Pressure ulcer guidance seeks to improve consistency

New guidance released by the NHS sets to improve consistency in reporting pressure ulcers.

Pressure ulcers are defined as “local damage to the skin and/or underlying tissue, usually over a bony prominence (or related to a medical or other device), resulting from sustained pressure (including pressure associated with shear). The damage can be present as intact skin or an open ulcer and may be painful.

Between April 2015 and March 2016 over 24,000 patients were reported to have developed a new pressure ulcer. Treating pressure damage is thought to cost the NHS £3.8 million every day. In many instances those suffering from the most severe pressure damage may seek to pursue a pressure sore claim in order to seek compensation for their suffering.

It is thought that previously there was significant variations in the techniques and practices used to report pressure damage across trusts. This meant that the level of reported pressure ulcers and pressure sores could not accurately represent the true picture of pressure ulcers within a set trust as some trusts would have over or under reported the true occurrence of the pressure ulcers. In these instances it could have led to patients pursuing a hospital negligence claim or care home negligence claim should they have developed a pressure sore due to negligent care.

The inconsistencies in current practices are thought to result in trusts under reporting the occurrence of pressure damage and therefore an accurate picture of the number of patients experiencing pressure damage remains unknown.

One of the major changes identified in the new guidelines is that pressure ulcers should no longer be reported as avoidable or unavoidable. This change is designed to ensure that all instances of pressure sores are investigated in order to ensure the best care is provided going forward and where necessary learnings can be made.

In addition, pressure ulcers that occur at the end of a person’s life should no longer be recorded separately according to the new guidance. These had sometimes been recorded as Kennedy ulcers, however this term will cease to be used going forward.

As well as the guidance a new curriculum to help assist with nurse training on preventing and treating pressure sores has also been issued. It is hoped that together this can help ensure best practice is implemented and help reduce the number of medical negligence claims relating to pressure sores.

Commenting on the new guidelines, Ruth May, Executive Director of Nursing at NHS Improvement said:

“We anticipate that full implementation of the recommendations from April 2019 will improve understanding of the level of pressure damage harm in England, This will in turn support an organisation’s ability to learn from reported incidents, and inform the quality improvement programmes that are required to help reduce reported pressure damage and improve the quality of care,”

The new guidelines are set to be in place with a full implementation across all trusts by April 2019.


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