Pressure Ulcer Reduction

Pictured are the team shortlisted for HSJ Safety Award, for the Sefton Pressure Ulcer Reminder (SPUR) Wheel.

EPUAP the European Pressure Ulcer Advisory Panel's goal is to provide relief for persons suffering from, or at risk of, pressure ulcers, through research and the education of the public and by influencing pressure ulcer policy in all European countries towards an adequate patient centred and cost effective pressure ulcer care.

TIME TO MOVE FOR PRESSURE ULCER PREVENTION  – their video is available with different language subtitles on EPUAP Youtube Channel HERE.


Our Aims at Mersey Care:

  • Aim for zero deterioration of grade 2 and 3 pressure ulcers for patients whilst under our care
  • Raise awareness by training for managing pressure ulcers in the mental health inpatient wards
  • Reduction plan in place with a target trajectory for reduction of grade 2 and 3 pressures ulcers
  • Zero grade 4 pressure ulcers in our care.

How we are achieving this:

  • All incidents of pressure ulcers are reported, the Duty of Candour processes been initiated and Root Cause Analysis investigations undertaken for all incidents of pressure ulcers
  • All Grade 3 and Grade 4 Pressure Ulcer incidents are reviewed in locality safety huddles and Being Open meetings. There is a Pressure Ulcer Harm Free Care Group which monitors key themes and identifies hot spot areas
  • A quarterly report is completed within each locality to ensure individual performance is reviewed and additional team support is implemented were required. The comprehensive Pressure Ulcer Reduction Programme continues to be developed and the Trust continues to participate in the national Stop the Pressure collaborative
  • Following review of all strategy notes, there were various gaps identified and a Quality Practice Alert has been developed / implemented across the division and wider organisation.

Key progress:

  • We are working in collaboration with NHSI (NHS Improvement) on the “Stop the Pressure” Programme (STPP) which is part of a wider Patient Safety Campaign and is an improvement priority within the NHSI business plan. STPP is a system wide improvement programme working across acute and community settings. We are also working in collaboration with key partners in social services and care home settings
  • A bespoke pressure ulcer dashboard has been developed to further enhance intelligence and identify key areas for improvement. Team level dashboards have also been developed and implemented to support team level monitoring of data
  • Work has started to develop and implement a pressure ulcer programme across the other divisions. This will be a pilot within two wards initially and a plan will be developed to support. This will then feed into the overarching pressure ulcer programme which will scale up across all divisions
  • As part of the NHSI Stop the Pressure Collaborative Approach, we are taking part in a Pressure Ulcer Reduction Pilot programme. This pilot aims to reduce the deterioration of grade 2 and 3 pressure ulcers for patients within our care and reduce the overall reduction targets. Two hot spot teams have been identified to participate in the pilot. Feedback to date has been positive, with both staff surveys and Plan, Do, Study, Act cycles being utilised to support improvements. A full report will be produced at the end of the pilot
  • A SEM (sub-epidermal moisture) scanner pilot is underway, in conjunction with the Perfect Care team. The scanner has been used in the acute and proven trials have shown that pressure ulcers can be identified up to 10 days before they present. This is yet to be trialled in a community setting. Pilot sites have been identified and the trial is due to commence December 2018
  • Machine Learning – this project is the development of an ‘app’ in conjunction with Liverpool John Moore’s University and Perfect Care. The app will support the grading of pressure ulcers alongside defining the tissue type. The project is currently in the ethical review stage and once agreed will be piloted by the Skin Team. If successful the app could not only be used by clinical staff but also patients and carers in the management of pressure ulcers
  • Latest NHSI Guidance in relation to pressure ulcers has been reviewed and a gap analysis has been completed with clear actions to support organisational implementation
  • Latest NHSI competency frameworks have been developed. Dedicated work stream implemented as part of pressure ulcer reduction programme. Target date for implementation is April 2019, in line with national implementation timeframes.

Prevention of pressure ulcers leaflet for carers and families