Quality Account 2010/11 - Royal Marsden Hospital

The Royal Marsden NHS Foundation Trust
Effective care priority 3:
Reduction in hospital acquired pressure ulcers
Rationale for choosing this priority
Pressure ulcers are a major cause of sickness and reduced quality of life for patients and create
significant difficulties for patients and their families. New pressure ulcers are estimated to occur
in 4–10% of patients admitted to acute hospitals in the UK, with one study putting this as high as
20% (Clark M, Bours G, Defloor T; 2004). Some people with cancer are at a higher risk of developing
pressure ulcers because they are immobile, have very fragile skin, have poor nutrition and some
medicines can increase the risk. As we have such a vulnerable patient population an important part
of our daily care is to do everything we can to prevent, diagnose early, monitor and treat effectively so
that the burden for patients and families is reduced. A rising incidence of pressure ulcers across many
patients can be an early indication of deteriorating care standards and must therefore be monitored
closely. Although the incidence of pressure ulcers at the Trust is relatively low for an acute Trust it is
important to note that the incidence has risen in 2010 as seen below:
Pressure Ulcers
2009/10 2010/11
Total No. Pressure Ulcers 250 296
Total No. Pressure Ulcers/1,000 Bed Days 3.84 4.93
In 2011/12 the national reporting of pressure ulcers has changed with all serious pressure ulcers
(grade 3 or 4) being reported as serious incidents.
In 2011/12 we are taking the following actions to increase vigilance around skilled care and to reduce
further the incidence of pressure ulceration:
1. Sutton and Merton Community Services have three expert tissue viability nurses who will work
with the Trust’s ward nurses to raise awareness and ensure that the Trust is using best practice
2. The Trust’s practice education nurses will work with nurses across the Trust to
ensure that pressure ulcer scoring is robustly standardised across the Trust.
2011/12 target: To reduce further the incidence of hospital acquired pressure ulcers (< 4 per 1,000 bed
days) and ensure that patients who are admitted with a pressure ulcer have expert assessment and
care quickly to avoid further deterioration.
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