The data from these surveys
from 2006 to 2009 demonstrated an increasing trend
in hospital acquired pressure ulcers (HAPUs) (see
Fig. 1) with approximately 22% of these wounds
occurring on units caring for surgical patients (see
Fig. 2). In 2008 the Centers for Medicare and Medicaid
Services (CMS), the largest U.S. payer of medical
care for the elderly, issued a ruling denying hospitals
reimbursement for care for Stage 3 and 4 pressure
ulcers that developed during hospitalization.Our
data coupled with the CMS ruling provided the impetus
for the development of an action plan to reverse
this trend. While wound and ostomy nurses possess
advanced knowledge in the assessment, treatment
and prevention of pressure ulcers and serve as an
important resource for staff nurses, there is insufficient
time for the limited number of these nurses to
educate an adequate number of staff to effectively