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Welcome to lesion two pressure injury for pressure injury. Fact, we will cover how to define and identify pressure in NP. The organization responsible for research and education, the Braden and Braden Q scales and the MOD database. We will also provide supporting materials for further development of your knowledge on pressure injuries. According to house and colleagues and the benchmarking to the International Pressure Ulcer Prevention Survey. In 2011, pressure ulcers are estimated to affect 2.5 million people annually to put that number in a visual. The population of Toronto, Canada, Chicago, Illinois and Houston, Texas are about 2.5 million people each every year. The entire population of Chicago Illinois is affected by pressure ulcers. This course will teach the student how to define and identify a pressure injury. It will explain in pu Braden, Braden Q and mod these databases organizations and assessments are being utilized around the country in an attempt to reduce injuries in the healthcare world. Pressure injuries occur because of a wide variety of conditions. One of those is microclimate, moisture in contact with the skin causing damage from outside. The nutritional deficiencies can cause and soft tissue to be more susceptible to damage. As we covered in the previous lecture, any obstructions to perfusion or flow of blood to the tissues can increase risk for pressure injury, comorbidities such as diabetes, stroke and lack of mobility often lead to pressure injuries in tissue conditions such as cancer, preexisting, pressure injuries and trauma can lead to pressure injuries as well. The NPUAP or National Pressure Ulcer Advisory panel published a pressure injury completes these things can be found on the NPUAP website at www dot NPUAP dot org. Their scale begins with healthy intact skin on the top left side with a healthy intact mucous membrane stage, one pressure ulcers, the the skin becomes slightly reddened. It is a non blanch erythema of intact skin. You might see a little redness, a little tenderness but it doesn't break the skin. Stage. Two pressure ulcers as seen in the top, right. Do in fact break the skin, you'll have partial thickness, loss of skin with exposed dermis. The wound bed is often pink or red and moist and may also present as an intact or ruptured blister. It is important that no fat tissue is seen. Any fat tissue that's seen would make that a stage three pressure injury as seen in the bottom left hand side stage IV pressure injuries break through the fat tissue and often expose muscle tendon ligament or cartilage, sometimes even bone, the unstageable pressure injury as seen in the bottom, right hand side is full thickness, skin and tissue loss in which the extent of the tissue damage within the ulcer cannot be confirmed. And according to the NPU website, if slough for Esker is removed, a stage three or four pressure injury will be revealed. A deep tissue pressure injury causes a persistent non Rodal red maroon or purple discoloration. The bran and Braden cu scales were developed to predict patients at risk for the Braden scale was initially published in 1987 by some nursing research. The Braden scale is for adults. The Braden Q scale is for pediatrics, both can often be found in the electronic medical record and are charted throughout a patient's course of hospitalization. This is the breathing scale for adults. You will notice that it covers sensory perception, moisture activity, mobility, nutrition, friction and shear. All of these are very important factors when looking at a patient's risk for pressure source. What's important to note is that a patient is at lower risk for pressure ulcers with a higher score. The lower the score, the higher the risk of pressure ulcers. A score of nine or less is a very high risk. A score of 19 to 23 is no risk of pressure ulcers. The brain and Q scale is very similar but is targeted for pediatrics. It also includes mobility activity, sensory perception, moisture, friction or shear, nutrition and tissue perfusion and oxygenation. This particular scale does include the risks with the scores at the bottom of the page. The MOD database is the manufacturer and user facility device experience database. It is produced by the FDA. It consists of reports from mandatory reporters and the general public on medical devices including topically applied lotions, creams and other substances. In this database. You will find things like 10 20 paste ec2, collodion electras of various kinds and how those affected that particular patient. You will also find a response from the FDA on their determination. What may have caused that particular experience or event. At the end of this section, you will find a link to all documents used in the creation of this particular material. Please note that none of the authors, companies or others involved in the production of the documents do support this particular educational material. We strongly suggest that you get your hands on some of these articles if possible in order to further improve your care of patients in their pressure injuries, you may now close the lesson and take the quiz.