Reducing pressure ulcers
Programme Lead: Ria Betteridge / Sarah Gardner
Ria is a Consultant Nurse – Tissue Viability, Oxford University Hospitals NHS Trust.
Sarah is a Clinical Lead – Community Tissue Viability Service, Oxford Health NHS Foundation Trust.
Reducing pressure ulcer resources
We aim to reduce the number and severity of pressure ulcers across the Oxford AHSN region over the next five years. In particular we aim to reduce the number of the most severe pressure ulcers (grades 3 & 4)
Pressure ulcers can affect a person’s quality of life, are often painful and may be life-threatening. Evidence suggests that 4.7% of patients surveyed through the Safety Thermometer reporting process had pressure damage of Category 2 or above. A number of these may have been avoided with simple, effective care interventions.
Pressure ulcers (also known as bedsores or pressure sores) are caused when an area of skin and the tissues below are damaged as a result of being placed under pressure sufficient to impair its blood supply (NICE, 2013). This commonly affects areas of the body such as heels, hips and bottoms. All patients are potentially at risk of developing a pressure ulcer. They are more likely to occur in people who are seriously ill, or have a neurological condition, impaired mobility, impaired nutrition, poor posture or a deformity (NICE, 2013).
Pressure ulcers cause patients to suffer pain and infection. In extreme cases they can result in plastic surgery, amputation or even death. There is a considerable cost to the health economy and it can prolong hospital stays. Most harm associated with pressure ulcers is avoidable with good care.
Pressure damage is categorised from 1 to 4, with 1 being superficial, marked redness of the skin and 4 being deep open wounds that may expose the underlying bone. In the most severe cases patients can be at high risk of life-threatening infections.
Treating and managing pressure damage can be costly to healthcare providers. The daily cost of treating a pressure ulcer ranges from £43 to £374. (Bennett, Dealey and Posnett, 2012).
We are working with service users, clinical experts, patients, carers and others across the Oxford AHSN region to develop a five year plan to ensure all people receiving care in the participating sites remain free from harm as a result of acquired pressure damage.
We are also working to establish a set of best care guidelines.
This group’s first aim is to improve the reliability of skin assessment, including skin inspection, to 100% in the project areas.
Five simple steps to prevent pressure ulcers
- Skin inspection: observe the skin over pressure points regularly to identify red marked areas
- Keep moving: regular repositioning to move pressure points
- Incontinence: keep clean and dry
- Nutrition: ensure a balanced healthy diet and keep hydrated
- Surface: check that any equipment in contact with the skin is appropriate and working correctly