Rosie CameronProject Manager – Tissue Viability

Beardmore Conference Centre

23 April 2012

Why raise the Pressure?

Overview

• Impact of Pressure Ulcers

• Facts and Figures

• Current Work in GGC

Definition

"A pressure ulcer is localised injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing or confounding factors are also associated with pressure ulcers; the significance of these factors has yet to be elucidated."

National Pressure Ulcer Advisory Panel (NPUAP)/European Pressure Ulcer Advisory Panel (EPUAP) 2009

Impact for Patients

• Pain and discomfort

• Quality of Life

• Significant difficulties

Grade 4 pressure damage

Severe skin excoriation

Impact for Organisation

• Increased bed days

• Increased workforce time

• Increased prescribing

• Litigation

The majority of pressure ulcers are

preventable!

Think……

WHY?

Facts and Figures

• 1 in 10 patients across Europe have a pressure ulcer. 50% of those are Grade 3 and 4 (Pressure Ulcer Advisory Panel and European Pressure Ulcer

Advisory Panel. Prevention and treatment of pressure ulcers: clinical practice guideline. Washington DC: National Pressure Ulcer Advisory Panel, 2009)

• 50% of patients who develop a severe ulcer will die within 4 months (Bliss )

• 90% of Grade 1s are reversible with adequate nursing intervention (Bader)

Facts and Figures

• Estimated 4% of healthcare expenditure

• Costs NHS £2 Billion per year

Section A: Total number of pressure ulcers                  

 

How many pressure ulcers does your organisation treat? (enter a number and press ENTER)

  861 

       

                 

Section B: Pressure ulcers by grade                  

 

How many pressure ulcers of each grade does your organisation treat?

Grade 1 49         

  Grade 2 254  

     

            Grade 3 350         

The default numbers are based on percentages Grade 4 208         

from the academic research study. Please overwrite              

if you are confident your numbers are different. Total 861  (Total of section B must be the )  

               same as the number in section A)

Section C: Results: Estimated cost of pressure ulcer care at 2008/09 prices    

(rounded to the nearest thousand £s)                  

  Central estimate  Lower range   Higher range     

                       

Grade 1 71,000   57,000   86,000      

                         

Grade 2 1,519,000   1,231,000   1,838,000      

                         

Grade 3 3,478,000   2,817,000   4,208,000      

                         

Grade 4 2,982,000   2,415,000   3,608,000      

                         

Total 8,050,000   6,520,000   9,740,000      

                         

Section D: Potential savings if the number of pressure ulcers is reduced            

                         

  Enter a planned percentage reduction                

  in the green box, to see the impact on                

  number of ulcers, and cost pressures:  

A reduction of 50% in pressure ulcers would mean 431 fewer pressure ulcers and a potential cost saving of £4025k

   

      50%      

               

                         

                         

                         

The majority of pressure ulcers are

preventable!

Remember……

WHY?

Facts and Figures

• FOI requests

• Sensational Headlines

Facts and Figures - Deaths

• Scotland - 78 people died as direct result of infected pressure ulcer

• Scotland - 566 cases mentioned pressure ulcer as underlying cause or contributory factor

• GGC - 11direct result

- 97 contributory factor

The majority of pressure ulcers are

preventable!

Remember……

WHY?

Current GGC Work Streams

• Strategic Steering Group

• Partnership Group

• Tissue Viability Specialist Nursing Team

• LBC – Revised CQI

• SPSP (Primary Care)

• eHealth

Primary Drivers

EFFECTIVE

NHSGGC – Tissue Viability High Level Project Plan

EQUITABLE

TIMELY

Aim:

To reduce the overall incidence of pressure ulcers across GG&C.

Corporate Measures of Improvement by 01 April 2013

50% reduction of Grade 3 and 4 pressure ulcers

100% Pressure Ulcer CQI reporting by all appropriate wards and Partnerships

100% Datix reporting of Grade 3 and 4 pressure ulcers

50% reduction in number of people admitted for pressure ulcer care

Monitoring of cost benefits of single Wound Formulary

Secondary Drivers

EFFICIENT

SAFE1. Prevent pressure ulcers by implementing SSKIN bundle2. Implement PU Safety Cross across all Wards and

Partnerships3. Promote Corporate education/awareness of prevention

Reduce Waste, Variation & Harm through promotion of EBP:1. National Tissue Viability Programme2. Releasing Time To Care Programme – CQI for Pressure Ulcer 3. Scottish Patient Safety Programme in Primary Care4. Joint Wound Care Formulary

1. Eliminate waste in referral processes to TVN Service2. Eliminate waste in use of unnecessary equipment3. Monitor compliance with Wound Care Formulary4. Use of eHealth solutions

1. Consistent development and implementation of policies, procedures, guidelines and work plans

2. Reduce variation in access to TV service3. Improve access to appropriate equipment and supplies

1. Skin inspection and assessment of risk2. Efficient referral systems

PERSON CENTRED1. Support and involve patients and families 2. Ensure appropriate assessment and treatment3. Optimise care transitions to home or elsewhere

September 2011 v3

ALL GRADE 3 & 4 REFERRALS TO ACUTE TVN SERVICEApril 2011 - March 2012

To Summarise

• COST

• Patient Safety – every patient, every time

• You have the resources/tools

WHY?

Over 95% of pressure ulcers are

preventable!

Remember……