With pressure ulcers remaining a challenge to the healthcare system across all care settings, this 12-week pilot study aimed to evaluate implementation of the SEM Scanner as an adjunct to standard of care (SoC) in pressure ulcer (PU) prevention. Two district nursing bases enrolled 17 palliative care patients, who received SoC and preventive interventions. Patients with Waterlow scores 10–19 who were able to be scanned for three consecutive days were included. Broken skin was not scanned, and visual skin checks were documented after SEM scans. Patients with SEM delta ≥0.6 were considered at high risk and preventive interventions were escalated using a clinical decision matrix aligning with SoC. The study found that implementing the SEM Scanner in an existing PU prevention pathway resulted in a reduction in community-acquired PU (CAPU) incidence by 26.7% from 16.1% to 11.8%; 88% (n=15) of patients remained PU free. Furthermore, clinical judgement informed by SEM deltas resulted in 82% (n=14/17) of nurses reporting that the SEM delta had changed their clinical decision-making.
With pressure ulcers remaining a challenge to the healthcare system across all care settings, this 12-week pilot study aimed to evaluate implementation of the SEM Scanner as an adjunct to standard of care (SoC) in pressure ulcer (PU) prevention. Two district nursing bases enrolled 17 palliative care patients, who received SoC and preventive interventions. Patients with Waterlow scores 10–19 who were able to be scanned for three consecutive days were included. Broken skin was not scanned, and visual skin checks were documented after SEM scans. Patients with SEM delta ≥0.6 were considered at high risk and preventive interventions were escalated using a clinical decision matrix aligning with SoC. The study found that implementing the SEM Scanner in an existing PU prevention pathway resulted in a reduction in community-acquired PU (CAPU) incidence by 26.7% from 16.1% to 11.8%; 88% (n=15) of patients remained PU free. Furthermore, clinical judgement informed by SEM deltas resulted in 82% (n=14/17) of nurses reporting that the SEM delta had changed their clinical decision-making.
A pressure ulcer is localised damage to the skin and/or underlying tissue, usually over a bony prominence (or related to a medical or other device), resulting from sustained pressure (including pressure associated with shear). The damage can be present as intact skin or an open ulcer and may be painful (NHS Improvement, 2018a). The consequences of pressure ulcers are increased length of hospital stays for the patient, estimated at 4.31 days (National Institute for Health and Care Excellence [NICE], 2005), but also an increase in cost to the NHS, which is identified at around £14-21 billion annually (Nutritional Pressure Ulcer Advisory Panel et al, 2014). Poor nutrition has been recognised as one of the risk factors in the development of pressure ulcers. Improving nutritional intake of patients is thus paramount in reducing patient harm and unnecessary cost. This article looks at the role nutrition plays in the prevention and treatment of pressure ulcers, provides practical advice and signposts readers to the resources produced by the Nutrition and Pressure Ulcer Task and Finish Group.
This article reports on the monitoring of healing rates of fullthickness pressure ulcers at one care provider in the Midlands. This was an agreed measure that was part of the Commissioning for Quality and Innovation (CQUIN) incentive scheme for the CCG. It was an attempt to provide data to support the anecdotal reports that pressure ulcer healing rates had improved after the implementation of a pressure ulcer reduction scheme called the Midlands and East Pressure Ulcer Ambition in 2012. The healing times for full-thickness pressure ulcers were recorded at 40 and 80 days after being reported by the community care provider (a community interest company [CIC], providing NHS funded services). There were 138 patients included in the data collected over a one-year period in 2015. A total of 34% of the patients were healed or healing at 40 days. A total of 55% of patients were healed or healing at 80 days. Of the 138 patients who had a full-thickness pressure ulcer, 56 died (41%), 15% had deteriorating or static wounds at 40 days and 9% at 80 days. This demonstrates that the majority of full-thickness pressure ulcers progress to healing unless the patient is at the end of life. There should be a continued emphasis on preventing as many pressure ulcers as possible to reduce avoidable harm to patients.