Pressure Ulcer Prevention


Pressure ulcers have a detrimental effect on patient health and well-being and place a significant economic burden on the NHS. Treating pressure ulcers costs the NHS more than £3.8 million every day. This adds up to an annual spend of £1.4 to £2.1 billion: four per cent of total NHS expenditure.

The majority of cases are avoidable if preventative action is implemented.

Using alternating mattresses

Spanish researchers have found alternating air pressure mattresses are more effective than overlays for preventing pressure ulcers in intensive care patients. The results of the study, published in the Journal of Advanced Nursing, found a significantly lower incidence of grade two or worse pressure ulcers following mattress use. Writing in the journal, the authors said the use of the mattress was found to be a “protective factor against pressure ulcer onset”.

In the 2013 updated NICE guidance on preventing pressure ulcers, the importance of using alternating mattresses for people with a grade three to four pressure ulcer was reaffirmed, with the institute describing the use as a “minimum provision”.

NHS Safety Thermometer

According to the Department of Health, pressure ulcers can be eliminated in 95 per cent of all NHS patients. In a bid to measure their prevalence across NHS organisations, the NHS Safety Thermometer has been introduced. The thermometer demonstrated a prevalence rate of patients with category two to four pressure ulcers of 5.39 per cent in October 2012 – 8,833 people in 477 UK organisations, both NHS and private, acute and community.

The thermometer is a minimum data set that provides the opportunity to measure each of the four harms at individual patient level, while patients are still in the care setting. The tool is ideally suited for measuring the incidence of pressure ulcers.

Pressure ulcer prevention initiatives

There are a number of toolkits and initiatives designed to prevent pressure ulcers which are helping to gain high-level attention on this hugely important issue.

SSKIN – the concept of the SSKIN care bundle is that simple steps prevent pressure ulcers. It is a five step model that asks nurses to consider: surfaces (such as mattresses and cushioning); skin inspection; the importance of keeping patients moving; incontinence (including moisture); and nutrition/hydration.

The SSKIN care bundle can help to prevent minor skin problems from becoming major pressure ulcers. It is a powerful tool that defines and ties best practices together.

Your Turn is a major campaign that aims to reduce pressure sore prevalence through education and awareness. It works closely with a number of acute trusts to support existing hospital programmes, for example, including Your Turn information within SSKIN care bundles.

Your Turn also works with a number of primary care providers to identify patients at risk in the community. These include GP practices, community nurses, social services, nursing and residential homes. Your Turn has developed a suite of tools to help community and hospital teams deliver the needed prevention education through simple and effective methods such as patient information leaflets, talking leaflets, patient at risk cards and a pressure ulcer prevention passport.