Clinical matron slashes number of avoidable pressure ulcers at trust

A clinical matron for an older people's care unit has slashed the number of avoidable pressure ulcers at her trust.

Elizabeth Green led a team at Hampshire Hospitals NHS Foundation Trust that provided training for staff, standardised all documentation, pressure-relieving equipment and dressings, and developed care pathways.

The trust missed the 2014-15 national Commissioning for Quality and Innovation (CQUIN) target of a 50% reduction in the incidence of hospital-acquired grade 2-4 pressure ulcers over the course of the year, which was the catalyst for the project.

CQUIN targets were introduced in 2009 to make a proportion of trusts’ income conditional on achieving quality improvement and innovation in specified areas of patient care.

Reducing avoidable harm

Ms Green spoke at the Older Person’s Fellowship (OPF) annual conference in London on 20 June, where Fellows presented their quality improvement projects (QIPs).

She said: ‘Pressure ulcers are mostly preventable. Working on an inpatient older person’s ward, where patients are at their most vulnerable, made me feel personally responsible for the avoidable harm caused to those under my care.’

Using a method called Rapid Spread, which involves introducing evidence-based change quickly across an organisation, Ms Green’s QIP aimed to achieve a 50% reduction in avoidable grade 2 pressure ulcers and eliminate avoidable grade 3 and 4 pressure ulcers by March 2017.

Audit process

Compulsory audits of compliance with the care pathways were completed by all clinical areas on every patient every month.

The result was a 70% reduction in the number of grade 3 and 4 pressure ulcers across the trust, and a 30% drop in grade 2 ulcers.

Ms Green added: ‘Improving the quality of care for older patients is my passion.’

The OPF is a one-year programme for senior nurses and allied health professionals,  run by King’s College London and funded by Health Education England, which aims to develop leadership and innovation in older people’s care.

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