Precious about Pressure

Background & Problem

The project was undertaken over a period of six months in conjunction with an NHSi Improvement project across the Trust on two sites. These were the 4B Care of the Elderly Ward at GRH and Avening acute Respiratory ward at CGH. The Team consisted of the multi-disciplinary staff and Specialist Support Nurses.

Our identified areas for improvement were the incidences of heel and device-related ulcers. During this time frame, the Trust implemented the six hour rule in relation to reporting pressure ulcers.

Aim

Our aim was to reduce the occurrence of hospital acquired pressure ulcers by 50% between October 2017 -March 2018.

Method

Weekly audits were undertaken in each area to review incidences, Waterlow assessment, timing of assessment, pressure relieving interventions, SSKINN bundles. This was benchmarked against previous data in each area to indicate improvements following PDSA's of interventions including use of a highly resourced trolley and heel alert magnets and additional Repose products on 4B.

The “Cheers Ears campaign” was launched on Avening Ward incorporating laminated prompts in the Patients’ bedside folders, use of Duoderm spot dressings prophylactically on ear clefts and cheeks with padding. The Team produced a video to share results with NHSi colleagues and wider Teaching within the Trust at large. We utilised data from DATIX to produce quantitative data to demonstrate improvement. Throughout the process the Team travelled across the UK to present and network with other Trusts as part of the collaboration with NHSi.

Results

The Team achieved their aim which was a reduction in ulcer formation within six months with 60% improvement on 4B and 100% on Avening Ward.

Implications

The importance of prompt assessment and prevention,identification of barriers,sharing knowledge across divisions and sustaining improvement across the Trust by communicating and sharing good practice.