Taking The Pressure Off

Tuesday 06 Dec 2022

Jersey Hospice Care’s successful Quality Improvement Programme sees 67% reduction in new pressure ulcers

Pressure ulcers (also known as pressure sores or bedsores) are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin which has caused the tissue to die.

They can happen to anyone of any age, but usually affect people who are unable to move, particularly those confined to bed or who sit in a chair or wheelchair for long periods of time.

It is estimated that more than 700,000 people are affected by pressure ulcers every year in the UK.  Not only do they generate clinical difficulties through longer hospital stays, the incidence of infections and additional treatment, but they also create other psychological and physical harm for patients, families and carers.

As part of Jersey Hospice Care’s duty of care to people with life limiting illnesses, we were keen to address the unfortunate, painful and uncomfortable reality that pressure ulcers represent for patients in our Inpatient Unit (IPU).

For a number of years, we have been working to reduce and prevent the number of instances of pressure ulcers for our patients, making them more comfortable and less prone to infection. Following the introduction of the Jersey Nursing Assessment and Accreditation System standards in 2016, we began to develop a system-wide quality improvement agenda to improve levels of care. As part of this agenda, a quality improvement project was commenced in 2018 to specifically target the incidence of new pressure ulcers on the IPU.

Last week Hilary Hopkins, Director of Palliative Care Services at Jersey Hospice Care, was invited to present the success of our programme at the National Hospice UK Conference in Glasgow to share best practice.

Working together as one team, this process involved members of staff on the IPU led by Hilary and Senior Nurse, Karen Eloury, to implement measures which resulted in an organisation-wide reduction of new pressure ulcer incidents. This included the introduction of an online incident reporting system, the roll-out of Pressure Ulcer Prevention competencies and a range of intentional measures specifically focused on patients and reducing patient harm.

As a result, by the end of 2021, Jersey Hospice Care had seen a 67% reduction in new pressure ulcer incidents, placing it significantly below the UK benchmark of similar hospices.

Jersey Hospice Care CEO, Mike Palfreman commented on the success. “Congratulations to the team on our IPU for this incredible achievement.  For Hilary to present this development to colleagues from across the UK demonstrates how we are leading by example for the benefit our patients as we continually look to make improvements to our care standards.”

Things To Look Out For

If you, a relative or person who you care for is immobile for long periods of time, it is important to keep an eye out for symptoms of pressure ulcers.

Early symptoms can include:

  • discoloration to part of the skin – pale skin tends to develop red patches whilst dark skin can display purple / blue patches
  • discoloured patches not turning white when pressed
  • skin patches that feel warm, spongy or hard
  • itchiness / pain to the area affected

Initially, the skin may not be broken but, without treatment, a wound and other infection can result.

If any of the above symptoms develop, it is important that you tell a healthcare professional as soon as possible. This may be a member of staff, if the person is in hospital or a care home, or their GP if they are at home.

More information about pressure ulcers can be found in this short video created by the European Pressure Ulcer Advisory Panel.