Clinical update
Pressure ulcers SPL
Essential facts About 700,000 people in the UK develop pressure ulcers every year. Previously known as pressure sores or bed sores, they are preventable in about 95% of cases, according to the NHS Stop the Pressure campaign. Each one costs an average of £4,000 to treat. The National Institute for Health and Care Excellence (NICE) advises that these wounds can lead to life-threatening complications such as blood poisoning and gangrene.
NICE pressure ulcer quality standard (June 2015) www.nice.org.uk/ guidance/qs89 NICE pressure ulcer guidance (April 2014) www.nice.org.uk/ guidance/CG179
What’s new Every patient admitted to a hospital or a care home with nursing staff should have a pressure ulcer risk assessment within six hours, according to a new quality standard from NICE. The standard aims to reduce the number of people developing pressure ulcers in all settings, prevent lengthy hospital stays and improve patients’ quality of life. It states that people with a risk factor for pressure ulcer development who are referred to community nursing services should have this risk assessment at the first face-to-face visit.
Causes/risk factors Pressure ulcers are caused by damage to an area of skin and/or the tissues below as a result of pressure or distortion sufficient to impair blood supply, according to NICE. They often occur in people confined to a bed or chair for long periods due to illness. NICE says that all people are potentially at risk of developing pressure ulcers, but they are more likely to occur in those aged over 75 and in people who are seriously ill, have a neurological condition, impaired mobility, poor posture, compromised skin or are malnourished. People
Expert comment Mark Collier, nurse consultant for tissue viability at United Lincolnshire Hospitals NHS Trust
Find out more
Wounds UK best practice statement (June 2013) tinyurl.com/ku4t2xl
are also at risk if they have significant loss of sensation, a previous or current pressure ulcer or are unable to reposition themselves.
How to help your patient NICE guidance published in 2014 says that clinical staff should assess and document pressure ulcer risk using a validated scale to support clinical judgement, such as the Braden scale or Waterlow score. People considered to be at risk should have a skin assessment which, in adults, should take into account any pain or discomfort, skin integrity in areas of pressure, colour changes or discoloration, and variations in heat, firmness and moisture, according to the new quality standard.
SSkIN bundle: five simple steps to prevent and treat pressure ulcers tinyurl.com/ncy5y7d Articles from Nursing Standard Documentation and record keeping in pressure ulcer management tinyurl.com/p5qos99 Engaging patients in pressure ulcer prevention tinyurl.com/prtstvl Preventing pressure ulcers in patients in intensive care tinyurl.com/or7u75q
See student life page 66
‘Pressure ulcers have an impact on all aspects of a patient’s quality of life. The increasing number of older people means there are more people at risk of developing pressure ulcers. While much of the quality standard may be met in hospital and community settings, there may not be as much awareness or training in care homes.
‘All nurses should be using the SSkIN bundle (see box above). The five elements of SSkIN are: support surface requirements; skin inspection; keep patients moving; incontinence/ moisture management; and nutrition and hydration assessment. Prevention from day one is the way forward, so that fewer pressure ulcers develop.’
NURSING STANDARD julyNo1 other :: vol uses 29 no 44 :: permission. 2015 17 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 21, 2015. For personal use only. without Copyright © 2015 RCNi Ltd. All rights reserved.
Pressure ulcers SPL
Essential facts About 700,000 people in the UK develop pressure ulcers every year. Previously known as pressure sores or bed sores, they are preventable in about 95% of cases, according to the NHS Stop the Pressure campaign. Each one costs an average of £4,000 to treat. The National Institute for Health and Care Excellence (NICE) advises that these wounds can lead to life-threatening complications such as blood poisoning and gangrene.
NICE pressure ulcer quality standard (June 2015) www.nice.org.uk/ guidance/qs89 NICE pressure ulcer guidance (April 2014) www.nice.org.uk/ guidance/CG179
What’s new Every patient admitted to a hospital or a care home with nursing staff should have a pressure ulcer risk assessment within six hours, according to a new quality standard from NICE. The standard aims to reduce the number of people developing pressure ulcers in all settings, prevent lengthy hospital stays and improve patients’ quality of life. It states that people with a risk factor for pressure ulcer development who are referred to community nursing services should have this risk assessment at the first face-to-face visit.
Causes/risk factors Pressure ulcers are caused by damage to an area of skin and/or the tissues below as a result of pressure or distortion sufficient to impair blood supply, according to NICE. They often occur in people confined to a bed or chair for long periods due to illness. NICE says that all people are potentially at risk of developing pressure ulcers, but they are more likely to occur in those aged over 75 and in people who are seriously ill, have a neurological condition, impaired mobility, poor posture, compromised skin or are malnourished. People
Expert comment Mark Collier, nurse consultant for tissue viability at United Lincolnshire Hospitals NHS Trust
Find out more
Wounds UK best practice statement (June 2013) tinyurl.com/ku4t2xl
are also at risk if they have significant loss of sensation, a previous or current pressure ulcer or are unable to reposition themselves.
How to help your patient NICE guidance published in 2014 says that clinical staff should assess and document pressure ulcer risk using a validated scale to support clinical judgement, such as the Braden scale or Waterlow score. People considered to be at risk should have a skin assessment which, in adults, should take into account any pain or discomfort, skin integrity in areas of pressure, colour changes or discoloration, and variations in heat, firmness and moisture, according to the new quality standard.
SSkIN bundle: five simple steps to prevent and treat pressure ulcers tinyurl.com/ncy5y7d Articles from Nursing Standard Documentation and record keeping in pressure ulcer management tinyurl.com/p5qos99 Engaging patients in pressure ulcer prevention tinyurl.com/prtstvl Preventing pressure ulcers in patients in intensive care tinyurl.com/or7u75q
See student life page 66
‘Pressure ulcers have an impact on all aspects of a patient’s quality of life. The increasing number of older people means there are more people at risk of developing pressure ulcers. While much of the quality standard may be met in hospital and community settings, there may not be as much awareness or training in care homes.
‘All nurses should be using the SSkIN bundle (see box above). The five elements of SSkIN are: support surface requirements; skin inspection; keep patients moving; incontinence/ moisture management; and nutrition and hydration assessment. Prevention from day one is the way forward, so that fewer pressure ulcers develop.’
NURSING STANDARD julyNo1 other :: vol uses 29 no 44 :: permission. 2015 17 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 21, 2015. For personal use only. without Copyright © 2015 RCNi Ltd. All rights reserved.
