b'VA Battles Potentially Deadly Pressure Injuries; Veteran Patients at Higher RiskPressure injuries, commonly known as bedsores, often can be deadlier then the condition that originally caused patients to be bedbound. Veterans are particularly at risk as a result of age, frailty and a high rate of spinal cord injuries. Preventing the condition and managing pressure ulcers when they occur has been an ongoingand extremely expensivebattle for the VA.By Annette M. BoyleHANOVER, NHFor 60,000 Americans each year,The 2022 congressional appropriations bill included the illness or injury that sent them to a hospital orfundingfortheVAtoadopttheInternational nursing home will prove less deadly than the pres- Guideline for Prevention and Treatment of Pressure sure injuries they acquire while bedbound at the fa- Ulcers/Injuries. Given the impact of PIs in U.S. VA cility. Pressure injuries, which are largely prevent- facilities,theVAappropriationsbillrecommends able, affect approximately 2.5 million patients, costincorporating best practices for PI prevention, spe-the U.S. healthcare system an estimated $26 billioncifically the Standardized Pressure Injury Prevention annually and rank among the top 10 causes of deathProtocols (SPIPP) checklist, said members of the in this country. NationalPressureInjury AdvisoryPanel(NPIAP) Veterans are particularly at risk as a result of age,in an editorial in Advances in Skin & Wound Care. 3 frailty and a high rate of spinal cord injuries (SCIs).The SPIPP checklist is a one-page tool based on Nearly one-third of patients with spinal cord inju- the International Guideline to implement key com-ries develop pressure injuries (PIs) within a year ofponents of prevention including skin check and risk the injury occurring. Further, these wounds often doassessment,repositioning,moistureandinconti-not resolve quickly upon discharge from a hospital.nence management, support surfaces, and nutrition.A recent study by researchers at the VA North TexasIn addition, the National Institutes of Health (NIH) Health Care System in Dallas found that nearly halfrecently added pressure injury to a spending tracker of grade 3 or 4 pelvic PIs in veterans with SCIs hadso we can begin to see what studies are funded in not healed 12 months after discharge. 1 the topic across institutes, NPIAP Immediate Past ServicemembersinjuredincombatalsofaceanPresident William Padula, PhD, told U.S. Medicine. increasedriskofpressureinjuries,alsoknownasIn contrast, DOD has earmarked up to $20 million pressure ulcers or bedsores. A team at the Universitythat can be spent on pressure injury specific studies of Washington School of Nursing noted that, underthrough the PRMRP funding mechanism. So far they operational conditions, it would be expected thathave not maxed spending at that threshold, and tend casualties would suffer skin damage within 2 to 5to hover in the range of a few million dollars in sup-hours. 2Once those casualties arrive at a hospital,port for research across several health technologies.those PIs will require prompt, consistent attention.ItsnowonderPIshavecapturedtheattention Even without the challenges of spinal cord injuriesoflawmakersandfundingagencies.Padula,who or rugged environments for initial care, veterans runis also an assistant professor of Pharmaceutical & a significant risk of acquiring PIs in hospitals andHealth Economics in the School of Pharmacy and a nursing homesand both the VA and Congress havefellow in the Leonard D. Schaeffer Center for Health taken note. Policy and Economics at the University of Southern 43'