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Trusts urged to focus on nutrition when treating pressure ulcers

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NHS Improvement has worked with specialist nurses to develop five “top tips” on nutrition that should be followed to help patients with pressure ulcers.

The regulator told Nursing Times it was urging nurses and other staff treating patients with pressure ulcers and wounds to be aware of the importance of nutrition.

“Good nutrition is vital to ensuring that patients have healthy skin and are less susceptible to developing pressure ulcers”

Ruth May

It noted that nutrition and hydration played a key role in keeping skin healthy and should be an integral part of pressure ulcer risk assessment and screening.

It was vital that this assessment was followed up by action, with personalised care plans detailing how patients can maintain a healthy balanced diet, said NHS Improvement.

As a result, NHS Improvement has worked with dietitians and specialist nurses to develop key tips to help patients eat well to treat skin well.

These include ensuring that patients have a healthy balanced diet to help prevent skin breakdown and improve healing, as well as staying hydrated to maintain good skin health.

If their appetite is poor, or they need food high in energy and protein, they should be encouraged to try to eat little and often with nutritious snacks and drinks.

Those helping someone who is unable to eat independently should provide adapted cutlery or crockery to support their independence, and also offer assistance when needed.

NHS Improvement highlighted that the success of focusing on good nutrition when treating pressure ulcers had been demonstrated by Leeds Teaching Hospitals NHS Trust, Sheffield Teaching Hospitals NHS Foundation Trust and Warrington and Halton Hospitals NHS Foundation Trust.

For example, nursing staff in Leeds had looked at how malnutrition could contribute to development of pressure ulcers and poor wound healing.

In Sheffield, they had looked at the importance of patients with reduced mobility losing weight gradually to ensure skin integrity was not compromised.

Queen's Nursing Institute

Nurse staffing shortage is ‘top priority’ for regulator

Ruth May

Meanwhile, Warrington and Halton had focused on how staff needed to recognise where a diet may result in nutritional depletion and the impact on wound healing.

The work is part of NHS Improvement’s Stop the Pressure campaign, a two-year programme aimed at producing a sustained reduction in the prevalence of pressure ulcers. This issue currently affects 700,000 people at a cost of more than £3.8m to the NHS, per day.

The importance of nutrition is also backed up by evidence from the National Institute for Health and Care Excellence.

Ruth May, executive director of Nursing at NHS Improvement, said: “Good nutrition is vital to ensuring that patients have healthy skin and are therefore less susceptible to developing pressure ulcers.”

“As part of its National Stop the Pressure campaign, NHS Improvement will support trusts to implement these five top tips to ensure that patients maintain a healthy diet,” she said.

She added: “This builds on the fantastic work being carried out at Leeds Teaching Hospitals NHS Foundation Trust, Sheffield Teaching Hospitals NHS Foundation Trust, and Warrington and Halton Hospitals NHS Foundation Trust to ensure optimal nutritional care of patients to prevent pressure ulcers.”

Five key tips

  1. Ensure you have a healthy balanced diet to help prevent skin breakdown and improve healing
  2. Stay hydrated to maintain good skin health
  3. If your appetite is poor, or you need food high in energy and protein you should try to eat little and often with nutritious snacks and drinks
  4. If you are overweight or obese:
  • choose low-fat dairy foods and remove visible fat from meat
  • avoid high sugar foods e.g. biscuits, cakes, chocolate, fizzy drinks, sweets
  • avoid crash diets

   5. If you are helping someone who is unable to eat independently:

  • Provide adapted cutlery or crockery to support their independence
  • Provide assistance (prompting, encouragement or feeding) when needed

Case studies

Leeds Teaching Hospitals NHS Trust Nursing staff looks at how malnutrition can contribute to development of pressure ulcers and poor wound healing. Find out more.

Sheffield Teaching Hospitals looks at the importance of patients with reduced mobility losing weight gradually to ensure skin integrity is not compromised. Find out more.

Warrington and Halton NHS Foundation Trust looks at how staff need to recognise where a diet may result in nutritional depletion and the impact on wound healing. Find out more.

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Readers' comments (2)

  • How much has it cost for NHS Improvement to work with Specialist nurses to come up with 5 top tips to prevent pressure ulcers? All nurses are fully aware of these, many are tearing their hair out as due to staff shortages and huge pressures they cannot give the care that they've been trained to give. Food is an issue also with nursing staff having less control over what is supplied. Pushing revolting tasting, highly chemicalised nutritional supplements is not the answer, there needs to be resources to have high quality food, juices and nutritious smoothies to tempt jaded palates.

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  • Village girl, you took the words out of my mouth.

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