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Kia āta kōwhiri Choosing Wisely

The Choosing Wisely campaign seeks to reduce harm from unnecessary and low-value tests and treatment.

Pressure injuries are a major cause of preventable harm to consumers of health care services. The Commission is working alongside the Accident Compensation Corporation (ACC) and the Ministry of Health (the Ministry) on preventing pressure injuries. Each agency has responsibility for a different area.

ACC has led the development of guiding principles for the prevention and management of pressure injuries, and is now working with DHBs to ensure the principles are implemented. You can find out more on our guidance page or by contacting the pressure injury team at ACC (

The Ministry is providing clinical oversight (particularly from a nursing perspective) and facilitating engagement with HealthCERT, who have been focused on pressure injury management across aged residential care. You can find out more in HealthCERT’s March 2018 Bulletin.

The Commission is leading work on developing and promoting patient stories and case studies for the purpose of raising the profile of the impact of the harm from pressure injuries and ensuring a consistent approach to the measurement of pressure injuries. Having a strong measurement approach in place means health care providers can measure the impact or success of their PI improvement and prevention work and track change over time.

This work commenced in 2015 with the Commission engaging Sapere Research Group and a small group of experts from across the sector to:

  • describe the current approach to measuring and reporting pressure injuries in New Zealand
  • support development of a methodology to assess pressure injury prevalence, which can be used in hospitals, residential care and home care settings.

The preferred method for data measurement and reporting that was arrived at is monthly random sampling with a minimum sample size of five patients per ward/unit. This is adequate for maintaining focus on quality improvement and provides enough data to evaluate the effectiveness of quality improvement initiatives.

The report from this piece of work was published in October 2016 and can be found here.

Since then the Commission has been working with four DHBs (Waikato, Whanganui, Capital & Coast and Southern) to pilot the proposed methodology. The Commission’s final report for the measurement workstream, a ‘how-to guide’ called Developing a national approach to the measurement and reporting of pressure injuries was published in April 2018. It summarises the work undertaken by the four DHBs to implement the measurement methodology and is intended to provide practical guidance on how to implement a robust pressure injury measurement approach, as part of wider PI prevention and management activities. It can be downloaded below, along with a supporting document of frequently asked questions and answers.

Published: 28 Oct 2021 Modified: 31 Jan 2022