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PRACTICE BLOG

'When a pressure ulcer occurs it is rightly considered a failure of care'

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A few weeks ago I was talking to a ward sister about some amazing work she had done to reduce incidence of hospital-acquired pressure ulcers on her ward.

Over a period of a year she had transformed the practice of her staff and the incidence had fallen as a direct result. Her trust was impressed by her work and has asked her to roll it out to other clinical areas.

As taken as I was with what she had achieved I was left with a number of uncomfortable questions.

Why was it left to one enthusiastic and motivated nurse to get pressure ulcer prevention onto the agenda in her trust?

Why had the trust failed to engage with national initiatives aimed at pressure ulcer prevention?

At Nursing Times we hear lots of success stories and in the last year I had actually started to believe that the problem of pressure ulcer prevention had largely been addressed.

”I had actually started to believe that the problem of pressure ulcer prevention had largely been addressed”

However talking to nurses it is clear that some are struggling to provide effective pressure ulcer prevention to patients because of poor staffing levels, competing priories, lack of access to appropriate equipment, and importantly education to ensure care provided is evidence based.

It seems that outdated practices such as using a 90 degree lateral rotation rather than the 30 degree tilt continue to be used despite evidence to support a change in practice.

As more and more essential care is delegated to non-registered staff it is essential that they have education and training to ensure that they not only understand the how but also the why of prevention.

”We all know and have probably seen the costs of pressure ulcer for patients”

We all know and have probably seen the costs of pressure ulcer for patients including pain, distress, and extended recovery and when a pressure ulcer occurs it is rightly considered a failure of care.

So my question remains. Why does one trust make pressure ulcer prevention a priority while others leave it to enthusiasm and motivation of individual nurses? What are the implications for patients?

If you want to update or check your knowledge on this issue take our online learning unit on pressure ulcer prevention. Click on the NT Learning tab above.

 

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Readers' comments (1)

  • Many "pressure ulcers" have origin outside of a hospital.

    Old people who fall and remain for hours on the floor before being discovered , are, for example, at major risk of developing an "ulcer"

    Decubitus ulcers have a complex and multifactorial etiology !

    To suggest the development of an "ulcer" is a "failure of care" is simplistic and typical of those who subscribe to a "blame & bully" culture.



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