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'Punitive financial penalties won't produce the results that patients deserve'

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Pressure ulcer reduction is one of the latest targets directed at nurses, as reported by Nursing Times last week. New rules linking them to trust funding mean you will face increased pressure to hit targets on reducing pressure ulcers this year.

The problem of pressure ulcers has always been with us. When I was a student nurse 30 years ago we saw pressure ulcers, sometime terrible ones, particularly in long-stay geriatric wards. But other than turning, an ineffective ripple mattress or a matted sheepskin there wasn’t much we could do. We didn’t know how many patients had pressure ulcers or how to describe or classify them and had no effective dressings to heal them.

In 2013 we have a wealth of knowledge and equipment at our fingertips, yet pressure ulcers are the biggest single cause of avoidable harm to NHS patients.

While targets may help to focus attention on the extent of the problem I am not sure punitive financial penalties will necessarily produce results that patients deserve. In fact they may actually encourage under-reporting. Tissue viability teams across the country are already making efforts to improve pressure ulcer rates without the stick of financial penalties, and these innovations need to be shared and celebrated.

On 7 February we are holding a NTclinical webchat with Vanessa McDonagh and Amy Oldfield, tissue viability clinical nurse specialists from University Hospitals Coventry and Warwickshire Trust. They set up a campaign to raise awareness of pressure ulcers and motivate wards to become free of hospital-acquired pressure ulcers.

Their “100 Days Free” campaign motivated nurses to take control and ensure their areas were free of pressure ulcers for that length of time and beyond. The campaign has reduced hospital-acquired pressure ulcers by 69.5% and saved £600,000. In a recent article in Nursing Times Vanessa said, “We did it because we are passionate about harm-free care.”

Vanessa and Amy are happy to share their experience with you so please join us on 7 February at 4pm. Go to the home page at and you will be directed to the chat. If you would like to submit a question in advance please email it to

You can also update you knowledge on pressure ulcer prevention by completing our Nursing Times Learning unit on Pressure Ulcer Prevention.

It will teach you:

  • Factors that increase a patient’s risk of developing pressure ulcers
  • How to undertake a pressure ulcer risk and skin assessment
  • A variety of techniques that can be used to minimise a patient’s risk of pressure ulcer development
  • How different pressure-relieving/reducing equipment can help to prevent the development of pressure ulcers
  • How ongoing pressure ulcer prevention should be addressed when transferring or discharging at risk patient’s
  • To identify causes and the classifications of pressure ulcers
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