressure ulcers involves the teaching of assessment of the total person as well as at-risk potential, daily examination of skin, and accurate assessment of progress or regression of a pressure ulcer. Suggestions and references are provided for teaching each of these aspects of assessment.

These guidelines are presented in a user-friendly format for quick reference in daily practice. The goals are to: 1) identify at-risk individuals needing prevention and the specific factors placing them at risk; 2) maintain and improve tissue tolerance to pressure in order to prevent injury; 3) protect against the adverse effects of external mechanical forces; and 4) reduce the incidence of pressure ulcers through educational programs. An algorithm helps to specify appropriate prevention measures.

Collaboration among all healthcare disciplines leads to success in planning strategies to prevent, treat, or heal pressure ulcers. Collaboration requires a respect for each discipline's scope of knowledge and uniqueness of functions as well as cooperation and communication in all aspects of patient care. The patient should be considered the quarterback and all the disciplines are merely the players.

The purpose of this study was to assist in assessing the validity and reliability of adaptation of the Knoll Tool, Assessment of Pressure Ulcer Potential. Data were retrospectively collected from charts of a random sample of patients (n = 62) who were admitted to a tertiary care facility. Total risk scores ranged from 0 to 22 with a mean of 8.7 and a standard deviation of 6.37. The alpha for the total assessment tool was .6352 with a standardized item alpha of .5973. Discriminant analysis predicted group membership at 62.9%. Group membership was most accurately predicted in Group 1 (76.9%). Discriminant analysis using a score of 11 predicted only 46.8% of group membership, although Group 1 predicted 88.5% and Group 4 predicted 85.7%. Low predictions may be related to small sample size.