1. COMMUNITY NURSING PREVENTION OF PRESSURE ULCERS NHS GG&C Community Nursing Teams supported by Linda Davidson : SPSP-PC Project Lead and Head of Clinical Governance Support Unit (Partnerships) Fiona Middler :Team Leader, Clinical Governance Support Unit (Partnerships) Challenges Collating data (time consuming) Consistency in data collection Preventative/anticipatory care Frequency of sampling Running test of change Local ownership of data & results Data for improvement not performance Random sampling Outcome measures Developed Guidance for data collection Risk Assessment, SSKINS plan and safety cross on CNIS Improved reporting of pressure ulcers Involved Patients and Carers in Self Management Solutions Person Centredness IMPROVEMENTS IN PROCESS AND OUTCOME MEASURES Know the number of pressure ulcers and grades Nurses are ‘Thinking Prevention’ Testing ideas in the real world Nurses beginning to own the data – asking for data Nurses are challenging the practice of other nurses - best practice Person Centred – challenging the culture Risk assessment and care plan is held electronically and information held in one place, making data collection easier This chart depicts the Prevention of Pressure Ulcers - % Compliance from January to December 2012 and shows a steady increase in the percentage compliance for the Prevention of Pressure Ulcers for all of the District Nursing Teams. Since August 2012 the reliability of the process has achieved 100% and has remained at this level ever since. The recording of Waterlow and the Safety Cross data on CNIS coupled with the use of the Preventing Pressure Ulcers leaflet and NHS GG&C Board Policy have all contributed to this progress in Prevention of Pressure Ulcers. These are the views and experiences of patients being cared for by the Community Nursing Teams Reliable Process Patients’ feedback on information and advice given by Community Nurses Check body/skin. Use mirror to check. Moisturise skin. Change position as often as possible. Move around as much as possible. Good diet. Drink fluids. Take care of skin including moisturising and importance of prevention. Use of sheepskin pad and fleece socks. Has equipment - cushion and mattress. Used the leaflet and self knowledge. Long term carer - already very aware of pressure ulcer care. Checks husbands skin daily and treats very early red marks with (name of cream). Has been successful with this method so far. District Nurse suggested avoiding bed rest in the afternoon, which I am now doing Patients Comments The service is excellent and the booklet was very helpful. The main thing was the way the DN talked to me, and explained everything. I now have more knowledge/awareness. ‘Second to None' service. I feel I have been very well looked after. The District Nurses work exceptionally well with me, and I am clear what I must do to prevent any problems. They also fit in with my daily routines and accommodate my needs. Happy with District Nurse support. District Nurse Service very good. Equipment provided to prevent pressure ulcers. Very happy with District Nurse service and pressure ulcer prevention. For further information email: linda.davidson2@ggc.scot.nhs.uk