Update - NICE guidelines on pressure ulcers ignored

VOL: 102, ISSUE: 16, PAGE NO: 36

Nurses are failing to following NICE guidelines on pressure ulcer management, according to wound care experts.

Nurses are failing to following NICE guidelines on pressure ulcer management, according to wound care experts.

A clinical practice guideline published by NICE in collaboration with the RCN in September last year recommended that pressure ulcers graded 2 or above should be reported as a local clinical incident.

However, Jacqui Fletcher, principal lecturer in tissue viability at HertfordshireUniversity, voiced concerns when it was discovered that only four out of 100 qualified nurses attending different wound care courses were aware of the recommendation.

NICE's decision not to publish a short version as well as a quick reference guide has not helped in the dissemination of the recommendations, according to Julie Stevens, consultant nurse, Hounslow Primary Care Trust and West Middlesex University Hospital.

But some tissue viability nurses have voiced concerns that the recommendations are unrealistic. Fiona Burton, nurse consultant in tissue viability at University Hospitals Coventry and Warwickshire NHS Trust said that while the guidance raised awareness and helped nurses argue for equipment, reporting grade 2 ulcers was not practical. 'We report grade 3 and 4 ulcers as clinical incidents but grade 2 are common and we do not have the resources to investigate all of these,' she said.

'We have found it more practical to investigate only grade 2 pressure ulcers that are reported as part of our pressure ulcer prevalence audit or clinical benchmarking activities,' Ms Burton added.

According to Julie Stevens, trusts do not always have systems in place to support clinical incident reporting which, although extremely important, is very time-consuming. 'Supporting trusts to implement the NICE recommendations can be a difficult process, which involves staff training, and there is not always a tissue viability nurse available to do it,' she said.