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NICE issues guidance on pressure ulcer prevention and management Patients ‘at risk’ of developing pressure ulcers should be repositioned at least every six hours and those considered ‘at high risk’ should have their position changed at least every four hours, according to new guidance. The updated guidance on preventing and managing pressure ulcers, produced by the National Institute for Health and Care Excellence (NICE), stresses the importance of risk assessment, adjusting patients’ positions, and the use of high-specification foam mattresses. Challenges specific to heel pressure ulcers are highlighted, as are the need for individualised care plans and the importance of training staff in pressure ulcer prevention. The guidance comes as NHS-wide targets are being finalised concerning minimising the proportion of patients with pressure ulcers in category two, three and four. These targets are expected to be introduced next year in the NHS Outcomes Framework. Four nurses, including Mark Collier, were among the 13 healthcare professionals who advised NICE on the guidelines. Mr Collier, a nurse consultant in tissue viability at United
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By Christian Duffin
Risk assessments and the monitoring of patients’ positions should be carried out at regular intervals
Lincolnshire Hospitals NHS Trust, said: ‘Risk assessments should be carried out on admission and at regular intervals. That is crucial. Assessments should be with validated tools such as the Waterlow tool. There should be ongoing assessments, especially when there are early signs of damage, such as discolouring or tissue hardening.’
Resources required
He acknowledged that some healthcare providers would find it challenging to provide high quality mattresses, and possibly enough staff to monitor patient positions as often as recommended.
British Dermatological Nursing Group operations manager Susan Maguire said the guidance is comprehensive, but staff need enough resources to deliver good quality care. In recent years, a debate among tissue viability nurses has focused on whether pressure ulcers are preventable. Ms Maguire said: ‘Pressure ulcer incidence can be reduced to zero if all the checks are done and nurses have the right equipment and support.’ She added: ‘Training in pressure ulcer assessment and management is very important, but it needs to be for all the multidisciplinary team.’ Go to tinyurl.com/omnt6bf
Drive to develop leaders in learning disability nursing A mid-career leadership programme for learning disability nurses in the UK will be developed as part of an initiative to improve career progression. A report published last week by the Department of Health (DH) states that the government will explore the possibility of creating a virtual leadership programme for all learning disability nurses. The report is an update of progress on a UK-wide review of learning disability 10 april 30 :: vol 28 no 35 :: 2014
nursing, published in April 2012, which made 17 recommendations. Improving the uptake of cancer screening among people with learning disabilities will also be tackled by the DH and Public Health England, says the report. In addition, a framework that allows healthcare professionals to measure outcomes for people with learning disabilities will be evaluated by the DH and learning disability academics.
RCN learning disability adviser Ann Norman told Nursing Standard she is happy with the progress made on some fronts, but there is still much to do. ‘Learning disability nurses have risen to the challenges and so have some trusts,’ she said. ‘Getting to the point where learning disability nursing is recognised and valued has been a long time coming.’ To read Strengthening the Commitment One Year On go to tiny.cc/DH_commit
NURSING STANDARD
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NICE issues guidance on pressure ulcer prevention and management Patients ‘at risk’ of developing pressure ulcers should be repositioned at least every six hours and those considered ‘at high risk’ should have their position changed at least every four hours, according to new guidance. The updated guidance on preventing and managing pressure ulcers, produced by the National Institute for Health and Care Excellence (NICE), stresses the importance of risk assessment, adjusting patients’ positions, and the use of high-specification foam mattresses. Challenges specific to heel pressure ulcers are highlighted, as are the need for individualised care plans and the importance of training staff in pressure ulcer prevention. The guidance comes as NHS-wide targets are being finalised concerning minimising the proportion of patients with pressure ulcers in category two, three and four. These targets are expected to be introduced next year in the NHS Outcomes Framework. Four nurses, including Mark Collier, were among the 13 healthcare professionals who advised NICE on the guidelines. Mr Collier, a nurse consultant in tissue viability at United
GETTY
By Christian Duffin
Risk assessments and the monitoring of patients’ positions should be carried out at regular intervals
Lincolnshire Hospitals NHS Trust, said: ‘Risk assessments should be carried out on admission and at regular intervals. That is crucial. Assessments should be with validated tools such as the Waterlow tool. There should be ongoing assessments, especially when there are early signs of damage, such as discolouring or tissue hardening.’
Resources required
He acknowledged that some healthcare providers would find it challenging to provide high quality mattresses, and possibly enough staff to monitor patient positions as often as recommended.
British Dermatological Nursing Group operations manager Susan Maguire said the guidance is comprehensive, but staff need enough resources to deliver good quality care. In recent years, a debate among tissue viability nurses has focused on whether pressure ulcers are preventable. Ms Maguire said: ‘Pressure ulcer incidence can be reduced to zero if all the checks are done and nurses have the right equipment and support.’ She added: ‘Training in pressure ulcer assessment and management is very important, but it needs to be for all the multidisciplinary team.’ Go to tinyurl.com/omnt6bf
Drive to develop leaders in learning disability nursing A mid-career leadership programme for learning disability nurses in the UK will be developed as part of an initiative to improve career progression. A report published last week by the Department of Health (DH) states that the government will explore the possibility of creating a virtual leadership programme for all learning disability nurses. The report is an update of progress on a UK-wide review of learning disability 10 april 30 :: vol 28 no 35 :: 2014
nursing, published in April 2012, which made 17 recommendations. Improving the uptake of cancer screening among people with learning disabilities will also be tackled by the DH and Public Health England, says the report. In addition, a framework that allows healthcare professionals to measure outcomes for people with learning disabilities will be evaluated by the DH and learning disability academics.
RCN learning disability adviser Ann Norman told Nursing Standard she is happy with the progress made on some fronts, but there is still much to do. ‘Learning disability nurses have risen to the challenges and so have some trusts,’ she said. ‘Getting to the point where learning disability nursing is recognised and valued has been a long time coming.’ To read Strengthening the Commitment One Year On go to tiny.cc/DH_commit
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 17, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
