European Pressure Ulcer Advisory Panel, National Pressure Injury AdvisoryPanel, Pan Pacific Pressure Injury Advisory Panel. Prevention and treatment of pressure ulcers/injuries: clinical practice guideline. 2019. https// (accessed 8 November 2022)

Gillespie P, Carter L, McIntosh C, Gethin G. Estimating the health-care costs of wound care in Ireland. J Wound Care. 2019; 28:(6)324-330

Guest JF, Fuller GW, Vowden P, Vowden KR. Cohort study evaluating pressure ulcer management in clinical practice in the UK following initial presentation in the community: costs and outcomes. BMJ Open. 2018; 8:(7)

Nguyen KH, Chaboyer W, Whitty JA. Pressure injury in Australian public hospitals: a cost-of-illness study. Aust Health Rev. 2015; 39:(3)329-336

Wood J, Brown B, Bartley A Reducing pressure ulcers across multiple care settings using a collaborative approach. BMJ Open Qual. 2019; 8:(3)

Eldridge N, Wang Y, Metersky M Trends in adverse event rates in hospitalized patients, 2010–2019. JAMA. 2022; 328:(2)173-183

Canadian Patient Safety Institute. Never events for hospital care in canada: safer care for patients. https// (accessed 8 November 2022)

Australian Commission on Safety and Quality and Healthcare. Hospital-acquired complication - pressure injury. 2018. https// (accessed 8 November 2022)

Prevention and treatment of pressure ulcers: clinical practice guideline. In: Cuddigan J (ed.). : NPUAP; 2009

Prevention and treatment of pressure ulcers: clinical practice guideline. In: Haesler E (ed.). : Cambridge Media; 2014

Chaboyer WP, Thalib L, Harbeck EL Incidence and prevalence of pressure injuries in adult intensive care patients: a systematic review and meta-analysis. Crit Care Med. 2018; 46:(11)e1074-e1081

Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020; 105

Triantafyllou C, Chorianopoulou E, Kourkouni E Prevalence, incidence, length of stay and cost of healthcare-acquired pressure ulcers in pediatric populations: a systematic review and meta-analysis. Int J Nurs Stud. 2021; 115

Shiferaw WS, Akalu TY, Mulugeta H, Aynalem YA. The global burden of pressure ulcers among patients with spinal cord injury: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2020; 21:(1)

Anthony D, Alosoumi D, Safari R. Prevalence of pressure ulcers in long-term care: a global review. J Wound Care. 2019; 28:(11)702-709

Grimshaw JM, Schünemann HJ, Burgers J Disseminating and implementing guidelines: article 13 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012; 9:(5)298-303

Kottner J, Haesler E. The dissemination of the prevention and treatment of pressure ulcers clinical practice guideline 2014 in the academic literature. Wound Repair Regen. 2020; 28:(4)580-583

Agency for Healthcare Research and Quality (AHRQ). Communication and dissemination strategies to facilitate the use of health-related evidence. 2013. https// (accessed 8 November 2022)

Kottner J, El Genedy-Kalyoncu M. The uptake of the international pressure ulcer/injury prevention and treatment guidelines in the scientific literature: a systematic analysis of two major citation databases. J Tissue Viability. 2022;

Schipper K, Bakker M, De Wit M Strategies for disseminating recommendations or guidelines to patients: a systematic review. Implement Sci. 2015; 11:(1)

United Nations. List of least developed countries (as of 24 November 2021). 2021. https// (accessed 8 November 2022)

Lau N, O'Daffer A, Yi-Frazier JP, Rosenberg AR. Popular evidence-based commercial mental health apps: Analysis of engagement, functionality, aesthetics, and information quality. JMIR Mhealth Uhealth. 2021; 9:(7)

Gordon WJ, Landman A, Zhang H, Bates DW. Beyond validation: getting health apps into clinical practice. NPJ Digit Med. 2020; 3:(1)

Koepp J, Baron MV, Hernandes Martins PR The quality of mobile apps used for the Identification of pressure ulcers in adults: systematic survey and review of apps in app stores. JMIR Mhealth Uhealth. 2020; 8:(6)

Kottner J, Cuddigan J, Carville K Prevention and treatment of pressure ulcers/injuries: the protocol for the second update of the international clinical practice guideline 2019. J Tissue Viability. 2019; 28:(2)51-58

Nouri R, R Niakan Kalhori S, Ghazisaeedi M Criteria for assessing the quality of mHealth apps: a systematic review. J Am Med Inform Assoc. 2018; 25:(8)1089-1098

Bol N, Helberger N, Weert JC. Differences in mobile health app use: a source of new digital inequalities?. Inf Soc. 2018; 34:(3)183-193

Khoja S, Durrani H, Scott RE Conceptual framework for development of comprehensive e-health evaluation tool. Telemed J E Health. 2013; 19:(1)48-53

Azad-Khaneghah P, Neubauer N, Miguel Cruz A, Liu L. Mobile health app usability and quality rating scales: a systematic review. Disabil Rehabil Assist Technol. 2021; 16:(7)712-721

mHealthHUB. Knowledge tool 1: health apps assessment frameworks. https// (accessed 8 november 2022)

Llorens-Vernet P, Miró J. Standards for mobile health-related apps: Systematic review and development of a guide. JMIR Mhealth Uhealth. 2020; 8:(3)

Murad MH. Clinical practice guidelines. Mayo Clin Proc. 2017; 92:(3)423-433

Development, dissemination and evaluation of a smartphone-based app for pressure ulcer/injury prevention and treatment for use at the bedside

02 December 2023
Volume 2023 · Issue 3



After launching the 2019 International Pressure Ulcer/Injury Guideline, the National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) collaborated with Sensorydata Corp., US, to develop a guideline app (InterPIP App). The app was designed to: present evidence-based guideline recommendations; incorporate search capacities and functionality to facilitate easy access to clinical guidance; provide accessibility in multiple languages; and to be available worldwide at a reasonable price, including opportunities for free access in low-resource countries. This paper describes the development, dissemination and formative evaluation of a mobile app providing evidence-based recommendations for pressure injury prevention, assessment/classification, and treatment at the point of care.


An evaluation tool was designed based on a framework developed by Nouri et al. and made available to all app subscribers.


The InterPIP App is currently available in 11 languages and had been downloaded 3616 times by February 2022 in 78 countries. A total of 62 individuals responded to the survey of end-users. In this formal evaluation of user experiences, the app was rated positively on criteria of: information/content; usability; design; functionality; ethics; and security/privacy (median=4 on a 1–5 Likert scale). Overall perceived value was ranked lower with a median of three. Users provided suggestions for ongoing app enhancement.


The InterPIP App offers a unique opportunity to bring evidence-based guidance to the point of care. Formal evaluation of end-user experiences identified opportunities for quality improvement, and informed plans for future development and evaluation.

A pressure injury (PI) is defined as localised damage to skin and/or underlying tissue, as a result of pressure or pressure in combination with shear.1 In Europe, the term pressure ulcer is preferred.1 PIs impact negatively on health-related quality of life (HRQoL) and are expensive to treat, with estimates suggesting that PIs consume a significant proportion of global healthcare budgets.2,3,4 In contemporary practice PIs remain an important safety concern, for example, Wood et al.5 reported that in the UK, PIs accounted for 19% of all patient safety incidents. This is echoed across the US,6 Canada7 and Australia.8 Despite the availability of International Pressure Ulcer/Injury Clinical Practice Guidelines1,9,10 and a plethora of global prevention initiatives, systematic reviews still report unacceptably high international incidence and prevalence rates across clinical settings in multiple countries11,12,13,14,15 (Table 1). This realisation prompted the International Guideline Consortium (consisting of the European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP) and the Pan Pacific Pressure Injury Alliance (PPPIA)) to reevaluate guideline dissemination and implementation strategies to more effectively improve patient outcomes throughout the world. This paper reports on evaluation of a guideline smartphone app, designed to support dissemination of the 2019 guidelines1 and evidence-based practice, in the early phases of development and dissemination.

Register now to continue reading

Thank you for visiting Wound Care Professional and reading some of our peer-reviewed resources for wound care professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Access to clinical or professional articles

  • New content and clinical updates each month