Ralph Boutflower, TVN at Sunderland Royal Hospital

I am a TVN at Sunderland Royal Hospital. We are currently working to reduce hospital acquired pressure ulcers. The approach we have adopted is to make pressure ulcers everyone's business. We are working collaboratively with neighbouring community teams and care providers, as well as part of a regional initiative to reduce pressure ulcers by 50%, using the SSKIN bundle as the basis for our care provision, in participating teams areas of work. We have also begun work with our neighbouring ambulance service to identify those patients entering our environment, who may have or be at risk of pressure ulcers, e.g. those patients identified by ambulance teams as having a history of a long line. Within our hospital we have full engagement of the multidisciplinary team, from ward to board, which has seen a culture change from pressure ulcers being strictly a nursing role to one that includes everyone. Medical teams are considering the risk these injuries present particularly when considering the source of infections, occupational therapist ensure pressure relieving  aids and mattresses are considered prior to discharge. Medical photography dieticians and podiatrist all work closely to ensure our patients receive the best and appropriate pathway of care. Our board has already audited our risk assessment tool and found that this can be improved to ensure reliable and valid patient assessment. We have restructured our pressure ulcer risk assessment tool to consider medical conditions and commodities, this is about to be rolled out in November 2015. The work so far is proving to affect our prevalence and incidents of pressure ulcers occuring within our hospital, and month on month this is reducing steadily. Our greatest challenge is to sustain and embed the work we have begun. Our TVN team believe we can reduce hospital acquired pressure ulcers to zero, and our next target is increasing awareness amongst our patients, relatives and carers, so that they can begin to share the responsibility for caring for their own skin and understand the risk pressure ulcers present to those at risk.



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