Risk Assessment
It is important when a person enters a new
care setting that an assessment of their pressure ulcer risk is
carried out. This assessment should take place as soon as possible,
as pressure ulcers can develop quickly. It is also important to
remember that a person’s condition can change which may mean a
change in their pressure ulcer risk. It is good practice to
re-assess a person’s risk of developing a pressure ulcer when there
is a change in their condition. In order to identify quickly a
change in a person’s pressure ulcer risk, undertake an assessment
of pressure ulcer risk on a daily basis.
When a person is identified to be at risk of
developing a pressure ulcer, communicate this to staff through
shift handovers, safety briefings and through the use of ‘at risk’
cards and visual cues. For more information on risk assessment see
the pressure ulcer prevention change package
Key resources for Risk
Assesment
Development of a simplified risk
assessment tool
As part of the National Tissue Viability
Programme’s focus on pressure ulcer prevention, a high level
pressure ulcer risk assessment tool was developed to make
assessment of risk easier (Preliminary Pressure Ulcer Risk
Assessment).
We first of all identified a collection of
risk factors through a 2-round method of consensus with Scotland’s
Tissue Viability Nurse Experts. We then mapped these factors to
those identified by an extensive systematic literature search
forming part of a research programme undertaken by Professor Jane
Nixon and colleagues (from the Leeds Institute of Molecular
Medicine, School of Healthcare, Leeds Institute of Health Sciences
and Leeds Teaching Hospitals NHS Trust).
Professor Andrea Nelson (from the University
of Leeds), contributed to our working group, providing advice and
support as the tool was developed and tested. In addition, we drew
on the expertise of Dr Michael Clark, (formerly Professional
Advisor to the Tissue Viability Society).
We have also drawn on work in Wales where Mr
Hamish Laing (Director of Acute Care and Consultant Plastic and
Reconstructive Surgeon) and the team at ABM University Health
Board, South Wales, tested a care bundle approach to pressure ulcer
prevention. The elements of the care bundle are evidenced based
actions, which when carried out together, minimise the occurrence
of a pressure ulcer. Elements of the care bundle have also been
mapped across to the collection of identified risk
factors.
Assessment linked to
prevention
Building on its extensive improvement work in
the area of pressure ulcer prevention, the National Tissue
Viability Programme tested a streamlined approach to pressure ulcer
risk assessment and preventative care. The framework used to guide
this innovation project was the Institute of Healthcare Improvement
90-Day Research and Development Process, and was carried out in
partnership with Annette Bartley (who is an independent Consultant
and Director of UK Safer Patient Network).
The results of our work illustrate that
using a simplified tool to assess pressure ulcer risk,
serves as a trigger for timely, effective, evidenced based
care to be delivered using a care bundle approach.
