top of page
Logo white + red.png


A red electrocardiogram
A red electrocardiogram
A red electrocardiogram

A Comprehensive Guide + Video to the PURPOSE-T Framework for Pressure Ulcer Prevention 


An example of a PURPOSE-T Framework Sheet
An example of a PURPOSE-T Framework Sheet

In our ongoing exploration of clinical risk assessment models, we now turn our attention to the PURPOSE-T framework. Arising from a major international research project initiated around 2009, PURPOSE-T has shaped the landscape of pressure ulcer risk assessment since its release in 2014. Backed by approximately £2 million in funding from the National Institute for Health and Care Research, the model is now extensively adopted across the UK.


Pressure ulcers, also known as bedsores, pose a formidable challenge within healthcare settings, necessitating unwavering diligence and strategic intervention. Far from being mere indicators of discomfort, they profoundly impact patient outcomes and healthcare economics, serving as benchmarks for care quality.


Understanding PURPOSE-T

PURPOSE-T sits at the heart of a pressure ulcer risk assessment framework (PURAF), developed to identify adults susceptible to developing pressure ulcers and classify preventive measures into primary or secondary actions. This critical distinction equips healthcare professionals with the means to craft bespoke interventions, preventing ulcers in at-risk individuals and managing existing ones with greater efficacy.


The formulation of PURPOSE-T ensued from an extensive collaborative effort, including systematic reviews, consensus studies, conceptual framework creation, and comprehensive clinical evaluations. This rigorous development cycle ensures that PURPOSE-T stands on a foundation of robust evidence, tuned to the nuances of clinical practice.


It's important to note that older pressure sore risk assessments previously discussed have often faced criticism for insufficient research and evidence basis.


The Mechanics of PURPOSE-T

The operationalisation of PURPOSE-T is streamlined into a three-step procedure, optimised for utmost efficiency and effectiveness:

  1. Screening: The initial phase zeroes in on at-risk patients, examining mobility status, skin condition, and employing clinical judgement to factor in any treatments or conditions that might influence risk levels. This step judiciously allocates resources, sparing comprehensive evaluations for those most in need.

  2. Full Assessment: Individuals flagged during screening undergo a detailed assessment, analysing a range of factors like independent movement, sensory perception, nutrition, and skin integrity. This creates a layered risk profile, pivotal for informed decision-making.

  3. Assessment Decision: The process culminates in establishing an apt prevention strategy, based on the assessment. A colour-coded system helps classify patients into categories for primary prevention, secondary prevention, or those not currently at risk, ensuring tailored and effective care plans.


Why PURPOSE-T Stands Out?

The impact of PURPOSE-T on pressure ulcer prevention is immense. Its methodical process yields several benefits:

  • Customised Prevention Strategies: PURPOSE-T's intricate patient risk profiles enable the creation of specific prevention strategies for individual needs.

  • Evidence-based Foundation: Grounded in rigorous research and clinical trials, PURPOSE-T's relevance and effectiveness align with the demands of real-world healthcare.

  • Efficient Use of Resources: By structuring the assessment process, only those who need thorough evaluations receive them, leading to optimised resource allocation.

  • Enhanced Patient Outcomes: Focusing on targeted prevention and management, PURPOSE-T could significantly curtail the prevalence of pressure ulcers, enhancing patient experiences and reducing healthcare costs.


Implementing PURPOSE-T in Clinical Practice

Integrating PURPOSE-T into daily clinical practice requires dedication to training and education. It's essential that healthcare professionals are well-versed in the tool's theoretical background, proficient in the assessment procedures, and adept at interpreting and acting on the outcomes. Interdisciplinary collaboration is key, with nurses, physicians, and other medical staff working in concert to embed the PURPOSE-T framework into the patient care continuum.


The mere introduction of PURPOSE-T is likely to spotlight pressure injury prevention, bringing it to the fore of healthcare priorities and potentially reducing the incidence of such injuries.


Looking Ahead

The PURPOSE-T framework heralds a substantial leap forward in the realm of pressure ulcer prevention. Its all-encompassing, evidence-based approach not only raises the bar for patient care but also underscores the critical nature of individualised and proactive interventions. As the healthcare community embraces and hones tools like PURPOSE-T, the enhancement of patient safety and care quality seems not just achievable but imminent.Elevating Patient Care: A Comprehensive Guide to the PURPOSE-T Framework for Pressure Ulcer Prevention


A photo of Scott Harding-Lister, Director at Apex Health Associates

Links to Other Blogs on Pressure Ulcer Prevention



bottom of page