Pressure ulcer prevention: making a difference across a health authority?

Pressure ulcers (PUs), their cause and prevention have been discussed in the literature for many decades. Their prevention and management has been the core of a tissue viability nurse's daily clinical and strategic workload. The important point to acknowledge is that not all PUs can be prevented but it is believed most of them can and all preventative measures must be implemented and evaluated. Initial efforts focused on establishing a baseline of incidence and prevalence. More recently, the Department of Health has proposed that PUs could be eliminated in 95% of all NHS patients and incentivised the measurement of PUs and other harms by use of the NHS Safety Thermometer through the introduction of a new initiative. A research company was commissioned to explore which communications interventions would be effective in helping health professionals to prevent and treat PUs. A campaign was subsequently set in motion to educate and inform clinical staff on the cause and prevention of PUs.

Collaboration improves outcomes: cross county, joint acute and primary care, working party to select a super absorbent dressing.

This abstract highlights the work undertaken by the Bedfordshire and Hertfordshire Tissue Viability Nurses Forum (BHTVNF) to select a super absorbent dressing for local formularies. A range of super absorbent dressings was selected to be included in the evaluation based on their accessibility via FP10 or NHS Supply chain. Dressings were evaluated in the hospital setting, community setting and leg ulcer clinics. Table top evaluations were also undertaken. Performance of dressings both clinically and via table top were considered along with costs. It was interesting to find out that hospital patients had different needs to community patients and as such three recommendations were made. The acute sector has added one super absorbent which is different from the community selected one. The community has also selected a lower performing super absorbent which the acute sector has not chosen.

Achieving consensus in pressure ulcer reporting.

Pressure ulcers are considered to be a key quality indicator and healthcare providers in England are required to report local pressure ulcer rates. However, there is a lack of standardisation in reporting due to lack of national guidance. The Tissue Viability Society has sought to develop consensus amongst all concerned parties on the most useful and robust methods of data collection. This document has been developed following a consensus meeting and consultation with the majority of Tissue Viability Nurses across England and provides guidance on reporting pressure ulcer rates. It is intended for use all organisations that are involved in the reporting of pressure ulcers. It represents the consensus view of a large number of Tissue Viability Nurses from across England and we recommend its adoption.

Pressure ulcer risk assessment.

The Department of Health wants to reduce harm caused by pressure ulcers dramatically. Identifying which patients are at risk is an important part of prevention. This article discusses the most common risk factors, the advantages and disadvantages of risk assessment tools, and challenges in prevention.

Using negative pressure therapy in wound healing.

Negative pressure wound therapy, also referred to as topical negative pressure therapy, is a useful treatment for a variety of acute and chronic wounds and, unlike many other wound treatments and dressings, has a relatively good evidence base to demonstrate its effectiveness. This article considers its application in both primary and acute care.

Now is the time for tissue viability.

Tissue viability nurses (TVNs) have always been interested in pressure ulcers. Many found our way into the specialism because of this interest and passion. We have always believed most of them could be prevented and our desire, our goal has been to prevent all avoidable pressure ulcers.

Managing highly exuding wounds with Eclypse dressings.

Wounds naturally produce exudate containing nutrients, blood cells, enzymes, cytokines and growth factors, which are all essential to the healing process. When this balance is altered by local or systemic conditions then exudate can become problematic. Wound healing is delayed, quality of life is detrimentally affected and nursing staff are faced with time-consuming dressings. The wound product market has always contained absorbent dressings, yet there is a need for further absorbent dressings to be made available to us. This has seen the introduction of super-absorbent dressings onto the market. One of these dressings, Eclypse, is discussed in this article. Eclypse uses highly absorbent crystal technology to increase its fluid handling capacity. The functionality of this product and the benefit for patients derived from its use are described in this article.

Pressure ulcer risk assessment and grading.

Heidi Guy outlines the key points that need to be considered in the risk assessment and grading of pressure ulcers.

Preventing pressure ulcers: choosing a mattress.

The standard hospital mattress is not suitable for patients at risk of developing pressure ulcers. The type of mattress or overlay system they require will depend on their pressure ulcer risk, medical history and local practice. This article provides a guide to pressure-relieving mattresses.