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Acute Burns - Guidelines and Quality Measures

Acute Burns - Guidelines and Quality Measures

Acute Burns - Guidelines and Quality Measures

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
    American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation, 2023 [2]
    American Burn Association, United States
    Guideline (Free)Focus on acute fluid resuscitation 
    American Burn Association Clinical Practice Guidelines on the Treatment of Severe Frostbite, 2023 [3]
    American Burn Association, United States
    Guideline (Free)Focus on frostbite management 
    European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan, 2023 [4]
    European Burns Association, Europe
    Guideline (Free)Focus on management of burn mass casualty incidents
    Management of severe thermal burns in the acute phase in adults and children, 2020 [5]
    SFAR, multiple countriesGuideline (Free)
    Focus on acute burn injuries in adults and children
    American Burn Association Guidelines on the Management of Acute Pain in the Adult Burn Patient: A Review of the Literature, a Compilation of Expert Opinion, and Next Steps, 2020 [6]
    American Burn Association, United States
    Guideline (Free)
    Focuses on pain management
    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  [7]
    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

    CMS and ASC Quality Collaboration
    CMIT Measure ID: 500
    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) (***)
    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
    Retired 




    SettingCMS Program
    Developed byMeasure ID
    Title
    Description
    Outpatient
    Quality Payment Program - Merit-based incentive payment system (MIPS) (***)
    US Wound Registry
    USWR24
    Patient 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
    Outpatient
    Quality Payment Program - Merit-based incentive payment system (MIPS) (***)
    Medicare
    MIPS 131
    Pain 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 ©2024 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. Cartotto R, Johnson LS, Savetamal A, Greenhalgh D, Kubasiak JC, Pham TN, Rizzo JA, Sen S, Main E et al. American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation. Journal of burn care & research : official publication of the American Burn Association. 2023;.
    2. Wibbenmeyer L, Lacey AM, Endorf FW, Logsetty S, Wagner ALL, Gibson ALF, Nygaard RM et al. American Burn Association Clinical Practice Guidelines on the Treatment of Severe Frostbite. Journal of burn care & research : official publication of the American Burn Association. 2023;.
    3. Leclerc T, Sjöberg F, Jennes S, Martinez-Mendez JR, van der Vlies CH, Battistutta A, Lozano-Basanta JA, Moiemen N, Almeland SK et al. European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan. Burns : journal of the International Society for Burn Injuries. 2023;volume 49(2):275-303.
    4. Legrand M, Barraud D, Constant I, Devauchelle P, Donat N, Fontaine M, Goffinet L, Hoffmann C, Jeanne M, Jonqueres J, Leclerc T, Lefort H, Louvet N, Losser MR, Lucas C, Pantet O, Roquilly A, Rousseau AF, Soussi S, Wiramus S, Gayat E, Blet A et al. Management of severe thermal burns in the acute phase in adults and children. Anaesthesia, critical care & pain medicine. 2020;volume 39(2):253-267.
    5. Romanowski KS, Carson J, Pape K, Bernal E, Sharar S, Wiechman S, Carter D, Liu YM, Nitzschke S, Bhalla P, Litt J, Przkora R, Friedman B, Popiak S, Jeng J, Ryan CM, Joe V et al. American Burn Association Guidelines on the Management of Acute Pain in the Adult Burn Patient: A Review of the Literature, a Compilation of Expert Opinion, and Next Steps. Journal of burn care & research : official publication of the American Burn Association. 2020;volume 41(6):1129-1151.
    6. 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.
    Topic 1268 Version 2.0

    RELATED TOPICS

    This topic provides an evidence-based 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

    Evidence-based, always current review on management of acute burns.

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