The Bermuda Triangle: Where Pressure Injury, Skin Failure and Unavoidable Pressure Injury Meet.

Pressure injury, skin failure and unavoidable pressure injury may co-exist at times and create a Bermuda triangle of confusion for the clinician. A recent think tank hosted by NPIAP furthered the discussion by examining a condition often called skin failure in the critically ill. Join us to hear the results of the think tank's discussion on skin failure and how these 3 concepts overlay each other leading to clinical questions of "Can I determine the cause by just looking at the wound?” Can I just tell by looking at the wound what the cause was ?" "Do we have to count it?' "Does skin failure only occur on the sacrum?" “Can skin failure go deeper than the skin?”" “What are reliable strategies for determining when a pressure injury is unavoidable?”

This live session of NPIAP's 2024 Virtual Fall Conference will take place on Wednesday, November 13th from 11:00AM-1:00PM CT. A recording of the session will be available within 24 hours after the session has ended.

Joyce Black, PhD, RN, FAAN

Joyce M. Black, PhD, RN is the Florence Neidfelt Professor in the College of Nursing at the University of Nebraska Medical Center in Omaha, Nebraska. She is the current President of the National Pressure Injury Advisory Panel, having previously served as President, Vice-President and Secretary. Dr Black served as the co-chair of the task force to update the definitions of the stages of pressure injury including medical device pressure injury. Dr. Black has received many awards for her work in pressure injury, most recently the Kosiak award from NPIAP for her work in rediscovering deep tissue pressure injury.

Janet Cuddigan, PhD, RN, FAAN

Dr. Cuddigan is Professor Emeritus at the University of Nebraska Medical Center in Omaha, Nebraska. She is a former president of the National Pressure Injury Advisory Panel (NPIAP). She currently serves as the Chair of the International Pressure Injury Guideline Governance Group.

Jill Cox, PhD, RN, APN-c, CWOCN, FAAN

Dr. Jill Cox is a clinical professor of nursing at Rutgers University and an advanced practice nurse, with a subspecialty in wound, ostomy, and continence nursing in the acute care setting. Dr. Cox currently serves as a U.S. member of the guideline governance group for the development of the 2025 International Pressure Injury Prevention and Treatment guideline. She is a former board of director for the NPIAP. Dr. Cox’s research interests include pressure injury risk detection and pressure injury prevention in the hospitalized patient population, with a specific focus on pressure injuries in critical care patients. She is also a member of the Center for Health Equity and Systems Research (CHESR) at Rutgers School of Nursing.”

Kathleen Vollman, MSN, RN, CCNS, FCCM, FCNS, FAAN

Ms Vollman is a Critical Care Clinical Nurse Specialist and Consultant. She has published & lectured nationally and internationally on a variety critical care, prevention of health care acquired injuries including pressure injury and HAI’s and serves as a subject matter expert on these topics for the American Hospital Association. From 1989 to 2003 she function as a Clinical Nurse Specialists for the medical ICU’s at Henry Ford Hospital in Detroit Michigan.

1. Identify one clinical dilemma surrounding high-risk patients when trying to prevent pressure injury.
2. List foundational concepts that recur in the evidence supporting the phenomenon of skin failure
3. Delineate the conclusions of the think tank on skin failure and pressure injuries in critically ill patients.
4. Define unavoidable pressure injury. Discuss current knowledge of unavoidable pressure injury.