Pressure injury
ADULT
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
- Systemic Inflammatory Response Symptoms (SIRS) or clinically unwell (see Sepsis Clinical Tools)
- Worsening pain and all pain not in keeping with current state of the wound/ulcer
- Pressure injury causing cellulitis and systemic infection
- Patients with spinal injuries should be referred to Spinal Outreach Team (SPOT)
- Patients from Residential Aged Care Facilities can access wound advice from RADAR services (Residential Aged Care District Assessment and Referral Service) where they are established.
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- Suggested interim care for patient while awaiting specialist appointment:
- Review HealthPathways Pressure Injuries in Spinal Cord Impairment information from aSKKINg Framework
- Preventing pressure injuries and wound management. (2020)) Australian Commission on Quality and Safety
- Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline 2019 (NPIAP) Quick Reference Guide
| Category 1 (appointment within 30 calendar days) |
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| Category 2 (appointment within 90 calendar days) |
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| Category 3 (appointment within 365 calendar days) |
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Please insert the below information and minimum referral criteria into referral
1. Reason for request Indicate on the referral
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
2. Essential referral information Referral will be returned without this
- Relevant wound history (e.g. duration, description, and size, wound initiating event and any previous surgical debridement or reconstruction)
- Co-morbidities and past medical history including disabilities
- Details of all treatments offered, and efficacy to date e.g. pressure relieving interventions, type of dressings used, antibiotic prescribing history
3. Additional referral information Useful for processing the referral
- List of current medications, and allergies and sensitivities history
- Current home personal care support history and/or nursing services
- Occupational therapy review and recommendations/equipment supplied
- Relevant pathology (as clinically indicated)
- Relevant medical imaging results if available –i.e. x-ray, ultrasound
- Clinical photograph – with patient's consent, where secure image transfer, identification and storage is possible
4. Request
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Patient's Demographic Details
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
Last updated: 4 December 2024
© State of Queensland (Queensland Health) 2023
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