Stop the Pressure: an update from NHS England Susan Bowler, Professional Advisor NHS England
Pressure Ulcer information at a glance There were 2101 recorded Pressure Ulcers in April 2013 There were 1189 PU s recorded in September 2015 On average 6000 pressure ulcers are newly acquired in hospital each month 48% Midlands and East has seen a 48% reduction in all acquired PU s in 2 years 4,638 per pressure ulcer Nurses recognise that improving care outcomes for patients and avoidable harms like PU are key to a high quality and sustainable NHS Ruth May On average each month 27,000 patients will be found to have a pressure ulcer across England
NHS Midlands and East regional NO pressure ulcers launch Ambition: To eliminate avoidable grade 2, 3 and 4 pressure ulcers by December 2012. National quality indicator and part of operating framework. Identified newly acquired pressure ulcers as a key improvement area Using a care bundle to prevent pressure ulcers CQUIN linked to safety thermometer
The campaign 4
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Improvements sustained and embedded over time Nationally there has been a 18.5% reduction Regionally There has been a 14.3% reduction (Oxford AHSN) Locally There has been a 87.5% reduction (Maidstone and Tunbridge wells)
NHS England - Patients with New Pressure Ulcers 2500 Number of New Pressure Ulcers - Grade 2+ Rest of England April 13 - September 2015 2000 1500 2102 1971 1845 1761 1649 1692 1704 1600 1569 1675 1687 1579 1551 1543 1570 1435 1518 1490 1525 1447 1386 1637 1577 1531 1500 1460 1360 1431 1339 1189 1000 500 1627 1499 1400 1350 1246 1303 1292 1187 1194 1278 1297 1184 1184 1145 1165 1052 1138 1125 1118 1060 1035 1186 1199 1133 1087 1059 968 1031 984 866 0 186 145 163 168 170 165 145 152 158 150 156 176 139 171 145 134 162 167 166 191 182 191 153 179 187 170 164 180 160 144 136 157 149 112 117 118 125 141 127 135 118 117 118 118 124 115 116 95 124 114 113 124 111 126 104 121 118 144 108 95 Grade 4 Grade 3 Grade 2 Grade 2+ Forecast Trend 2+ 800 Number of New Pressure Ulcers - Grade 2+ Midands and East April 13 - September 2015 Change from April 13-22% 700 600 500 400 300 672 456 585 575 575 416 378 377 541 563 348 366 548 547 365 365 577 576 397 395 603 413 550 566 346 399 583 378 518 531 521 348 373 326 545 338 610 406 544 323 601 393 639 409 520 338 561 573 572 559 578 348 360 368 354 373 509 525 317 344 7 200 100 186 145 163 168 170 165 145 152 158 150 156 176 139 171 145 162 167 166 191 182 191 153 179 187 170 164 180 160 144
NHS Midlands and East - Patients with New Pressure Ulcers Number of New Pressure Ulcers - Grade 2+ - April 2012 to September 2015-48% 1200 1018 1019 1000 837 834 800 748 600 400 749 747 637 603 531 702 519 614 450 643 621 618 472 444 437 635 658 437 470 672 456 585 575 575 416 378 377 541 348 563 366 548 547 365 365 577 576 397 395 603 413 550 346 566 399 583 378 518 531 348 373 521 326 545 338 610 406 544 323 601 393 639 409 520 338 561 573 572 559 578 348 360 368 354 373 509 525 317 344 200 192 189 151 170 165 138 133 132 132 144 158 159 186 145 163 168 170 165 145 152 158 150 156 176 139 171 145 134 162 167 166 191 182 191 153 179 187 170 164 180 160 144 0 77 83 49 61 52 45 31 39 45 37 40 29 30 24 34 30 23 32 38 30 22 31 34 28 28 34 25 24 33 40 38 30 26 39 29 34 26 34 41 25 32 37 Grade 4 Grade 3 Grade 2 Grade 2+ Forecast Trend 2+ 8
Driving Innovation.. Future Case Study :Chasing zero at Wigan, Wrightington, and Leigh Patients are scanned using a SEM scanner to assess sub-epidermal moisture. The scanners allow the practitioners to identify damage before it can be visibly seen! Over 45 days no pressure ulcers were recorded Case Study : Sally Sore at UHCW UHCW TV team have continued to innovate and develop new methods for teaching including a simulation tool that roves the wards highlighting best practice and offering opportunity to improve knowledge Case Study : Non-Invasive Monitoring of Pressure Ulcer Formation- University of Southampton In conjunction with Eindhaven University of Technology, Southampton University are undertaking research to identify a non invasive monitoring method for PU in spinal cord injured patients. By monitoring biomarkers in urine, they are asking - do these marker concentrations change before a PU becomes visible?
What are our priorities going forward? Further Website development Care Homes Economic analysis 10
Website development Expert Working Group work stream Transfer to the NHSI website Update to ensure reflects current demand 11
Building on the opportunities Innovation to drive reductions in Care Homes PROSPER 58 Nursing / Residential Homes enrolled so far. 40 more due to commence Nov 2015 (cohort 4) 20% reduction in pressure ulcers across care homes 1 Care home 167 days free of PU and a second 200 days free Ideas generated internally Jelly Champions! - Compact Mirrors Your Turn React to Red Coventry Health Economy 1,100 Care staff trained 74 Nursing and Residential homes received training and 4 accredited 20% reduction in grade 2 PU in the community Maastricht visit East Midlands AHSN International LPZ project Pilot of 35 care homes A different way of working University Hospitals Coventry and Warwickshire NHS Trust (UHCW) has put in a enhanced care team of 34 WTE (Healthcare Assistant) posts to help their special and complex care patients. Thereby, leading to estimated direct cost saving of 1million this year and 2million next to the Trust when compared to agency costs or ad hoc savings
Future opportunities Financial savings o The Economics team at Monitor are leading a piece of work to undertake an updated economic analysis on the cost of pressure ulcers International results that we can strive for; o New Jersey 70% reduction in new PU Incidence Mission, objectives, focus on prevention Build upon the energy within our system o 18 UK poster presentations at the European Wound Management Conference o Establish a Public Health campaign to raise PU awareness amongst the general public Recognise the power of social media to engage and make change o > 1000 student nurses have attended education events from one twitter conversation
Pressure Ulcers UK Supporting the elimination of preventable pressure ulcers Charity No. 1160101 w: PressureUlcers.UK e: Info@PressureUlcers.UK 14
Please become a #stopthepressure champion and thank you for listening! @RMayNurseDir Or email: ruthmay@monitor.gov.uk www.stopthepressure.co.uk 15 RMayNurseDir
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