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Supporting Guidance Standard 2.2

Health and Care Standards

Supporting Guidance

Standard 2.2  Preventing Pressure and Tissue Damage

 

What is the Standard about?

This standard is about minimising the risk of people developing avoidable pressure ulcers. Pressure ulcers are one of the most frequently reported adult in-patient forms of clinical harm. An assessment of the range of factors which are known to increase risk of developing pressure ulcers is important in developing a plan of care which aims to minimise the risk of individuals developing pressure ulcers.

 

Who is it for?

All healthcare staff in all settings

In relation to the standard criteria below (in bold) the following key questions need to be considered:

 People are assessed for risk of pressure and tissue damage and if considered at risk, they receive further assessment and a plan of care is developed and implemented.

  • Has the individual been assessed for pressure ulcer risk within 6 hours of admission to hospital/care home or 1st visit in community?
  • Is there evidence of appropriate skin assessment on admission to hospital/care home or 1st visit in community?
  • Was an appropriate care plan developed and documented in line with risk assessment score?

People are made aware of the risks of pressure and tissue damage and shown ways of preventing them. They and those caring for them are encouraged and advised on appropriate care procedures, including nutritional advice.

  • Are all staff trained and competent in pressure ulcer prevention?
  • How many pressure ulcers (any grade) have developed in this clinical area/care home/caseload over the last 3 months?
  • Is there evidence that the patient/carer(s) were involved in the care plan and agreed with it?
  • Was patient/carer information provided?

Appropriate beds, chairs and other equipment are made available to reduce the risks of pressure and tissue damage and specialist preventative equipment such as special mattresses and cushions are also available if necessary. All equipment is clean and properly maintained.

  • In response to the risk identified was an appropriate mattress provided as per local policy?
  • In response to the risk identified was an appropriate cushion provided as per local policy?
  • In response to the risk identified was appropriate heel offloading provided as per local policy?

Correct moving techniques are encouraged, including regular turning and appropriate self-care, helping people to avoid pressure and tissue damage, increasing their well-being, independence and dignity.

  • Is there evidence of frequent repositioning day and night? i.e. SKIN Bundle, Repositioning, Turning charts, Carer's Log (community) etc.

Risk assessments are in place to identify if a person is at risk, their skin is checked at least once daily, and preferably when their personal hygiene is attended to.

  • Is there evidence of on-going, accurate, risk assessments as per local policy?
  • Is there evidence of re-assessment, evaluation and adjustment of care plans?

 

Legislation and Guidance

 Pressure Ulcer Reporting and Investigation (All Wales Guidance) 2014

  

Good Practice Guides

All Wales Best Practice Statement on the Prevention and Management of Moisture Lesions (2014)

European Pressure Ulcer Advisory Panel website