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Pressure ulcer prevention: what’s missing?

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Alisen Dube Alisen Dube, Doctoral Candidate at Birmingham City University and Tissue Viability Nurse at University Hospitals Coventry and Warwickshire NHS Trust

As a tissue viability nurse in a large university hospital, I see the devastation caused by pressure ulcers first-hand. Despite substantial efforts to eradicate them, an estimated 200,000 pressure ulcers are experienced by patients each year at an estimated cost to the NHS of £1.4 million each day, not to mention the human impact they have on patients.

The difficulties with managing pressure ulcers are heightened in the community setting; without round the clock monitoring, the adoption of the 'aSSKINg'simple steps to prevent and treat pressure ulcers has been difficult.

The 'Stop The Pressure' programme run by NHS Improvement has launched the ‘Red Dot’ campaign to increase awareness among the public and NHS staff around what can be done to stop people developing pressure ulcers whilst in hospital, other care settings and at home. This coincides with the launch of the NHS National Wound Care Strategy, of which pressure ulcer prevention is a key element.

With 1,300 new pressure ulcers reported monthly through the NHS Safety Thermometer, efforts are focused on both prevention and treatment, including providing improvement tools for healthcare professionals, the development of a definition and measurement framework, and a national pressure ulcer education curriculum.

Although efforts to prevent pressure ulcers developing have been widespread, the eradication of pressure ulcers has been elusive There is little robust, scientific evidence to quantify the relationship between underlying risk factors and the development of pressure ulcers.

My own research looks at potential contributing factors for heel pressure ulcers to better understand these relationships, which may help us better prevent their development. I will be exploring whether there are underlying physiological reasons for pressure ulcer formation and the extent to which they impact quality of life, as well as exploring the extent to which they are preventable at the point of care.

Collecting data at a time when pressure ulcer development is lower than it has been in the past should help us uncover what is missing from our current prevention strategies, as all patients involved in the study will be receiving care that already incorporates the 'aSSKINg' care bundle. We are making some progress in treating this condition, but there is still a distance to go.

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