AMDA's Clinical Practice Guidelines for Pressure Ulcers and Pressure Ulcer Therapy

Release Date: September 2004

Slide notes for presentation

CME Information

Please read the following information before proceeding to the Post-Test and Evaluation Form

Eligibility for AMA PRA Credit

Physicians with current and valid licenses in the United States, Canada, or Mexico who read the continuing medical education content contained in this self-study Clinical Practice Guideline (CPG) on Pressure Ulcers and Pressure Ulcer Therapy and who complete the corresponding tests and evaluations and submit them to AMDA as directed at the bottom of the Post-Test and Evaluation Form will receive category 1 credit. There is a $14 fee for processing and mailing the credit certificate for this educational activity.

Physicians with current and valid licenses issued by one of the United States, Canadian, or Mexican licensing jurisdictions or who are engaged in residency training in an accredited program in the United States or Canada are eligible for category 1 credit. Physicians licensed in other countries are also welcome to participate in this CME activity. However, the AMA PRA is available only to physicians licensed by the jurisdictions described above and to International members of the AMA.

Three credit hours may be earned in category 1 toward the AMA PRA for completing the Pressure Ulcer and Therapy Guidelines and corresponding test and evaluation form.

Participants who review the program, complete the post-test, and receive a score of 70% or higher, can earn CME credit.  Participants who do not receive at least 70% on the post-test are permitted the opportunity to retake the same test one time with no additional fee.

Credit hours will be awarded for three years after the release date of the Clinical Practice Guidelines on Pressure Ulcers and Pressure Ulcer Therapy in Long Term Care.

Accreditation Statement

The American Medical Directors Association (AMDA) is accredited by the ACCME to provide continuing medical education to physicians.

Designation Statement

The American Medical Directors Association (AMDA) designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)^TM

Physicians should only claim credit commensurate with the extent of their participation in the activity.

Target Audience

This CME activity is intended for physicians who practice as medical directors and/or attending physicians as well as consultants, nurse practitioners, and other clinicians in the long term care continuum.

Statement of Need and Learning Objectives

• AMDA members have asked AMDA for ways to participate in self-assessment and self-study CME activities in verbal comments to staff and Education Committee members and in written comments on course evaluation forms.
• AMDA's Education Committee recognizes the need to diversify methods of delivery of CME and recognizes the value of providing distance learning opportunities through enduring materials for self-study.
• Topics and content are determined by ongoing needs assessment by the Clinical Practice and Education Committees using course evaluations, emerging issues in clinical practice, emerging issues in federal and state regulations and survey requirements, a review of the medical literature for long term care, and discussions with peers.

Needs addressed by this Clinical Practice Guideline include:

• prevalence of patients with pressure ulcers in institutional setting is between 2.5% and 24%;
• average of wounds per institutionalized patient is 1.6-2.5;
• incidence of pressure ulcers in nursing facilities is .20-.56/1,000 patient days, and may increase to 14/1,000 patient days among those at high risk;
• 70% of pressure ulcers occur in patients over the age of 70;
• wounds present physical, functional, and pshychosocial issues;
• wounds are often caused by medical conditions and give rise to medical complications;
• physicians must not perceive wounds solely as a nursing problem;
• prevention and managing wounds requires a cooperative, interdisciplinary team effort of members with varying skills.

AMDA provides this CME activity with the following objectives. By incorporating the information in this CPG into facility specific policies and procedures, practitioners should be able to:

• recognize medical conditions that create a risk to the patient of pressure ulcers.
• develop facility specific protocols, policies, and procedures to include all members of the care team in implementation of the guidelines.
• use the guidelines in conjunction with Minimum Data Sets, Resident Assessment Instruments, and Resident Assessment Protocols.
• weigh the effects of a workup against the burden of the workup in relation to the benefit of treatment to the patient and against patient or proxy preferences.
• determine when palliative care goals take precedence over standard guidelines for prevention and treatment of pressure ulcers.
• create individualized treatment plans for best practice.
• monitor the course of the condition to prevent further decline.
• use the algorithm in a step-by-step process to work through the identification, treatment, and monitoring cycles for pressure ulcers.

AMDA Disclaimer Statement

Readers understand that medical and scientific knowledge are constantly evolving. The views and treatment modalities of the authors are their own and may reflect innovations (including off-label or investigational use of medical products) and opinions not universally shared. Every effort has been made to assure the accuracy of the data presented in the context of accepted medical practice. Physicians should check specific details such as drug doses and contraindications, off-label uses, or other details in standard sources prior to clinical application. The views and treatment modalities of the authors are not those of the American Medical Directors Association (AMDA), but are presented in this forum to advance scientific and medical education.

Disclosures:
The test writer for this CPG disclosed they have no relevant financial relationships with any commercial interests to report.