Pressure ulcers are an unwanted and often avoidable complication of care that affect over 700,000 UK patients per year. They are a common occurrence, particularly in patients whose mobility is limited due to illness, severe physical disability or increasing frailty. Pressure ulcers can lead to increased mortality, morbidity, and reduced quality of life for the patient. Pressure ulcers can also result in longer hospital stays, with hospital acquired pressure ulcers increasing length of stay by an average of 5-8 days per pressure ulcer. In addition, they represent a substantial financial cost to local NHS trusts and care providers. In 2015, the cost per pressure ulcer was estimated to vary between £1,214 and £14,108 depending on its severity. Given the often preventable nature of pressure ulcers, the occurrence of this harm to patients is a key indicator of nursing standards.
This work aimed to reduce the percentage of pressure ulcers across multiple care settings in North East and North Cumbria (NENC) where the incidence of pressures ulcers was higher than the national average. The Patient Safety Collaborative (PSC) funded and supported a two-year Pressure Ulcer Collaborative (PUC), involving secondary care, community services, care homes and the ambulance service, where they had been developed by patients within their care. The Breakthrough Series Collaborative Model from the Institute for Healthcare Improvement (IHI) provided the implementation framework. In year 1, pressure ulcers were reduced by 36%, and 33% in year 2 with an estimated cost saving of £513,000, and a reduction in the number of bed days between 220 and 352.
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