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Implementing the NICE Quality Standard for Pressure Ulcers and Implementing NICE Guidance for Pressure Ulcers

Professor Gerard Stansby, Chair, Guideline Development Group, Prevention and Management of Pressure Ulcers Guideline and Quality Standard, National Institute for Health and Clinical Excellence discussed Implementing the NICE Quality Standard for Pressure Ulcers and Implementing NICE Guidance for Pressure Ulcers at today’s conference. In his presentation Professor Gerard Stansby discussed:  

  • implementing the NICE Quality Standard for Pressure Ulcers
  • the Quality Statements
  • implementing the standard in practice
  • challenges and critical success factors

In his presentation Professor Gerard Stansby stated:

“To make change happen we need to get the right balance of carrot and stick but we need to get the right people involved.”

“There's still a lot of people who aren't too interested or involved and we have to get those people involved.”

“You want it to be proactive and have it at the front of their minds and not wait until a CQC inspection comes up.”

“Why wouldn't you want to focus on this or be proactive about this?”

“I think educating patients is really important. Patients have helped drive forward the hand washing campaigns for MRSA and increasingly they are becoming aware of the issues and looking out for things that might be poor care for them or their family.”

“One of the 'stick' aspects is being fined by your commissioners, league tables (which aren't common for pressure ulcers, but do still come up every now and again), litigation increasingly, and then all the random press and media articles which can be positive if you go out and work with and negative where you don't.”

“One of the things I think the tissue viability nurses need to do is go and make sure there's adequate resources.”

“I think there is this big gap between nursing staff and allied professionals and the medical staff. Most medics don't see this as their problem, they see it as a nursing problem. And worst of all, they don't seem to want to get on board and help.”

“If you were to ask me how many pressure ulcers were preventable I would have thought it was about 50-70% but I would tag onto any conversation about avoidable or not, a thorough root cause analysis. Before you say something is avoidable or unavoidable I would ask a number of questions. Did you evaluate risks and conditions at admission? At all stages? Was there a plan? Did you implement that plan? Did you monitor and evaluate any interventions and did you revise those interventions as required?”

“We need to be quite clever at who we get to do root cause analysis and how they do it.”

“The clinical guideline from NICE is available on the NICE website.”

“With every NICE guideline, the starting point is to set your scope. The key things for the scope for the pressure ulcer guidelines are that they apply to all ages and that they apply to all people under NHS care or NHS funded. So it does apply widely.”

“We recommend a risk assessment should be done for all. If there is a risk, you need to reassess when things changed and then there's an individualised care plan which needs to be documented.”

“We've got to empower people, it's not just training its motivation.”

Professor Gerard Stansby Biography

Professor Gerard Stansby qualified from Cambridge University and Addenbrooke’s Hospital in 1982. He carried out many junior training posts in Cambridge and the East Anglian area before moving to the Royal Free Hospital as Registrar and subsequently Lecturer in Surgery. In 1993, he went to St Mary’s Hospital in London as a Senior Clinical Vascular Fellow and, in 1994, became Senior Lecturer in General & Vascular Surgery at St Mary’s Hospital and Imperial College, London. In January 2000, he obtained his current position of Professor of Vascular Surgery at the University of Newcastle and the Freeman Hospital.

Professor Stansby is the author of more than 200 scientific articles and several books on venous and arterial diseases. He is president of the RSM Venous Forum and coordinating editor for the Cochrane Vascular Diseases group and several medical journals. He has been on the NICE VTE prevention group (CG92), Chair of the NICE Venous thromboembolism (CG142) and Pressure Ulcer guidelines (CG 179) and associated quality standards.  He is vascular lead of the North of England  network and Senate. His other interests include undergraduate medical education and he is the author of a best selling surgical text book for undergraduates.

Future events of interest:

Nurse Prescribing for Wound Care
Tuesday 19 January 2016
ICO Conference Centre, London

Eliminating Heel Pressure Ulcers
Wednesday 10 February 2016
Hallam Conference Centre, London


2 December 2015

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