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Zero tolerance for pressure ulcers urged


The National Patient Safety Agency is urging NHS organisations across England and Wales to adopt a zero tolerance approach to pressure ulcers.

In the majority of cases they can be prevented if simple measures are followed, such as observing patients’ skin and changing the position of patients at regular intervals, as well as checking for a moisture free environment and monitoring their nutritional status.

The NPSA will be conducting briefings and workshops at NHS organisations, highlighting best practice.


Readers' comments (7)

  • Ahh, that's nice. I wasn't aware that there wasn't a zero tolerance for pressure ulcers. I think maybe a zero tolerance for understaffing and poor staff support and training would be a good start

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  • Agree totally with the above. The trust in which I work have a pressure ulcer care pathway however it is lengthy and time consuming to complete. Nursing staff barely have time to carry out the care let alone document it!! Many NHS trusts employ hundreds of specialist nurses (often band 7 and above) Perhaps it's time to get back to basics and provide more band 5 nurses at ward level so that basic care can be achieved and all the boxes ticked!

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  • Pressure sores are not always preventable - the NPSA has no knowledge base to make these rash statements. Patients with poor nutritional status break down irrespective of nursing care. Patients on high dose steriods etc etc etc

    Give us the resources and we can do the job. Keep us under staffed and without the right tools at hand to do the job and we cannot. --- Simple!!

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  • Yes I am sure there are conditions that increase the likelihood of pressure ulcers developing, but come on now there are many that are preventable using good basisc nursing skills that are not reliant on equipment or staff shortage.
    I speak from experience having been a charge nurse on a older persons mental health unit in the 80's where we prided ourselves on not having any pressure sores on the ward. This was done by focusing on prevention and a total acceptance that pressure relief was the most important element of care for individuals at risk. I must admit I was a bit of nag but care staff needed to get the message that once you start talking about dressings you have failed!

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  • Again spreaking from experience.Can't argue about good nursing care preventing most cases of pressure ulcers, however times have changed since the 80s. Now more paperwork and less staff on the floor !!! Not conducive with providing good nursing care.

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  • Martyn Butcher

    Regardless of the pressure on nurses to complete paperwork etc, the current situation regarding pressure ulcers is a totally unacceptable. It is estimated that between 1:5-1:10 patients in hospital will receive some form of pressure damage. This is a national disgrace and is costing the NHS over £2 billion/year! That's as much as we spend on psychiatric health care services.

    True, in some individuals the development of pressure damage cannot always be avoided due to multi-system failures, but this only accounts for a small % of those in our care.

    Unfortunately, pressure ulcer prevention is often seen as "boringly basic". The right to good care, including appropriate pressure relief, skin hygeine, nutrition, mobilisation, correct manual handling, management of incontinence etc is not "basic", it is "fundamental".

    Yes, we are no longer in the 1980's. In those days we assessed every patients skin on a regular basis as part of the "back round". It may have been ritualised, but at least we knew what was happening with our patients, knew those at risk and did something about it. Woebetide any nurse who allowed a patient to develop an ulcer while in his/her care.

    How many nurses actually check their patients now? How many RN's check on the work of their juniors? How many ward managers take their nurses to task about pressure care issues (or actually know what care is being given)? How many staff know and implement current "best practice" in pressure ulcer prevention?

    This focus on pressure ulcers is not new and not unique to the UK; in the US funding has changed in the last couple of years so that hospitals don't get paid if they have to treat an ulcer which developed in their care, in Japan care institutions are fined for every pressure ulcer that develops.

    The NPSA are ideally placed to demand changes; it is them that have to pick up the pieces all too frequently.

    Unless changes are made there will be more £ wasted repairing the effects of poor care, and more resources lost from future direct care.

    Patient care is multi-professional and multi-agency and everyone needs to be involved in preventing pressure damage; but whether we like it or not, the burden of PU management is, and is likely to remain on the shoulders of our profession.

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  • Having just left the ward environment, to work on the district, I totally agree that pressure ulcers can be prevented. One of the reasons why iIleft (an older persons, acute ward) was that rgns were expected to give good quality care for 12 patients. I am a very hard and dilligent worker and found this impossible to do, Put a couple of extra nurses on each shft and standards will rise without a doubt. Please can the people who say these thing go and work on one of the busier wards and they will see for themselves.

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