Annual Report and Accounts 2012/13 - Royal Devon & Exeter Hospital

26 2. Progress on our
2012/13 Priorities
Royal Devon and Exeter NHS Foundation Trust
Quality Report 2012/13
CASE STUDY
Pressure ulcers – zero tolerance
approach to care-acquired skin damage
Pressure ulcers are a type of injury that
breaks down the skin and underlying
tissue. They are caused when an area
of skin is placed under pressure. They
are also sometimes known as 'bed
sores' or 'pressure sores'.
Pressure ulcers can range in severity
from patches of discoloured skin
to open wounds that expose the
underlying bone or muscle. The
damage is usually caused by pressure,
the weight of the body pressing down
on the skin, and can occur when
patients are moved incorrectly or
nursed in chairs or on mattresses that
are not suitable for their risk.
The most common places for pressure
sores are over bones that are close to
the skin like the bottom, heel, elbow,
ankle, shoulder, back and back of
the ear. Patients are more at risk of
developing a pressure ulcer if they:
• Have difficulty moving and cannot
change position
• Cannot feel pain over part or all of
their body
• Are incontinent, are seriously ill, or
have had surgery
• Have a poor diet and don’t drink
enough water
• Are very young or very old
• Have damaged their spinal cord
and can neither move nor feel
their bottom and legs
• Are older people who are ill or
have suffered an injury like a
broken hip.
* The red line in the graph indicates the Trust's target achievement for the year 2012/13.
Pressure ulcers cause patients
long-term pain and distress and 95%
of them are avoidable. As well as
causing pain and discomfort, pressure
ulcers also result in patients staying in
hospital longer than planned.
Avoiding pressure ulcers is a key
indicator of the quality of nursing care.
Tackling pressure ulcers
Pressure ulcers are graded according to
severity, with grade 1 being the least
serious and signalling a precursor to
pressure damage and grade 4 being
the most severe. The Trust has had no
grade 4 pressure ulcers in 2012/13.
The graph above shows the reduction
in grade 2 and 3 pressure ulcers.
If a patient comes into hospital with
a pressure ulcer or develops damage
whilst a patient, they will be seen
by a Tissue Viability nurse who will
undertake an assessment and ensure
their care is the best we can deliver
to resolve the pressure ulcer as soon
as possible. This may involve specialist
equipment, moving and handling,
wound management, dietary input and
continence advice.