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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……