Top Picks: Key resources on pressure ulcers

Summary

Pressure ulcers, or bed sores as they are often called, can affect people of all ages. They can lead to serious complications and immense pain for patients, so prevention and awareness is key. Patients with mobility difficulties, conditions affecting blood flow (such as Type 2 Diabetes), and those over 70 are particularly vulnerable. 

Stop Pressure Ulcer Day is organised annually by the European Pressure Ulcer Advisory Panel and aims to bring knowledge to a wider audience to reduce the harm caused by pressure ulcers. 

In support of the campaign, we're shining a spotlight on a selection of fantastic resources that have been shared with us via our patient safety platform - the hub. 

Content

Click on the headings below to read more about each resource.

1. Conducting a systems review of pressure ulcers in the intensive care unit

Pressure ulcers within the intensive care unit have long been recognised as a persistent and complex patient safety issue. In this blog, Patient Safety Learning's Associate Director Claire Cox shares how she adopted a systems approach using the Systems Engineering Initiative for Patient Safety (SEIPS) model to review pressure ulcers.

2. Implementing the aSSKINg pressure ulcer care bundle – a blog by Susan Martin

In this blog, Susan Martin, a Tissue Viability Specialist Nurse at East Sussex, describes how she implemented the aSSKINg model (assess risk; skin assessment and skin care; surface; keep moving; incontinence and moisture; nutrition and hydration; and giving information or getting help) for pressure ulcer prevention into her Trust.

3. Skin Assessment: Assessing skin on patients with darker skin tones in relation to PU prevention

In this 56 minute presentation by The Society of Tissue Viability, Jacqui Fletcher looks at how wound care and pressure ulcer prevention can be improved for patients with darker skin tones.

4. PURPOSE-T (Pressure Ulcer Risk Primary or Secondary Evaluation Tool)

PURPOSE-T (Pressure Ulcer Risk Primary or Secondary Evaluation Tool) is an evidence-based pressure ulcer risk assessment instrument that was developed by the University of Leeds using robust research methods. PURPOSE-T identifies adults at risk of developing a pressure ulcer and supports nurse decision‐making to reduce that risk (primary prevention), but also identifies those with existing and previous pressure ulcers requiring secondary prevention and treatment. It uses colour to indicate the most important risk factors and forms a three‐step assessment process.

5. PSIRF planning – Pressure ulcer example scenario

The Patient safety incident response framework (PSIRF) represents a new approach to responding to incidents. Under PSIRF, those leading the patient safety agenda within provider organisations, together with internal and external stakeholders (including patient safety partners, commissioners, NHS England, regulators, Local Healthwatch, coroners etc), decide how to respond to patient safety incidents based on the need to generate insight to inform safety improvement where it matters most. Key issues must first be identified and described as part of planning activities before an organisation agrees how it intends to respond to maximise learning and improvement. This guidance has been developed collaboratively between Stop the Pressure Programme, National Wound Care Strategy leads and members of the Patient Safety Team, with the support from the Patient Safety Incident Response Framework (PSIRF) Implementation and Working Groups. 

6. Embedding skin tone diversity into undergraduate nurse education: Through the lens of pressure injury

This study, published by the Journal of Clinical Nursing, explores health disparity in on-campus undergraduate nurse education through the analysis of teaching and teaching material exploring pressure injuries.

7. Measuring standards of care, not negative outcomes (Interview with Head of Nursing Quality)

In this interview, Head of Nursing Quality Gavin Porter talks about his positive, team-focused approach to improving pressure ulcer outcomes. "Counting the number of pressure ulcers doesn’t really tell you about the standards of pressure ulcer care. I wanted to look at things differently; to focus more on the interventions and good practice that helps keep patients safe."

8. Sign up to safety - pressure ulcers (Barts Health NHS Trust)

In this six minute video, Barts Health NHS Trust explains the measures frontline medical staff can take to help avoid the risk of pressure ulcers using the SSKIN acronym. 

9. This Is Nursing podcast: We don't want a good wound. We want to prevent them!

Alison Schofield, Tissue Viability Clinical Nurse Specialist, discusses the challenges facing her role in this current world of nursing, the impact of COVID-19 has had on the delivery of community tissue viability services and on people in receipt of the services in care homes and in their own homes.

10. Incidence of hospital-acquired pressure injuries and predictors of severity in a paediatric hospital

Hospital-acquired pressure injuries (HAPIs) pose significant challenges in healthcare and cause increased patient suffering, longer hospital stays and higher healthcare costs. Children in hospital face unique risks, but evidence about this remains scarce. This study in the Journal of Advanced Nursing aimed to identify and describe HAPI admission incidence and severity predictors in a large Australian children's hospital. The authors found that HAPI injuries in paediatric patients are unacceptably high. They argue that prevention should be prioritised and the quality of care improved globally. They also call for further research to develop targeted prevention strategies for these vulnerable populations.

11. Reducing hospital-acquired pressure injuries in a cardiothoracic intensive care unit

Hospital-acquired pressure injuries are a significant patient safety concern. The US Centers for Medicare & Medicaid Services tracks hospital-acquired pressure injuries as a patient safety indicator. Healthcare organisations with higher-than-expected rates may incur penalties. The aim of this study was to reduce the prevalence and incidence of hospital-acquired pressure injuries in the cardiothoracic intensive care unit.

12. Safeguarding adults protocol: pressure ulcers and raising a safeguarding concern

Pressure ulcers are a significant challenge for the patients who develop them and the healthcare professionals involved in their prevention and management. They can result in serious complications and avoidable harm, with patients with mobility difficulties at particularly risk from this. This guidance from the Department of Health and Social Care is designed to help practitioners and managers across health and care organisations to provide caring and quick responses to people at risk of developing pressure ulcers.

For more resources, see our dedicated Pressure ulcer section of the hub.

Do you have a resource or story to share on pressure ulcer care or prevention? the hub is designed for frontline staff, patients, managers, and anyone else else with an interest in patient safety, to come together and share their insights.

You can sign up today for free for full access to our library of resources and all of the benefits on offer to our members.