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Expert nursing programme helps trust reduce pressure ulcers  


A hospital trust has seen a fall in serious pressure ulcers after providing specialist tissue viability training to key nurses who then passed on their knowledge to other nursing staff at the bedside.

Senior nurses say the move has contributed to a 30% drop in severe pressure ulcers at Doncaster and Bassetlaw Hospitals NHS Foundation Trust.

The trust’s tissue viability team introduced a new “bespoke” training package called the Ward Based Training Programme.

“We had to devise something completely different to reduce the number of severe pressure ulcers in the trust”

Tracy Vernon

Nurses with an interest in pressure ulcer prevention were chosen to go on an intensive, six-month course to become tissue viability practitioners.

As well as becoming more specialised themselves, the idea was that could also help provide advice to colleagues on their ward.  

Tracy Vernon, lead nurse for tissue viability, and the trust’s team of three tissue viability sisters said they had needed to “devise something completely different” to reduce the incidence of severe pressure ulcers. 

“Being a small team we needed to expand our expert knowledge about skin damage prevention out into the wards,” she said. “The idea of having a pool of fully-trained tissue viability practitioners on each ward who could teach other nurses and provide 24/7 seamless care was the best solution.” 

Ms Vernon said ward managers were asked to identify nurses who were “most passionate” about preventing pressure ulcers who were then put through an intensive six month training programme.

To complete the programme, they had to achieve a 90% pass rate for 12 practical assessments and spend a day working one-to-one with a tissue viability sister on their ward.

“By giving each nurse the opportunity to work closely with a tissue viability expert helped to further embed their knowledge and skills,” she said. “The investment in time and effort of my team is now showing fantastic results.”

The nurse training programme is part of the trust’s three-year pressure ulcer reduction strategy. Other measures include the purchase of 114 special pressure relieving beds and an extensive bed replacement programme for all patients.

The first wards to gain their own tissue viability practitioners were two rehab wards, the assessment and treatment centre, the acute medical unit and surgical assessment unit.

The training package is now being rolled out to further wards.

During 2013-14, the trust recorded a total of 163 stage 3 ulcers and six stage 4 ulcers. Latest data shared with Nursing Times shows ulcer levels at 112 and 3, respectively, for 2014-15.

“We are predicting a 32% reduction at year end [on 31 March],” said a trust spokeswoman.



Readers' comments (2)

  • Surely that's the approach specialist practtioners should follow anyway. They theoretically do them selves out of a job by upskilling others.
    And are they reporting a reduction in incidence or prevalence?

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  • what special mattresses would it be
    nimbus, trans-air, its all to do with the patient whether it be underlying condions,medecation, mobility the is a number of factors notstopping in bed is one as well,nutrion the list is endless bring back the comfort rounds if the is enough staff.

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