Pressure ulcer prevention and care: preventing and managing pressure ulcers in long-term care: an overview of the revised federal regulation.

Although the Centers for Medicare and Medicaid Service's Federal Regulation as it relates to pressure ulcer prevention and care in long-term care facilities has not changed, the Guidance to Surveyors (F-314) has been expanded significantly. In addition to more clearly defining commonly used terms, the new guidance document emphasizes the use of pressure ulcer risk assessment and prevention strategies, pain assessment and treatment, and monitoring the care outcomes. The Centers for Medicare and Medicaid Service has clearly raised the bar on pressure ulcer care. Based on currently available evidence, the guidance document is clear in its intent to encourage all long-term care facilities to adopt evidence-based pressure ulcer protocols of care. This transition, and the development and implementation of this guidance document, may present considerable challenges to some long-term care facilities. However, the lack of ambiguity in the F-314 document and its consistency with currently available evidence may be helpful to staff and improve outcomes of care.