Pressure Ulcers: a proactive solution?

Published on Tuesday, 20 July 2010 01:00

Posted by Julie Cutler

Pressure ulcers or bed sores seem to be very much a Cinderella condition. According to the Royal College of Nursing (2005), the costs of treatment in the UK are estimated to be equivalent to 4% of the NHS yearly budget - about £2.1 billion a year

The true cost is potentially higher overall: 59% of pressure ulcers are deemed to be hospital acquired and severe cases can potentially become the basis for legal action by the afflicted patient. In the worst case scenario an ulcer can cause tissue destruction down to the bone, sometimes leaving no option but amputation. As it is considered that 10% of hospital patients suffer from pressure ulcers, the expenses of the resultant lengthening of a hospital stay and the subsequent reduction in the quality of care are more difficult to quantify.

It is not the case that the seriousness of this condition has not been recognised by health professionals. NICE guidelines suggest that within six hours of admission all patients should be fully assessed - both to document existing sores and to identify those at risk of developing the condition whether they are chair or bed-bound.

National Institute for Health and Clinical Excellence: The management of pressure ulcers in primary and secondary care: a clinical practice guideline. September 2005. Clinical guideline 29 http://www.nice.org.uk/cg029) . 
In response to the issue, the specialist role of a tissue viability nurse has been created to address an individual hospital's policy.

However in busy wards with shift changes, is it any wonder that with the demands of modern nursing that recommended assessments for susceptibility to pressure ulcers fall by the wayside? The emphasis, of necessity, will always be on treating the primary condition. When carers rely on paper based systems where an assortment of care booklets and records are stapled together, how can the ward sisters and tissue viability nurses easily maintain rigorous control of the situation, when there are so many other demands on their time?

Yet as patients and their families have ready access to online resources spelling out NICE's recommendations for early assessment and avoidance -such as the British Medical Journal's collaboration with the Guardian Newspaper:
http://www.guardian.co.uk/lifeandstyle/besttreatments/pressure-sores-prognosis how long will it be before carers are forced to impose a more rigorous systematic approach to prevent increasing legal action?

For more information, please contact Julie Cutler, Director, Tortrix Limited e: This email address is being protected from spambots. You need JavaScript enabled to view it. , t: 02476 15 8060
www.tortrix.net