Eliminating Avoidable Pressure Ulcers
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1 Eliminating Avoidable Pressure Ulcers Jackie Stephen-Haynes Professor & Consultant Nurse in Tissue Viability ICO Conference Centre, London November 3 rd 2014
2 Aims and Objectives Introduction Reducing pressure ulcers in community settings Creating the culture Engaging staff in the elimination of avoidable pressure ulcers Learning in practice Our experience in Worcetershire
3 ...So lets take a closer look....
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5 Worcestershire Health & Care NHS Trust Always caring about you To promote health and wellbeing through the provision of high quality, innovative and cost effective services.
6 WH&CT We will always provide an excellent patient experience Our services will always be safe and effective We will work in partnership to improve the integration of health and care Our organisation will be efficient, inclusive and sustainable
7 Courageous Ambitious Responsive Empowering Supportive Care Compassion Competence Communication Courage Commitment
8 The WH&CT Tissue Viability Team 2014 WH&CT 3971 headcount 3112 WTE 35.9% Registered Nurses 20.7 Support roles 9.26% AHP
9 Strategic Vision Accountability Quality Care Plan Strategy Organisational Intentions Ambition STOP THE PRESSURE Safety & Avoiding Harm Action & Change Thursday 10 th September 2009 Prevention Elimination of the avoidable pressure ulcer
10 A strategy for the elimination of avoidable pressure ulcers in WH&CT 1. Education and staff development 2. Pressure reducing equipment 3. Shared Learning from Serious Incident Forum 4. Information/education for patients & carers in Pressure Ulcer Prevention 5. Safeguarding & Mental Capacity 6. Documentation & Assessment 7. Sharing/Use of Data 8.Patient experience 9. Clinical Audit/Effectiveness
11 We know where we are......where are we?
12 Safety thermometer data April 94.7 May 94.9 July 94.3 August 94.6 Sept 93.4 Oct 93.8 Nov 94.8 Dec 94.6 Jan 94.5 Feb 94.1 March 93.9 Aspirant 100% Performance target 95%
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14 Triangulation... Data collection ELMS Ulysees Safety thermometer
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17 r We are in the Red!
18 We have a BIG problem...
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20 Education: training Needs Analysis Waterlow risk assessment SSKIN Equipment selection Documentation RN AHP HCA Competency Based Education
21 Skin care bundle :S.S.K.I.N. S Surface S- Skin K Keep Moving I Incontinence N Nutrition sequence of steps no component is eliminated (McCarron 2011)
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23 Pressure reducing equipment strategy Deliveries: standard, 24 hour, & OOH Receive 36,664 referrals, supporting 16,168 patients with over 70,000 items 250 standard items: 10 Pressure reducing
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25 Pressure relief> ICES activity CY November 12 to October 13 3,500, ,400, ,300, ,200, ,100, ,000, ,900, ,800, ,700, ,600, ,500, ,400, ,300, ,200, ,100, ,000, ,900, ,800, ,700, ,600, ,500, ,400, ,300, ,200, ,100, ,000, , , , , , , , , , Dynamic Sum of Value equipment delivered 3,248, ,129, Sum of Value equipment collected 3,093, , Sum of value purchased 233, , Static
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29 Appropriate seating??
30 SI forum Decision against advice Learning from RCA Safeguarding
31 Public Awareness
32 QUALITY
33 Number of Pressure Ulcers Reported Grade of Pressure Ulcers Reported from October 2013 to September 2014 and % and Number Acquired Within Our Care % % % 31.8% 0 Grade 1 Grade 2 Grade 3 Grade 4 Total Number Reported No. Acquired within our care
34 Number Of Pressure Ulcers Reported in September 2014 Community Hospital Acquired Pressure Ulcers reported in September Abbott Cottage Pershore Tenbury Lickey William Astley Number Acquired Within Our Care Total Number of Pressure Ulcers Reported by Ward
35 Pressure Ulcer for Community Hospitals per 1000 occupied bed days (Rolling 12 Months)
36 A strategy for the elimination of avoidable pressure ulcers in WH&CT 1. Education and staff development 2. Pressure reducing equipment 3. Shared Learning from Serious Incident Forum 4. Information/education for patients & carers in Pressure Ulcer Prevention 5. Safeguarding & Mental Capacity 6. Documentation & Assessment 7. Sharing/Use of Data 8.Patient experience 9. Clinical Audit/Effectiveness
37 In August 2014, 70% of the pressure ulcers have been assessed as unavoidable. 3 grade 3 in September... Statistical process control (SPC) charts...7 or more consecutive points lying on the same side of the mean, implies a change in the mean of the process... In October we have achieved 7 consecutive points
38 C E L E B R A T E WORCESTERSHIRE 2014
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40 Together we can achieve No Ulcers! N Nutrition & fluids O Observe skin U Up & walking: turn & position L Lift. Don t drag C Clean skin & Continence care E Elevate heels R Risk assess S Support surfaces
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44 Contact Details Rosie Callaghan Tissue Viability Nurse Stourport Health Centre Jackie Stephen-Haynes Professor in Tissue Viability Professional Development Unit, Birmingham City University Consultant Nurse, Worcester Health and Care NHS Trust Mobile: Jayne Allchurch Secretary Tissue Viability Stourport Health Centre
Root Cause Analysis for Pressure Ulceration This tool MUST be completed electronically paper copies will not be accepted.
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