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Inconsistent risk assessment led to pressure ulcers at Mid Staffs, inquiry finds

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Inconsistent assessment of the risk of pressure areas is likely to have been one of the causes of pressure ulcers among people who contacted the independent inquiry into Mid Staffordshire Foundation Trust.

The inquiry’s report, published today, said around 20 people complained of bad experiences with pressure ulcers.

It said: “Their stories suggested a lack of care; these stories were not surprising given the general description of care afforded at times.”

In addition to inconsistent assessment techniques, the report highlighted an apparent lack of multidisciplinary team working and shortage of staff as other likely causes.

“Shortage of staff and other obstructions made it inevitable that there would be cases of avoidable skin breakdown,” it said.

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Readers' comments (1)

  • I don't Mid Staffs is such an isolated case although we should welcome this report.

    It's simple really: either registered nurses are professionally accountable for their standards of care (including those nurses in management & on trust boards) or we're no better than wage slaves and all our talk about nursing standards and a caring ethic is just window dressing.

    As for the 'culture of fear', I know it exists for isolated individuals trying to stand up for decent care. But if we as a profession allow such individuals to be picked off and intimidated, we're not much good to our patients and our professional codes of ethics are a waste of paper.

    It'll be interesting to see if there's any NMC response.

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