SSKIN care bundle

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SSKIN care bundle

The SSKIN Care Bundle is a powerful tool as it defines and ties best practices together. The bundle also makes the actual process of preventing pressure ulcers visible to all. This minimises variation in care practices.

A process is a series of actions which are required in order to achieve a desired outcome (such as a reduction in the number of pressure ulcers). Reliably delivering all elements of the care bundle at every care opportunity, will improve the pressure area care that a person receives. This will have impact on improving care outcomes.


As part of an American healthcare initiative, representatives from the Institute for Healthcare Improvement and Ascension Health together developed a blueprint for change in pressure ulcer prevention.

Pressure Ulcer safety cross imageThe results of this work, together with discussions with clinical and quality improvement colleagues, highlighted that the element of skin inspection (accounting for the second ‘S’ – SSKIN) should be brought to the fore.

By checking the skin more regularly when delivering best practices, early signs of pressure damage will be identified sooner by staff.

In order to know if people are complying with a process, it is useful to measure if they are.

Building on the improvement work of Annette Bartley (who is an independent Consultant), a simple tool to measure process compliance has been developed, tested and adapted (see Compliance Measurement Chart).

It is useful to collect process compliance data in real time (ie on the day you check the care bundle charts) as this enables continuous improvements to be made at the time, based on the data you collect.

Published Date: 15 April 2011


What’s the difference between pressure ulcers and tissue viability?

"Tissue viability is a growing speciality that primarily considers all aspects of skin and soft tissue wounds including acute surgical wounds, pressure ulcers and all forms of leg ulceration." - (Tissue Viability Society 2009).

"Pressure ulcers are an injury that breaks down the skin and underlying tissue. They are caused when an area of skin is placed under pressure. They are sometimes known as 'bedsores' or 'pressure sores'." - (with thanks to NHS Choices).

Scottish Patient Safety Indicator

Scottish Patient Safety Programme logo

The Scottish Patient Safety Indicator (SPSI) was developed to help reduce the occurrence of specified harms, including pressure ulcers. Discover more on the Scottish Patient Safety Programme website.