Session Summary: This session equips PALTC providers with tools to accurately identify and document terminal ulcers resulting from skin failure. Misclassifying these lesions as avoidable pressure injuries can lead to regulatory citations, legal exposure, financial penalties, as well as provider, patient and family distress. Attendees will learn the pathophysiology of skin failure and to differentiate terminal ulcers from pressure-related injuries using clinical indicators and evidence-based frameworks. The session will also address best practices in documentation, interdisciplinary communication, and family education. Emphasis will be placed on diagnostic precision, ethical and compassionate care, and legal defensibility to reduce provider risk and improve outcomes at the end of life.
Learning Objectives:
At the completion of this session, learners will be able to:
Identify the multiple risk factors that predispose to skin failure including age, co-morbidities, medications, nutritional status and immobility. Gain confidence in Identifying the characteristics that differentiate an avoidable from an unavoidable pressure injury.
Apply the concepts of skin pathophysiology in relation to skin failure and to improve evaluation of skin ulcerations. Differentiate the confusing terminology used to describe terminal skin ulcers and consider a proposal to reach a consensus on diagnostic, similar to terms used for other organ systems, and applying them to the body's largest and most complex organ, the skin.
Mitigate the medical legal risks to medical providers and institutions by thorough documentation and use of appropriate terminology when evaluating a pressure injury. Decrease the stress on patients, families and medical providers by having compassionate and ethical discussions that offer accurate prognostications of life expectancy.
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