1. No Needless Skin Breakdown Tina Chambers – Project Manager Professor Nigel Davies - Executive lead No Needless Skin Breakdown

2. No Needless Skin Breakdown Work Stream Vision To eliminate needless skin breakdown amongst the population of South Central

3. Caution This is not all our own work.

4. Aim To increase reporting of all pressure ulcers year on year To reduce the % of grade 3 and 4 ulcers year on year To reduce the number of pressure ulcers across the SHA by 30% by 2012 To raise awareness of Prevention of leg ulceration services and encourage the spread of these.

5. Development of an active network for sharing experience and agreeing consensus.

6. Actions undertaken and … Raising the Profile Protect your Birthday Suit Awareness campaign Awareness week 26 th September – 30 th September Information / workshop for Commissioners – re CQUIN process, SUI process, Avoidable/unavoidable. Healthcare economies linking up to work together

7. http://www.nes.scot.nhs.uk/initiatives/healthcare-associated- infection/educational-programmes/tissue-viability---an- overview/pressure-ulcers-workbook

8. Protect Your Birthday Suit Awareness week 26th September – 30th September 2011 No Needless Skin Breakdown

9. Protect Your Birthday Suit Awareness Week

10. No Needless Skin Breakdown

13. What have we achieved A Tissue Viability competency framework for Registered Nurses and Clinical Support Workers.

14. We are currently working on: A brief Guide to differentiate between pressure ulcers and moisture lesion Education and training materials to implement the Texas Scoring System for the Diabetic Foot

15. Actions currently underway… Getting to Zero – Safer Care Improvement Programme Series of learning events across SHA Safety Cross 4 eyed skin check Safety Huddle Visual reminder intentional rounding / skin Bundle. Alpha Sites Community Hospital, Acute Trusts, Nursing homes

16. Intentional Rounding – What is it? Structured process where frontline staff regularly round on patients and reliably perform scheduled/required tasks Rounding with purpose- linked to an aim 8 key behaviors 1.Opening key words – managing up 2.Perform scheduled tasks 3.Address the 3 ps of pain, potty? position (SKIN Bundle)(toileting), and 4.Assess comfort needs 5.Environmental assessment 6.Closing key words 7.Explain when you or others will return 8.Document the round on the log

17. A pilot project to apply the rounding methodology in the community patient in their own homes. A pilot project to develop a multi agency patient "Passport" for the prevention and management of pressure ulcers

18. Issues and Concerns. We are struggling to do our day jobs Pressure Ulcers very high profile SHA /Commissioners - Misunderstandings about grading of ulcer and the severity of ulcers. Issues in relation to skin failure Avoidable Pressure ulcers Safeguarding

19. Questions Thank you for listening Working together to get the job done [Bob the builder] tina.chambers@nhs.net www.patientsafetyfederation.nhs.uk