NDNIQI Pressure Injury Training Case Study
Scenarioswith complete solution
An 81 Y/O female was admitted to the oncology unit with metastatic cancer for
pain control. On day 4 of hospitalization, she suffered circulatory complications
and she was transferred to the step down unit. The pressure injury survey was
conducted on day 5 of hospitalization and her family verbally consented to have
her included in the pressure injury survey. The survey team found a large Stage 1
area of nonblanchable redness over her right ischial tuberosity.
Review of her hospital admission assessment record revealed her skin was
warm, dry, and intact. The skin assessment documented on arrival to the step
down unit noted a small Stage 1 pressure injury at this site.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Hospital Acquired Pressure Injury Only
Reasoning:
No pressure injury was identified at this site on the admission assessment record.
Therefore, the pressure injury developed after the patient was admitted to the hospital
and it is a hospital acquired pressure injury.
Review of the patient's record on transfer to the step down unit revealed the presence of
a Stage 1 pressure injury at this site. Therefore, the pressure injury was present upon
arrival to the unit and it is not a unit acquired pressure injury even though the area was
larger since arrival to the unit.
An 88 Y/O male was admitted with urosepsis to the step down unit from a local
long term care facility. On day 3 he was transferred to the medical-surgical unit.
The pressure injury survey was conducted on day 4 of hospitalization and the
survey team saw an unstageable pressure injury on the back of his head.
Review of the hospital admission assessment record revealed his skin was very
warm and dry with a pressure injury documented at this site. The skin
assessment documented on arrival to the medical-surgical unit also noted a
pressure injury at this site.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Community Acquired Pressure Injury
, Reasoning:
The injury was present on admission to the hospital as documented on the admission
assessment record; therefore, it is a community acquired pressure injury.
A 68 Y/O male was admitted to the ICU after a coronary artery bypass procedure.
He was unstable with several episodes of hypotension for 3 days and then began
to improve and stabilize. The pressure injury survey was conducted on day 6 of
hospitalization and the survey team saw a Stage 2 pressure injury over his
coccyx.
Review of his hospital admission assessment record revealed his skin was warm,
dry, and intact.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Hospital Acquired and Unit Acquired Pressure Injury
Reasoning:
No pressure injury was identified at this site on the admission assessment record.
Therefore, the pressure injury developed after the patient was admitted to the hospital
and it is a hospital acquired pressure injury.
He was originally admitted to the ICU where he remained until the pressure injury
survey. Therefore, the pressure injury was acquired on the unit and it is also a unit
acquired pressure injury.
A 56 Y/O female was admitted to the neurosurgical ICU after a 10 hour
neurosurgical procedure. On day 2, she was transferred to the medical-surgical
unit. The pressure injury survey was conducted on day 6 of hospitalization and
survey team saw a localized area of deep maroon colored intact skin (deep tissue
pressure injury) over her right iliac crest.
Review of her preoperative admission assessment record revealed her skin was
warm, dry, and intact. The skin assessment documented on arrival to the medical-
surgical unit noted the deep tissue pressure injury at this site.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Hospital Acquired Pressure Injury Only
Reasoning:
No pressure injury was identified at this site on the admission assessment record.
Therefore, the pressure injury developed after the patient was admitted to the hospital
and it is a hospital acquired pressure injury.
Scenarioswith complete solution
An 81 Y/O female was admitted to the oncology unit with metastatic cancer for
pain control. On day 4 of hospitalization, she suffered circulatory complications
and she was transferred to the step down unit. The pressure injury survey was
conducted on day 5 of hospitalization and her family verbally consented to have
her included in the pressure injury survey. The survey team found a large Stage 1
area of nonblanchable redness over her right ischial tuberosity.
Review of her hospital admission assessment record revealed her skin was
warm, dry, and intact. The skin assessment documented on arrival to the step
down unit noted a small Stage 1 pressure injury at this site.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Hospital Acquired Pressure Injury Only
Reasoning:
No pressure injury was identified at this site on the admission assessment record.
Therefore, the pressure injury developed after the patient was admitted to the hospital
and it is a hospital acquired pressure injury.
Review of the patient's record on transfer to the step down unit revealed the presence of
a Stage 1 pressure injury at this site. Therefore, the pressure injury was present upon
arrival to the unit and it is not a unit acquired pressure injury even though the area was
larger since arrival to the unit.
An 88 Y/O male was admitted with urosepsis to the step down unit from a local
long term care facility. On day 3 he was transferred to the medical-surgical unit.
The pressure injury survey was conducted on day 4 of hospitalization and the
survey team saw an unstageable pressure injury on the back of his head.
Review of the hospital admission assessment record revealed his skin was very
warm and dry with a pressure injury documented at this site. The skin
assessment documented on arrival to the medical-surgical unit also noted a
pressure injury at this site.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Community Acquired Pressure Injury
, Reasoning:
The injury was present on admission to the hospital as documented on the admission
assessment record; therefore, it is a community acquired pressure injury.
A 68 Y/O male was admitted to the ICU after a coronary artery bypass procedure.
He was unstable with several episodes of hypotension for 3 days and then began
to improve and stabilize. The pressure injury survey was conducted on day 6 of
hospitalization and the survey team saw a Stage 2 pressure injury over his
coccyx.
Review of his hospital admission assessment record revealed his skin was warm,
dry, and intact.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Hospital Acquired and Unit Acquired Pressure Injury
Reasoning:
No pressure injury was identified at this site on the admission assessment record.
Therefore, the pressure injury developed after the patient was admitted to the hospital
and it is a hospital acquired pressure injury.
He was originally admitted to the ICU where he remained until the pressure injury
survey. Therefore, the pressure injury was acquired on the unit and it is also a unit
acquired pressure injury.
A 56 Y/O female was admitted to the neurosurgical ICU after a 10 hour
neurosurgical procedure. On day 2, she was transferred to the medical-surgical
unit. The pressure injury survey was conducted on day 6 of hospitalization and
survey team saw a localized area of deep maroon colored intact skin (deep tissue
pressure injury) over her right iliac crest.
Review of her preoperative admission assessment record revealed her skin was
warm, dry, and intact. The skin assessment documented on arrival to the medical-
surgical unit noted the deep tissue pressure injury at this site.
For the pressure injury survey, this would be reported as:
a. Community Acquired Pressure Injury
b. Hospital Acquired Pressure Injury Only
c. Hospital Acquired and Unit Acquired Pressure Injury
Hospital Acquired Pressure Injury Only
Reasoning:
No pressure injury was identified at this site on the admission assessment record.
Therefore, the pressure injury developed after the patient was admitted to the hospital
and it is a hospital acquired pressure injury.
