Using the PUSH Tool
Clinicians and educators can use the the Pressure Ulcer Healing Scale (called the PUSH Tool by the National Pressure Ulcer Advisory Panel [NPUAP], which has copyrighted it) as long as they use it for educational, research, and practice purposes. Other uses require written permission and possibly royalty fees. The only requirement is that users acknowledge the NPUAP and the version number of the tool on any hard-copy or electronic reproduction.
The NPUAP also cautions that PUSH is "a research-validated tool. Therefore, we recommend that the content of the tool not be altered or modified by individual users. If you chose to modify the tool, please note that you have made modifications after citing the NPUAP as the original source." (The Push Tool and accompanying Pressure Ulcer Healing Chart are shown on pp. 66-67.)
The NPUAP offers the following suggestions for use of the two documents:
Clinical users indicate that the PUSH Tool is readily adopted and easy to use. Using a pocket calculator will facilitate accurate length and width calculations. The NPUAP recommends use of the PUSH Tool at regular intervals. The federal Agency for Health Care Policy and Research Treatment Guideline recommends assessments be performed at least weekly and if the condition of the patient or of the wound deteriorates. The pressure ulcer healing chart (which is attached to the PUSH Tool) will allow you to graph PUSH Tool scores over time for each ulcer. You should be able to tell at a glance whether the ulcer is healing, unchanged, or deteriorating. If you have any questions regarding use of the PUSH Tool, contact the NPUAP at (716) 829-3516 or via e-mail at [email protected].
When introducing any new assessment tool, staff should be educated regarding appropriate use of the tool through formal education programs. The NPUAP recommends demonstrating use of the tool on actual patients and conducting interrater reliability checks (i.e., comparing assessments made by experienced and new users).
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