Quality Account 2010/11 - James Paget University Hospitals

Current Position:
Inpatient Pressure Ulcers Grade 2 and above (inc.'not stated April and May 10)
25
Number of Incidents
20
15
10
20
19
18
17 17
16
16
13
14
13 13
11
13
12
14
13 13
14
13 13 13 13 13 13
10
9
8
Grade 2
Grade 3
Grade 4
Practice Development
Trajectory
5
0
0 0 0 0 0 0
1
0 0 1
0 0 0 0
Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11
Month and Year
During March 2011 87.6% of patients had a pressure ulcer risk assessment (Waterlow) on
admission.
Successes:
• Significantly raised awareness
• Review of evidence base
• Review of Trust documentation
• Working on the principle of 8 Key Responsibilities for pressure ulcer prevention
• Revised documentation in all ward areas
• Communication cascade regarding pressure ulcer prevention care
• Hospital at Night team link nurse involvement – promotion of standards 24/7
• Dedicated resource to support change process
• Inclusion of pressure ulcer prevention training as part of Trust Practice Development
Training Programme.
Concerns:
• Reporting system(s) ineffective
• Under reporting
• Inaccurate reporting
• Under use of the mattress loan store
• Pressure ulcer classification tool used inaccurately
• Volume of patients admitted with existing pressure ulcer.
James Paget University Hospitals NHS Foundation Trust
Quality Account 2010/11 Page 32 of 62