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Grading wheel helping nurses identify pressure ulcers

  • 3 Comments

Tissue viability nurses at Northern Lincolnshire and Goole NHS Foundation Trust have devised a pressure ulcer grading wheel to help staff identify the correct grade of ulcer.

The pressure ulcer grading (PUG) wheel features photographs of real pressure ulcers, showing how they worsen from grade one to four.

“We’ve been able to demonstrate a significant improvement in the recognition and grading of pressure ulcers”

Carole Linfoot

On the other side of the wheel are images showing what moisture lesions and deep tissue injuries look like to prevent these being incorrectly identified as a pressure ulcer.

It was the idea of tissue viability nurse Judith Barnard and has already had a positive impact since it was introduced last year.

Between January and September 2015, there were 263 hospital acquired pressure ulcers at the trust.

The number each month gradually decreased from 50 in January 2015 to 16 in September, of which just 3% were grade four, said the trust.

Tissue viability nurse Carole Linfoot said: “Since the wheel has been rolled out we’ve been able to demonstrate a significant improvement in the recognition and grading of pressure ulcers.”

Before rolling out the wheel, the team carried out a test. They asked 20 nurses to grade pressure ulcers without the wheel.

It resulted in 80% correct answers. However, using the wheel the nurses were 100% accurate in their grading of sores.

Staff nurse Fiona Thompson said: “I think the PUG wheel is brilliant, I always use it to diagnose and classify pressure ulcers. It’s great to have a device that’s so accessible and easy to use.”

Care Quality Commission inspectors highlighted the wheel as an excellent example of innovation on a recent visit.

It is one of a number of recent initiatives devised to tackle pressure ulcers at the trust over the last year.

Pocket mirrors have been given to all nursing staff to help them identify early any pressure sores in hard-to-see places, such as on heels, and a children’s activity book has been created to spread the message to younger patients and their families.

As part of the government’s Sign up to Safety initiative, the trust has pledged to reduce the number of avoidable grade three pressure ulcers by 50% and avoidable grade four pressure ulcers to zero by 2017.

 

  • 3 Comments

Readers' comments (3)

  • michael stone

    'The number each month gradually decreased from 50 in January to 16 in September, of which just 3% were grade four, said the trust.'

    Well done ! And nice thinking by Judith Barnard.

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  • Sounds simple and effective. When is it going nationwide?

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  • michael stone

    ANONYMOUS14 FEBRUARY, 2016 10:47 AM

    Call me a cynic:

    'Sounds simple and effective. When is it going nationwide?'

    Probably never ?

    If that level of reduction - about two-thirds - had been reported in a 'statistically-proven' trial of some new drug, it would doubtless get a lot of attention. This idea seems to be cheap, very effective and will perhaps get ignored !

    A little money should be spent of 'refining' this colour wheel, and making sure it does 'work', then they should be mass-produced and distributed widely to hospitals, etc.

    At least the CQC seems to be onboard.

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