Quality statement 8: Pressure redistribution devices

Quality statement

People at high risk of developing pressure ulcers are provided with pressure redistribution devices.

Rationale

Pressure redistribution devices work by reducing or redistributing pressure, friction or shear forces. Devices include high‑specification mattresses, pressure redistribution cushions and equipment that offloads heel pressure. The type of device a person needs will depend on their circumstances, for example, their mobility, the results of the skin assessment, their level of risk, the site that is at risk, the person's weight and the person's general health. Using pressure redistribution devices as soon as possible can prevent pressure ulcers developing and help to treat them if they do arise, ensuring patient safety and improving the experience of people at high risk of pressure ulcers.

Quality measures

Structure

Evidence of local arrangements to provide pressure redistribution devices for people at high risk of developing pressure ulcers.

Data source: Local data collection.

Process

Proportion of people newly identified as being at high risk of developing pressure ulcers who receive a pressure redistribution device.

Numerator – the number in the denominator who receive a pressure redistribution device.

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

Data source: Local data collection.

Outcomes

a) Waiting times from the identified need for a pressure redistribution device to the time the device is requested.

b) Waiting times from the time the pressure redistribution device is requested to the time the device is received.

Data source: Local data collection.

What the quality statement means for service providers, health and social care practitioners and commissioners

Service providers (primary care, community care, hospitals and care homes with nursing) ensure that people at high risk of developing pressure ulcers in all settings are provided with pressure redistribution devices when they need them.

Health and social care practitioners ensure that people at high risk of developing pressure ulcers in their care are provided with pressure redistribution devices.

Commissioners (NHS England area teams, clinical commissioning groups and local authorities) should specify that pressure redistribution devices are available and provided for people at high risk of developing pressure ulcers.

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

People who have a high risk of developing pressure ulcers are given 'pressure redistributing equipment'. This term is used to describe any item, such as a mattress or an overlay (a layer placed on top of a mattress), that either spreads out the pressure or removes pressure regularly from different parts of the body. (They may also be called 'pressure reducing', 'pressure relieving' or 'pressure redistributing devices'.) If you use a wheelchair or sit for long periods of time, you may also be offered a special cushion. Babies, children and young people at risk of developing a pressure ulcer on the back of the head should have a special pillow or pad.

Source guidance

  • Pressure ulcers (2014) NICE guideline CG179, recommendations 1.1.13 (key priority for implementation), 1.1.14, 1.1.17, 1.2.17, 1.2.18, 1.2.20, 1.2.21, 1.4.9, 1.4.12, 1.5.10, 1.5.11 and 1.5.12

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)]

Pressure redistribution devices

Pressure redistribution devices include different types of high‑specification mattresses and overlays, pressure redistribution cushions and seating, and equipment that offloads heel pressure.

[Pressure ulcers (NICE full guideline CG179)]