Worcestershire Acute Hospitals NHS Trust Use Your Turn

October 27th, 2010

Louise Morris, Tissue Viability Nurse talks about using Your Turn as part of a pressure ulcer prevention strategy in Worcestershire:

The Your Turn Campaign was first introduced to the Trust in April 2007. Although the Trust had made significant progress in the prevention and management of pressure ulcers, there were still areas that we wanted to further improve. The Your Turn Campaign was seen as a support mechanism to promote a unified, proactive pressure ulcer prevention programme, which would help the Trust achieve its clinical, operational and financial objectives ultimately enhancing our patients experience and safety. The Tissue Viability Team and Link Nurses currently continue to utilise this campaign fulfilling these objectives successfully.

Many of the recent activities and achievements implemented positively link to various Department of Health (DoH) Quality initiatives. The Essence of Care (EOC) pressure ulcer benchmarking process has been reviewed and improved to provide more in depth assessment about the quality of care being provided enabling assessment and comparison of how clinical departments are performing. The Pressure Ulcer High Impact Actions (HIA) and Commissioning for Quality and Innovation, (CQUIN) has provided an opportunity to re-visit and improve our monitoring and audit processes and encouraging staff to be innovative about improving standards.

Some of the latest quality improvements/developments include:

  • Pressure ulcer prevention core care plan
  • Pressure ulcer treatment core care plan

Both of these being quick to complete and providing reminders about timely completion of clinical incidents and root cause analysis

  • Updating the pressure ulcer risk assessment to include time of completion to ensure NICE guideline standards are being met and inclusion of pressure ulcer categories should the patient have a pressure ulcer so the severity can be identified and denoted accurately
  • Tissue viability documentation pathway to ensure the correct tissue viability documentation is implemented in a timely manner and not missed
  • A repositioning schedule to ensure patient repositioning is recorded accurately
  • Promotion of the Thompson chart to ensure the appearance of patients pressure areas are recorded
  • Updating the patient information leaflet to reflect the Your Turn Campaign format
  • Tissue viability service information leaflet
  • Pressure ulcer work book and pressure ulcer competency framework
  • Mandatory training that references the Your Turn Campaign
  • As well as Tissue Viability Link Nurses, a forum has been inaugurated to promote High Impact Actions/Energising for Excellence (CQUIN), Essence of Care, QUIPP and Your Turn, including facilitating audits and actions. Once pressure ulcer related Patient Reported Outcome Measures (PROMs) are established, the group will be active in facilitating this survey

Pressure Points

September 6th, 2010

Pressure Points – Taking Practice Forward within the Royal Cornwall Hospitals NHS Trust

 Julie Trudgian Lead Nurse Tissue Viability, June 2010

Pressure ulcers are an avoidable consequence of admission to hospital with up to 20% of patients developing pressure damage.  Within the Royal Cornwall Hospitals NHS Trust an average of 4% of patients experienced pressure damage during 2009.  However, it is still possible to reduce this figure by improving the quality of patient care and increasing public awareness.

The Pressure Points Campaign was commenced at the beginning of 12010 by the Tissue Viability Team and Tissue Viability Link Practitioners to promote a reduction in the number of patients experiencing pressure damage.  Early indicators suggest it has resulted in a reduction in pressure ulcer prevalence and led to further activity highlighting the value of pressure area care, as outlined below.

The Pressure Points Campaign included a number of initiatives within 3 areas of practice, namely, education, raising awareness and audit.  Education was led by the Tissue Viability Team, who produced a Pressure Points leaflet reinforcing the actions required to prevent pressure damage.  This was disseminated to all clinical staff within the Trust.  Monthly workshops on Pressure Ulcers and how to prevent them were initiated and, for those unable to attend, self directed learning resources were updated and developed.  The Tissue Viability Nurses also offered to provide educational support within the clinical areas and assistance for Link Practitioners with ad hoc teaching sessions.

Raising awareness includes having visible evidence of the importance of pressure area care within the clinical areas.  Tissue Viability Link Practitioners identified areas where they could display information and were provided with posters on repositioning to prevent pressure damage, seating, equipment, staging of pressure damage and mattress care.  They were also provided with the Trust audit results, the Your Turn newsletter and website details and the Trust patient information leaflet – Pressure Ulcers and How to Prevent Them.

Prevalence audit of the number of patients with pressure damage on a given day has been increased to monthly to allow the Tissue Viability Team to closely monitor the number of patients with Pressure Damage and determine the impact of the campaign.  In addition the importance of reporting every new pressure ulcer is outlined in the Pressure Points leaflet.

Although it is still early days the Pressure Points Campaign has already had an impact on the prevalence with the most recent audit (May 2010) identifying that 2.5% of patients have hospital acquired pressure damage.  There is still room for improvement however the campaign has lead to further activity including a pressure aware event.  This will take place in October 2010 and include displays in the hospital corridors and staff wearing Your Turn badges to promote patient enquires. Other activities will be undertaken by Link Practitioners within their clinical settings.  Pressure Aware will be launched with a conference at the Eden Project which will include presentation of the latest research from nationally recognised speakers and examples of good practice and innovation from practitioners from within the Trust who have developed ideas to raise patient and staff awareness.  This should help staff internalise the values associated with pressure area care so they are implemented as part of everyday nursing practice.

The Pressure Points Campaign has been a successful driver of pressure ulcer prevention within the Trust and will continue to be developed to meet the learning needs of staff and clinical needs of patients.  Improving patient awareness is key to prevention as patients entering hospital should be able to ask whether they are at risk and what action is being taken to prevent pressure damage.   They can then feel safe and reassured that all is being done to protect their skin.   This together with clear Trust strategies, provision of equipment and good patient care ensures the Royal Cornwall Hospitals NHS Trust are committed to reducing the prevalence of pressure damage and ensure any skin damage occurring within the Trust is unavoidable.

Sidhil: Investing in New Products To Support The Your Turn Campaign

May 20th, 2010

As a member of the BHTA, Sidhil wholeheartedly endorses the ‘Your Turn’ campaign, which is gaining momentum spurred on by the alarming statistics that pressure sores are currently estimated to affect one in five hospital patients in the UK, costing the NHS up to £4billion each year.


The BHTA’s Your Turn campaign is seeking to achieve mandatory reporting of incidents of pressure sores in the UK, in order to highlight the scale and severity of the problem. 


Although pressure sores are inherently a visible and preventable issue, they are often viewed as a secondary issue to the patient’s primary condition. The NHS has also recently set out an ambition to eliminate all avoidable pressure ulcers in NHS-provided care.


Sidhil is one of the group of BHTA members involved in the voluntary funding of the Your Turn campaign, which is also run with the objective assistance of the Tissue Viability Nurses Association and The Wound Care Society.


Investing in technology – surfaces to combat pressure sores


The best way to avoid pressure sores is to keep moving, turning over or changing position as often as possible.  However, there are both dynamic and static mattress systems that can help here, using technology to successfully alleviate pressure in areas most subject to ulceration.


Sidhil’s dynamic therapy mattress systems (such as the Trio, Plus and Solo) are designed to prevent the problems of pressure sores for vulnerable patients.  The products work on the principal of moving areas on the mattress surface away from the body at regular intervals, thus stimulating blood-flow. These mattresses are made up of separate air-filled ‘cells’, which inflate and deflate in a regular pattern to vary pressure on the skin surface. 


Heavier bariatric patients have an even higher risk, and suitable dynamic therapy systems (such as the Sidhil Bariatric Dynamic Mattress) are a major benefit for such users.


Sidhil’s range of static, multiple layered surfaces using different grades of visco elastic foam also provide successful pressure relieving therapy, considerably reducing the ‘shearing’ pressures that contribute to the formation of pressure ulcers.  Non-bariatric patients can benefit from products such as the Acclaim VE and the Softrest VE, while for bariatric patients there is the Acclaim Bariatric VE.


Over the past five years, Sidhil has invested in a significant program of research, planning, testing and product development, which has resulted in the introduction of a range of surfaces designed to combat pressure sores.


Sidhil’s clinicians are now working with major Trusts around the country, in consultation with tissue viability nurses, ward managers, financial and purchasing professionals, community care-workers and moving and handling personnel, to further develop the product range.  2010 will see the introduction of a new generation of dynamic products developed to provide further ammunition in the fight against pressure sores.

Frontier gets behind the Your Turn Campaign

May 20th, 2010

Frontier Medical Group is one of the eight founding industrial supporters of the ‘Your Turn’ Campaign.  Frontier actively support the aims and objectives of this campaign and in particular helping inform the public about pressure ulcer prevention and treatment.            

NHS expenditure on pressure ulcers is estimated to be between £1.4 and £2.1 billion each year.  The Nice guidelines (2003) stressed the value of relatively low-cost technology in the prevention and treatment of pressure ulcers.[1]  

 Since its launch in 1997, Repose has contributed to the successful treatment of more than 1 million patients and more people are currently treated on Repose than any other pressure redistribution mattress in the NHS.  Approximately 70% of Repose usage is in the domestic and nursing home setting.

 Repose® is recognised as a reactive mattress in that it reacts instantly to patient movement ensuring that the patient is supported at all times at optimum low contact pressure.  This is achieved by immersion where the patients load is spread across the surface area of the mattress lowering contact pressure in the most vulnerable areas.

 Since its inception, Repose has continually evolved.  New Repose continues the tradition with further improvements and extensions to the range to making it easier to use and improving durability without adding cost.

 The Repose product range comprises:

 Repose Mattress overlay
Repose Cushion
Repose Foot protector*
Repose Wedge
Repose Babytherm
Repose Babynest

 Most nurses are familiar with the Repose Foot protectors as one of the most commonly used pressure redistribution devices and recognised as second to now in providing comfort and pressure relief to the heels – one of the most difficult areas to prevent and treat pressure ulceration.    

For further information on the Repose range of Pressure Redistribution devices please contact us on 01495 235 800 or visit our new website at www.frontiermedical.eu.

[1]  National Collaborating Centre for Nursing and Supportive Care. Guideline commissioned by the National Institute for Clinical Excellence (NICE) 2003



[1]  National Collaborating Centre for Nursing and Supportive Care. Guideline commissioned by the National Institute for Clinical Excellence (NICE) 2003

Pressure ulcers deserve to be talked about

March 16th, 2010

Many years ago pressure ulcers (once known as bedsores or pressure sores) were called the epidemic under the bed sheets. This was not only a reference to the vast numbers of people who develop pressure ulcers while ill and immobile but also to the lack of awareness of the challenges posed by these wounds among both the health professionals and the general public.

As time passed health professional awareness of pressure ulcers increased through the actions of charities such as the Tissue Viability Society and the European Pressure Ulcer Advisory Panel. However for the general public, the people who developed pressure ulcers and their friends and relatives there was really no change in their awareness of pressure ulcers. Although the internet provides thousands of pages devoted to pressure ulcers, their causes and treatments how does anyone know which the sound pages with valid information are and which ones are full of sales talk!

Pressure ulcers deserve to be talked about, each year many thousands of us will develop some form of pressure ulcer – if you are no longer able to move yourself or to feel the discomfort that comes when we sit still too long then pressure damage to the skin and the tissues under your skin are indeed likely to occur in the absence of preventive care. The Your Turn campaign is becoming a strong voice providing advice to the public and health professionals alike. For once there is a resource intended to help people likely to have pressure ulcers or those who have these wounds already, with this resource supported by a number of the charities that support wound care health professionals and by the responsible commercial manufacturers devoted to developing new and innovative ways to help prevent pressure damage.

I support the Your Turn campaign because we all need to know how to look after our skin, and when and where to ask for professional help if your risk of pressure ulcers rapidly changes – for example when ill and staying in bed. Sharing the simple ways in which risk can be reduced and pressure ulcers avoided helps everyone – from stopping us discovering the pain and unpleasantness that can come with pressure ulcers through to helping our hard pressed NHS save money – each year the NHS might spend up to 4% of all its funds just dealing with pressure ulcers. Just as hospital infections and ‘superbugs’ have become commonly known and actively fought, campaigns such as the Your Turn campaign can help us all recognise the importance of pressure ulcers and help to remove this age-old problem from our society and our health care. Visit the Your Turn web site and make sure you know the early signs and risks of pressure ulcers.
Dr Michael Clark
Professional Advisor
Tissue Viability Society