Standards for prevention and management of pressure ulcers
Pressure ulcers are injuries to the skin and underlying tissue
caused by prolonged pressure on the skin. Anyone can get pressure
ulcers (sometimes known as ‘bed sores’ or ‘pressure sores’) but the
following factors can make them more likely to develop, or for
existing pressure ulcers, to deteriorate:
- reduced levels of mobility or physical activity (for example,
when people spend extended periods in bed due to illness or
following surgery)
- medical conditions that reduce blood supply or make the skin
more fragile (for example, diabetes, peripheral arterial disease,
kidney failure, heart failure, multiple sclerosis and Parkinson’s
disease)
- incontinence or other skin moisture
- compromised nutrition and hydration
- cognitive impairment
- palliative and end-of-life care needs
- acute illness.
The following document updates and replaces the
clinical standards on prevention and management of pressure ulcers
published by Healthcare Improvement Scotland in 2016 and
incorporates advice contained in the (now withdrawn) 2009 Quality
Improvement Scotland best practice statement.
The standards include reference to the SSKIN care bundle which is a tool designed to
help identify risk factors linked to the development or
deterioration of pressure ulcers. The SSKIN care bundle enables
healthcare professionals to effectively assess key factors
associated with the prevention and management of pressure
ulcers.
The standards are informed by current evidence, best practice
and stakeholder recommendations. These standards are a key
component in supporting an organisation’s approach to quality
assurance of the prevention and management of pressure ulcers.
Monitoring and improving performance against these standards, at
both organisational and national level, will improve the
experiences and outcomes of people with, or at risk of developing,
pressure ulcers.
Scope of the standards
The standards should be read alongside relevant legislation,
policies, national health and wellbeing outcomes and health and
social care standards.
The standards support the principles of realistic medicine,
recognising the importance and value of informed choice and
ensuring that people are at the centre of care decisions. In
addition, the standards emphasise the role of multidisciplinary
working and coordinated care and support for people with, or at
risk of developing, pressure ulcers.
The standards apply to:
any person at risk of developing, or identified with, pressure
ulcers regardless of age (including babies and children) services
and organisations responsible for pressure ulcer care across health
and social care, including:
- primary and secondary care
- hospices and independent clinics
- care at home services
- care homes.
Summary of standards
The standards cover the following areas:
- Standard 1: leadership and governance
The organisation demonstrates leadership in the prevention and
management of pressure ulcers.
- Standard 2: staff education and training
The organisation demonstrates commitment to the education and
training of all staff involved in the prevention and management of
pressure ulcers, appropriate to roles and workplace
setting.
- Standard 3: person-centred information and
support
Information and support is available for
people with, or at risk of developing, pressure ulcers, and/or
their representatives where
appropriate.
- Standard 4: initial assessment of risk of developing a
pressure ulcer
An initial risk assessment is
undertaken as part of admission to, or first contact with, a care
service to inform care planning.
- Standard 5: reassessment of risk
Regular
reassessment is used to re-evaluate an individual’s risk of
developing pressure ulcers or experiencing further damage to
existing pressure ulcers.
- Standard 6: care planning for prevention of pressure
ulcers
A person-centred care plan is developed and
implemented to reduce the risk of developing pressure
ulcers.
- Standard 7: assessment, grading and care planning for
identified pressure ulcers.
People with identified
pressure ulcers will receive a holistic assessment and experience
high quality and person-centred treatment and
support.
Published Date: 23 October 2020
