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Professor Jackie Stephen-Haynes, Wound Care Alliance UK speaks on Implementing stop the pressure in community settings

Professor Jackie Stephen-Haynes, Professor & Consultant Nurse in Tissue Viability, Worcestershire Health and Care NHS Trust & Chair, Wound Care Alliance UK discusses implementing stop the pressure in community settings: 

  • reducing pressure ulcers in community settings
  • tips for implementing stop the pressure
  • our experience in Worcetershire 

Jackie is a professor of Tissue Viability at Birmingham City University Wound Healing Practice Development Unit and also provides a strategic and operational role in Tissue Viability across the Worcestershire Health Care Trust. This includes education and clinical care for patients in their own homes, community hospitals and hospices across Worcestershire.

This presentation outlines the challenge of providing care for patients in the community, particularly in the prevention and management of pressure ulcers. The lack of reliable incidence and prevalence data for pressure ulcers is highlighted and the strategies employed by WH&CT are discussed.

Pressure ulcers are a significant outcome indicator. Pressure ulcers also have a significant political agenda and national concern regarding the high number of people who develop pressure ulcers. This is due to the clinical (Gerick et al 2009) and financial outcomes (DH 2010a).  Treating and caring for people in a safe environment and protecting them from avoidable harm are a key objective in the NHS Outcomes Framework. This is outlined in the Compassion in Practice Strategy (December 2012)  with the shared purpose as nurses, midwives and care staff to deliver high quality, compassionate care, and to achieve excellent health and wellbeing outcomes. The vision is underpinned by six fundamental values: care, compassion, competence, communication, courage and commitment - six areas of action to support professionals and care staff to deliver excellent care.

NICE have updated guidance for Pressure Ulcer Prevention (CG179) 2014.  The evidence bases for the actions within this plan are based on this NICE guidance.Importantly, wound care is estimated to cost the NHS £2.03 million per 100,000 of the population (Vowden &Vowden 2009 b).  Pressure ulcers are estimated to cost £363 000 and £543 000 for a category 3 pressure ulcer and between £447 000 and £668 000 for a category 4 ulcer costs (DH, 2010a) and have a   significant impact on quality of care. The overall estimated cost of pressure ulcers is £2.3–£3.1 billion per year in the UK. Importantly this is 3% of the annual NHS expenditure at 2005/6 levels (Posnett and Franks, 2007).Drew et al (2007) reports that the majority of these wounds are chronic in nature and are cared for in the community setting by GPs and community. This is clearly a high percentage of the overall budget on an area that is considered largely avoidable.

The real cost of pressure ulcers to the patient is discussed. The issue of vulnerable patients being nursed in environments which are not under the control of the nursing staff, i.e. patients own home or in a care home residential is highlighted. The challenge of the nursing teams not  constantly monitoring  patients in their environment to ensure they are adhering to agreed care plans is also raised. The provision of pressure reducing equipment across the community and the implemented strategy is discussed.

A conclusion is made that this a key area of care that significantly affects patients  and that it is only when there is full support within an organisation can this be achieved.  

In her presentation Jackie States: 

"The 6cs- care, compassion, competence, communications, courage and commitment"

"Have we got the staff that we need in order to deliver?"

"We have had approval for next year for gaining patient experience on category 3 and 4 pressure ulcers in order to see what they can improve on"

"The question is… is the pressure ulcer superficial or deep?"

"Training needs analysis"

"Receive 36,664 referrals a year in Worcestershire"

"Mattress on the beds are vital and make patients lie flat as there is no point them having their backs and legs supported by the adjustable beds or we might as well place a chair in the bed as this creates problems causing pressure ulcers"

"Reducing pressure ulcers in care homes and  more considered with residential homes"

"70% pressure ulcers have been assessed as unstageable"

"Be clear about what you are seeing"

Scroll down for full presentation

This event will be again in 2015: 

Eliminating Avoidable Pressure Ulcers
Wednesday 4 February 2015, Birmingham

Download: Professor Jackie Stephen-Haynes full presentation

3 November 2014


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