A 78 Y/O female was admitted with heart failure to the ICU from home. By day 3 of hospitalization, she had improved and was transferred to the medical cardiac unit. The pressure injury survey was conducted on day 4 of hospitalization and the survey team saw a Stage 1 area of persistent, nonblanchable redness on her right heel. Review of her hospital admission assessment record revealed that she had 4+ lower right leg edema and brown discoloration of the lower calf and ankle skin. A 2 cm by 4 cm wound with serous drainage also was also documented over her medial lower leg midpoint between her calf and ankle. The skin assessment documented on arrival to the medical cardiac unit noted a Stage 1 pressure injury at this site in addition to the wound, edema, and brown discoloration on her left lower leg as noted on the admission assessment. For the pressure injury survey, this would be reported as:__________

the pressure injury was not observed and documented in the admission assessment record. Since, the pressure injury is obtained after hospitalization, it is a hospital acquired injury. When the patient is admitted into the cardiac unit, the presence of Stage 1 pressure injury was documented which was already present on arrival to medical unit. Hence, the pressure injury is not cardiac unit acquired pressure injury. The admission assessment record does not contained information about the venous ulcer which the patient already had upon admission and this ulcer was in the same lower proximity as the pressure injury and this venous ulcer might have been the reason of this injury.