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.