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Acute Burns - Overview

Acute Burns - Overview

Acute Burns - Overview

INTRODUCTION 

Overview

    This topic provides a list of Guidelines, Quality Measures and other resources on Acute Burn Injuries. See topic "Acute Burns - Introduction and Assessment" for a review and framework for assessment of acute burns, including epidemiology, risk factors, etiology, pathophysiology, first aid, primary and secondary assessment, transfer criteria, burns classification, documentation and ICD-10 coding. For management of acute burns see " Acute Burns - Treatment".

    Background

    • Definition: Burns are cutaneous injuries caused by various agents or mechanisms, including thermal (further subdivided into liquid, solid and gaseous agents), electric, chemical, and other rarer tissue insults such as radiation. The physiologic effects of burns are manifested by tissue damage and subsequent cell death.
    • Relevance: Annually in the United States, over half a million patients will present to emergency department with burns, and 10% of those require hospitalization.[1]

    Figure 1. Acute burn on hand - Deep partial thickness (deep second degree)

    EVIDENCE-BASED CLINICAL GUIDELINES

    Below is a list of the some of the most recent evidence-based guidelines on Acute Burns: 

    Evidence-based guideline,  year Publishing Organization, country Links Comments
    ISBI Practice Guidelines for Burn Care, Part 2, 2018
    ISBI Practice Guidelines Committee, multiple countries
    Guideline (Paid)
    Focuses on assessment and management of burn injuries
    The wound/burn guidelines - 6: Guidelines for the management of burns, 2016  
    Wound/Burn Guidelines Committee, Japan
    Guideline (Free)Focuses on management of acute burns
    ISBI Practice Guidelines for Burn Care, 2016
    ISBI Practice Guidelines Committee, multiple countries
    Guideline (Free)Focuses on methods of evaluation and management of burn injuries.
    Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient, 2016  [2]
    Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)
    Guideline (Free)
    Nutrition guidelines for critically ill patients with acute burns

    QUALITY MEASURES

    Setting CMS Program Developed by Measure ID Title Description
    Ambulatory Surgery Centers (ASC)
    • Ambulatory Surgical Center Quality Reporting
    • Hospital Compare
    CMS and ASC Quality Collaborative
    NQF ID: 0263
    Patient BurnThe number of admissions (patients) who experience a burn prior to discharge from the ASC. Numerator is Ambulatory Surgical Center (ASC) admissions experiencing a burn prior to discharge; Denominator is All ASC admissions
    Burn CentersThis set of quality measures is not part of a Quality Program by CMS. American Burn Associationn/aBurn Quality Improvement Program
    The purpose of the Burn Quality Improvement Program (BQIP) is to support and supplement ongoing Quality Improvement efforts at Burn Centers. It is based on data that is collected and reported by participating Burn Centers on the patients they care for.
    OutpatientQuality Payment Program - Merit-based incentive payment system (MIPS) (***)
    US Wound RegistryUSWR22Patient Reported Measure: Patient Reported Nutritional Assessment in Patients with Wounds and Ulcers
    The percentage of patients aged 18 years and older with a diagnosis of a wound or ulcer of any type who self-report nutritional screening with a validated tool (such as the Self-MNA® by Nestlé) as well as food insecurity assessment, AND for whom the clinician provides and documents  a follow up/ intervention plan within the 12-month reporting period.
    OutpatientQuality Payment Program - Merit-based incentive payment system (MIPS) (***)
    US Wound Registry
    USWR24Patient Reported Experience of Care: Wound Outcome
    All eligible patients with wounds or ulcers who completed of Wound Outcome Questionnaire who showed 10% improvement at discharge or transfer to another site of care during the 12 month reporting period
    OutpatientQuality Payment Program - Merit-based incentive payment system (MIPS) (***)
    MedicareMIPS 128
    Preventative Care and Screening: Body Mass Index (BMI) Screening and Follow-Up
    Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter
    OutpatientQuality Payment Program - Merit-based incentive payment system (MIPS) (***)
    MedicareMIPS 131Pain Assessment and Follow-Up
    Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present

    *** The Quality Payment Program (QPP) was implemented in the U.S. by Medicare in 2017. Merit-based incentive payment system (MIPS) is designed for eligible clinicians who bill under Medicare Part B. 

    RESOURCES

    Official reprint from WoundReference® woundreference.com ©2018 Wound Reference, Inc. All Rights Reserved
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    NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

    REFERENCES

    1. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA, Gervasio JM, Sacks GS, Roberts PR, Compher C, Society of Critical Care Medicine., American Society for Parenteral and Enteral Nutrition. et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN. Journal of parenteral and enteral nutrition. 2016;volume 40(2):159-211.
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