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Hospital trust’s nurses celebrate achieving pressure ulcer milestone

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A department at Doncaster and Bassetlaw Teaching Hospitals NHS Trust that cares for older and vulnerable patients is celebrating an entire year without a severe hospital-acquired pressure ulcer.

From October 2016 to October this year, no patients cared for by the musculoskeletal (MSK) and frailty group of wards and departments experienced a severe, avoidable ulcer.

“Reaching this milestone is an outstanding achievement”

Cindy Storer

A trust spokesman noted that this included pressure damage above category 2, covering suspected deep tissue injury, ungradeable and category 3 and 4 pressure ulcers.

Some wards have gone four years without the older and infirm patients they cater for developing a painful and potentially life-threatening acute pressure ulcer, according the trust.

The spokesman acknowledged that some grade 2 ulcers had been reported but said these “were also reducing”. “We are currently focusing on our low harm agenda as part of our 2017-18 strategy,” he said.

The care group, which was a finalist in the Care of Older People category in this year’s Nursing Times Awards, consists of 14 wards and departments across Doncaster, Bassetlaw and Mexborough with the largest number of beds of any department in the trust.

Nursing Times asked what the hospital-acquired pressure ulcer rates in the department were before October 2016. The trust spokesman said that from 2013-14 to 2016-17, the care group saw an 87% reduction. This compares to a reduction of 78% across the whole organisation for the same four year period.

Hospital-acquired pressure ulcer (HAPU) rates for the care groupHAPU rates for whole trust
 2013-14 31 incidents of severe, avoidable HAPU (grade 3 and 4) – pre-reorganisation into care group structure 169
 2014-15 21 incidents of severe, avoidable HAPU (grade 3 and 4) (the year Care Groups formed) 103
 2015-16 18 incidents of severe, avoidable HAPU (grade 3 and 4) (Care Groups maturing and quality improvement interest sparked) 52
 2016-17 4 incidents of severe, avoidable HAPU (grade 3 and 4) 37
 2017-18 No incidents of severe avoidable HAPU (grade 3 and 4) -

To celebrate the achievement, the wards were visited by their matrons, the head of nursing and the trust’s skin integrity team and presented with an award.

“Reaching this milestone is an outstanding achievement and one which every member of the MSK care group at the trust should be proud of,” said Cindy Storer, head of nursing and quality for musculoskeletal and frailty at the trust.

“Each and every day our team work hard to ensure our patients receive the best quality care, treating people who are acutely unwell as well as ensuring proactive steps are taken in order to ensure preventable harms, such as pressure ulcers, do not occur,” she said.

“This highlights the important, caring and innovative work of our staff”

Richard Baker

Among steps to prevent ulcers, staff have been trained in skin care and the types of moisturising creams and dressings to use when a patient’s skin is at risk of damage.

Other innovative projects include the #EndPJParalysis – being adopted by many hospitals around the country – and 24 Hour Rehab campaigns to encourage patients to move away from their beds and make use of ward facilities, such as getting up for a bite to eat or socialising with other patients in the day room.

Meanwhile, open visiting times mean relatives and carers can visit at any time of the day or night as important “guardians of patient safety”.

Trust chief executive Richard Baker said achieving the pressure ulcer milestone was a “fantastic achievement”.

“This highlights the important, caring and innovative work of our staff,” he said. “I want to say ‘thank you’ to every member of staff who has made this milestone possible and for consistently putting patient safety at the heart of everything they do.”

The announcement came in the same week as World Wide Pressure Injury Prevention Day, organised by the National Pressure Ulcer Advisory Panel and held this year on 16 November.

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