1. Stewart, Thomas P. PhD

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I have been asked to write a short piece to commemorate the 30th anniversary of the National Pressure Ulcer Advisory Panel (NPUAP). I think it is only proper to pay tribute to those who first laid the foundation for the organization.


Thirty years ago in a conference room (at Gaymar Industries, Inc) in a small town (Orchard Park) 15 miles south of Buffalo, New York, the NPUAP was formed when a multidisciplinary group of 13 healthcare professionals joined me and Louise Colburn, MS, RN, to hold its first meeting. (The NPUAP headquarters were subsequently moved to the SUNY at Buffalo Center for Aging, thanks to Dr John Feather.)


I would like to pay tribute to those 14 individuals who were willing to join me on a journey and in many cases stake their own reputations and/or careers to further the cause for the prevention of pressure ulcers/injuries in the United States. They were:


* Roberta Abruzzese, EdD, RN, FAAN (deceased)


* Victor Alterescu, MBA, MPH, RN, ET


* Louise Colburn, MS, RN


* John Feather, PhD, CAE


* Davina J. Gosnell, PhD, RN, FAAN


* Jan Jennings, MPH


* Ronald M. Linder, MD, FACS


* JoAnn Maklebust, DNP, APRN, AOCN, FAAN (deceased)


* Barbara Oot-Giromini, MS, RN


* Steven I. Reger, PhD, CP (deceased)


* George Rodeheaver, PhD


* Karen Schankweiler, BSN, RN, CWOCN


* Mary Lou Shannon, EdD, RN


* Joseph A. Witkowski, MD



There is no doubt in my mind that the reason for the success of the NPUAP was because of these first members. At this first meeting, there was no need to explain the seriousness of the problem, because many of these individuals were speakers and/or faculty participating in a live national conference series on the prevention and treatment of pressure ulcers/injuries we had been hosting around the United states for a few years. They had heard directly from conference attendees about the lack of guidelines, standards, multidisciplinary participation, consistency, and the continued use of antiquated treatments. Many were also published authors, educators, and frontline clinicians facing the day-to-day problem of pressure ulcers/injuries-it was a crisis that no one was paying any attention to from a national, strategic standpoint.


At the meeting, we simply explained that it was time for them to step forward as leaders, and that even though they may not have known it, they had been preparing for this for a good part of their careers. They were going to lead the effort to put together the guidelines and standards that their colleagues had been asking of them for the past few years. They were also going to set a strategy with goals for the nation to collectively deal with pressure ulcers/injuries.


Together, they would find just the right methodologies, pathways, and action plans to make it all happen, drawing on our shared education, training, experience, knowledge, and common resources to be successful. And the reason that I promised them success was because they only needed to look at the people who were assembled in the room to know success was guaranteed.


Fortunately for me, no one got up and left, which I took as a testament to the great leaders they were (or perhaps they were all too terrified to move at the time). They all agreed to start the unbelievably difficult journey, and together we built the NPUAP from the ground up on that day in 1987. The only things that had been determined were the name of the organization, the first 15 members, the initial funding source, and the understanding that we would work collaboratively with all existing credible organizations and individuals.


I ask that if you know any of the founding members-thank them. I cannot tell you what courage it took and what incredible faith they had to believe that they could accomplish what they did in the formative years of the NPUAP. There were no stipends, and even though efforts were made to hold meetings in warm or resort locations, the members never had any time to enjoy their weekend meetings. There was no choice but to work from morning into the late evening because there was so much to accomplish, yet the board members kept coming back and worked tirelessly between meetings to accomplish their action plans.


These founding members were an extraordinary group of individuals, and they deserve our praise; but then came class after class of NPUAP board members1 who had to follow their lead. They have all been equal to the task and continue to raise the bar for practice guidelines and standards, whether working with government agencies or collaborating with professional organizations.


Subsequent classes helped foster the launch of European, Japanese, Pan-Pacific, and other organizations focusing on pressure injury who saw the American group as scholarly collegial organizations worthy of emulation and collaboration. Each subsequent president and board brought their unique set of talents and executed a set of plans that we all now enjoy as the collective accomplishments of the NPUAP.


And what a trove of resources they have put together for all of us who have to deal with pressure ulcers/injuries.2 All of the panel members over the years have been volunteers. They have worked long hours to complete their work on behalf of countless patients and providers. They have also improved the quality of care in many aspects of healthcare across settings.


Most of this commentary has focused on the past, which is fine and well for a commemorative anniversary. That being said, the NPUAP is a young organization, and its finest hours and work lay ahead of it. By the time this commentary is published, the NPUAP will have celebrated its 30th anniversary at its annual meeting in Las Vegas. There, I plan to address the attendees in the opening session and recount how the panel was founded and thank everyone who has supported the organization and its mission and those who have cared for pressure ulcer/injury patients over the years.


The NPUAP is at a critical milestone in its history where it needs to continue to demonstrate its leadership not only in matters of policy, education, and research, but also as the unifying organization in the area of pressure ulcers/injuries.


Although I thought I was writing this piece to commemorate the 30th anniversary of the NPUAP, I now realize that what I really wanted to do was to write a long overdue thank-you to all of you who have so thanklessly given of your time and served on the NPUAP. You have made this country (and the world) a much better place for patients and caregivers alike. I also want to thank you for continuing to care about the management of pressure ulcers/injuries and doing so with what can only be described as selfless, heroic effort. I thank you from the bottom of my heart, and I know what sacrifices you have made. I am eternally grateful for your caring service, given so freely, which often goes without an acknowledgement. I will continue to support the NPUAP and sincerely hope and pray that the NPUAP of the present and future continues to follow your lead.




1. National Pressure Ulcer Advisory Panel. Alumni Council. Last accessed March 26, 2018. [Context Link]


2. National Pressure Ulcer Advisory Panel. Resources. Last accessed March 26, 2018. [Context Link]