Quality statement 7: Information on preventing pressure ulcers

Quality statement

People at high risk of developing pressure ulcers, and their carers, receive information on how to prevent them.

Rationale

Many pressure ulcers are preventable. Much of the preventative care needed takes place in a person's own home and needs to be delivered regularly to ensure patient safety. Healthcare professionals should give information to people at high risk of developing pressure ulcers (and their carers, as appropriate) about preventative care that may stop pressure ulcers from developing. To improve patient experience, information about preventing pressure ulcers should be appropriate to the individual person and their carers. Information should include the causes and signs of pressure ulcers and how they affect health and quality of life. It should also include a demonstration of how to use equipment that may be supplied, and what people can do to help prevent pressure ulcers from developing.

Quality measures

Structure

a) Evidence of local arrangements to ensure that people at high risk of developing pressure ulcers, and their carers, receive information on how to prevent them.

Data source: Local data collection.

Process

a) Proportion of people newly identified at high risk of developing pressure ulcers who receive information on how to prevent them.

Numerator – the number in the denominator, or their carer, that receive information on how to prevent pressure ulcers.

Denominator – the number of people newly identified at high risk of developing pressure ulcers.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (primary care, community care, hospitals and care homes with nursing) ensure that systems are in place for healthcare professionals to give tailored information on preventing pressure ulcers to people who are at high risk of developing pressure ulcers (and to their carers, as appropriate).

Healthcare professionals ensure that they give people who are at high risk of developing pressure ulcers, (and to their carers, as appropriate), tailored information on how to prevent them.

Commissioners (NHS England area teams and clinical commissioning groups) should specify that tailored information on preventing pressure ulcers is given to people who are at high risk of developing pressure ulcers, (and to their carers, as appropriate).

What the quality statement means for patients, service users and carers

People who have a high risk of developing pressure ulcers are given information by a healthcare professional about preventing pressure ulcers from developing. This should be tailored to the person's needs, and should include advice about the causes and early signs of pressure ulcers, and information on how pressure ulcers can affect health and quality of life. The information should also include a demonstration of how to use any equipment (for example, any mattresses or cushions) that may be supplied, and information about what people can do to help prevent pressure ulcers from developing.

Source guidance

Definitions of terms used in this quality statement

Risk of developing pressure ulcers

People considered to be at risk of developing a pressure ulcer are those who, after assessment using clinical judgement and/or a validated risk assessment tool, are considered to be at risk of developing a pressure ulcer. Risk factors include:

  • significantly limited mobility (for example, people with a spinal cord injury)

  • significant loss of sensation

  • a previous or current pressure ulcer

  • malnutrition

  • the inability to reposition themselves

  • significant cognitive impairment.

[Pressure ulcers (NICE guideline CG179) recommendations 1.1.2 and 1.2.1]

High risk of developing pressure ulcers

People considered to be at high risk of developing a pressure ulcer will usually have multiple risk factors identified during risk assessment with or without a validated risk assessment tool. Adults with a history of pressure ulcers or a current pressure ulcer are also considered to be at high risk.

[Pressure ulcers (NICE guideline CG179)]

Information

The information should include:

  • the causes of pressure ulcers

  • the early signs of pressure ulcers

  • ways to prevent pressure ulcers

  • the effect of having a pressure ulcer (for example, for general health, treatment options and the risk of developing pressure ulcers in the future)

  • a demonstration of techniques and equipment used to prevent a pressure ulcer.

[Pressure ulcers (NICE guideline CG179) recommendation 1.3.2]

Equality and diversity considerations

The information provided needs to be tailored to the individual. This is especially the case for people with degenerative conditions, impaired mobility, neurological impairment, sensory impairment, cognitive and behavioural difficulties, impaired tissue perfusion and differing skin tones and types. The information should also be age‑appropriate, taking into account the needs of children and young people and their parents or carers.