Quality Standard Details
Pressure Injuries: Care for Patients in All Settings
- Publication Date
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2017-December-01
- Status
- Published
- Topic Area
- Injuries, Accidents and Wounds
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Wounds represent a significant burden for patients, their caregivers and families, clinicians, and the Ontario health system, but the human and financial costs of wounds are not fully appreciated. People with pressure injuries report low levels of health-related quality of life, high rates of depression, and high rates of pain and discomfort. Pressure injuries are more likely to occur in people who are older; reside in long-term or critical care settings; are acutely or seriously ill; have experienced trauma; or have a spinal cord injury, a fractured hip, a neurological condition, diabetes, impaired mobility, or nutritional deficiency.
Wound care represents a significant area of opportunity for quality improvement in Ontario. Previous efforts to improve the coordination and delivery of wound care across the province have highlighted the inconsistent application of best practice guidelines, a lack of standardized documentation, tracking of wound outcome measures, and poor coordination of care.
This quality standard focuses on care for people who have developed or are at risk of developing a pressure injury. The scope of the standard covers all settings, including primary care, home and community care, long-term care, and acute care. It also provides guidance on optimal care when a person transitions between these settings – for example, when someone is discharged from a hospital to their home or a long-term care home.
Quality Standard in Brief
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Quality Statement 1: Risk and Skin Assessment
People with at least one risk factor for developing a pressure injury undergo a comprehensive risk assessment, including a skin assessment, to determine their level of risk. Those at risk are reassessed on an ongoing basis.
Quality Statement 2: Patient Education and Self-Management
People who have developed or are at risk of developing a pressure injury and their families and caregivers are offered education about pressure injuries, including an overview of the condition; the importance of mobilization and repositioning for pressure redistribution; and who to contact in the event of a concerning change.
Quality Statement 3: Comprehensive Assessment
People with a pressure injury undergo a comprehensive assessment, including an evaluation of risk factors that affect healing to determine the healing potential of the wound.
Quality Statement 4: Individualized Care Plan
People who have developed or are at risk of developing a pressure injury have a mutually agreed-upon individualized care plan that identifies patient-centred concerns and is reviewed and updated regularly.
Quality Statement 5: Support Surfaces
People who have developed or are at risk of developing a pressure injury are provided with appropriate support surfaces based on their assessment.
Quality Statement 6: Repositioning
People who have developed or are at risk of developing a pressure injury receive interventions that enable repositioning at regular intervals, encouraging people to reposition themselves if they are mobile or helping them to do so if they cannot reposition themselves.
Quality Statement 7: Wound Debridement
People with a pressure injury have their wound debrided if it is determined as necessary in their assessment, and if it is not contraindicated. Debridement is carried out by a trained health care professional using an appropriate method.
Quality Statement 8: Local Infection Management
People with a pressure injury and a local infection receive appropriate treatment, including antimicrobial and non-antimicrobial interventions.
Quality Statement 9: Deep/Surrounding Tissue Infection or Systemic Infection Management
People with a pressure injury and suspected deep/surrounding tissue infection or systemic infection receive urgent assessment (within 24 hours of initiation of care) and systemic antimicrobial treatment.
Quality Statement 10: Wound Moisture Management
People with a pressure injury receive wound care that maintains the appropriate moisture balance or moisture reduction in the wound bed.
Quality Statement 11: Surgical Consultation
People who are adherent to treatment and have a stage 3 or 4 healable pressure injury that is not responding to optimal care are referred for a surgical consultation to determine their eligibility for surgical intervention.
Quality Statement 12: Health Care Provider Training and Education
People who have developed or are at risk of developing a pressure injury receive care from health care providers with training and education on the assessment and treatment of pressure injuries.
Quality Statement 13: Transitions in Care
People with a pressure injury who transition between care settings have a team or provider who is accountable for coordination and communication to ensure the effective transfer of information related to their care.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Technical specifications
Last Updated: February 24, 2026
