Westford, MA (June 22, 2023) – The National Pressure Injury Advisory Panel has released the second version of their Standardized Pressure Injury Prevention Protocol - abbreviated as “SPIPP” (pronounced S – PIP). The SPIPP is a shortened checklist of preventive actions to implement at the bedside, adapted from the 2019 Guidelines on pressure injury prevention. As the EPUAP-NPIAP-PPIA guideline has gotten longer, it was important to create a streamlined evidence-based operational approach to prevention.
The second version of SPIPP is directed at the critically ill patient. Immobility is the common denominator in the risk of pressure injury development. The first item in the SPIPP checklist addresses current or anticipated mobility problems as a risk factor. Consistent with the guideline, SPIPP states that clinical judgement should be used to refine risk assessment and SPIPP lists those risk factors to aid in identification of the additional risk. Methods to redistribute pressure for bedbound and chairbound patients are addressed - such as turning patients every 2-3 hours to a 30-degree lateral angle, and to use wedges and move the upper leg forward when the patient is on his/her side.
Patients with dark skin tones are addressed in SPIPP 2.0, noting darkly pigmented skin as a risk factor. There is guidance on how to inspect darker skin tones to determine areas of pressure injury when the skin remains intact. Enhanced assessment methods are also identified as a method to determine early signs of pressure injury.
Skin care actions in the SPIPP encourage managing moisture and incontinence with the use of urinary and fecal management systems for high-risk patients, keeping the skin clean and moisturized, and appropriately using low friction textiles/breathable pads/and wicking materials in skin folds. Nutritional interventions include a screening assessment for malnutrition on admission and when to notify the dietician – such as for patients with (or at risk for) malnutrition as well as when the patient is not eating, has been NPO for over 48 hours or has an open/ulcerated wound.
The document reminds the staff to explain to the patient and family the risk for pressure injury and the plan for prevention.
Using a panel of experts from across the United States, the SPIPP 2.0 demonstrated acceptable validity with a content validity index of 0.93. The SPIPP offers a realistic and practical method to ensure pressure injury prevention efforts are provided at the patient’s bedside.
The entire SPIPP 2.0 can be downloaded for free on NPIAP’s web site HERE.
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