This Blog I wanted to say a huge thank you to all the wonderful speakers at the first OSKA Stop the Pressure Roadshow days on the 4th and 5th of November.
These events were fantastic and, thanks to the speakers, we had a diverse range of subjects and discussions on the emerging themes on preventing pressure ulcers in long term care and hospices. I will try and summarise the key themes below with the hope that this will in turn give you some last minute ideas on what you may want to do for this years international stop pressure ulcer day on the 21st November.
Speakers and key themes discussed:
Tracey Wilson – Head of Quality at Glenholme Senior living and Kate Martin from Order of St Johns Trust spoke on the challenges and success in long term care. Both Kate and Tracey gave excellent presentations on prevention PUs in long term care and learning from incidences. Key themes around learning from incidences and sharing challenges was a theme across both presentations. How to start this process can be very difficult as you need cross organisational support. No one person can investigate harms alone. Starting with a ‘Root cause analysis’ (RCAs) templates may be a good tool to guide you.
Christine Mullins – St Raphael’s Residential home for adults with learning disabilities spoke about Becoming a care champion. I have worked with Christine for many years in the stop the pressure campaign, she never fails to inspire me for just how much difference carers make in harm prevention. Discussions around recruiting carers to be champions can help them feel they have a voice in resident care plans and be key influencers for complex care planning. This in turn may make the carer feel valued and improve retention of valuable staff in a time where recruitment of care and nursing staff may be challenging.
Stela Peycheva – TV lead Nurse spoke about Being a Tissue Viability Lead in an ‘Outstanding Home’. Stela gave a fantastic and practical guide of how to implement, deliver, measure and evaluate a pressure ulcer plan within and organisation. With examples of audits and staff training they have managed very low numbers of PUs and have been awarded ‘Outstanding’ by the CQC. Stela shows the impact of having a passionate lead in harms in house can lead to demostratable improvements in resident care.
Steve Lawman – Head of Inpatient services at St Michaels Hospice spoke about Learning from a SSKIN audit. Steve gave a presentation on launching an internal SSKIN audit to look at the documentation compliance benchmarked to SSKIN. He discussed his findings which were definitely an emerging pattern from what I have found in my clinical focused work on PU projects. What was fantastic is how this has led the organisation to create some focused work on these key areas. Sharing this with the delegates led to some great discussions on the SSKIN as an audit tool and how similar patterns can be across care organisations. This was a fantastic example of gold standard risk assessment in practice.
Mike Higginson – Chief Operating officer at At Matthews Healthcare spoke about Sepsis and Post Sepsis Syndrome. Mike gave a very powerful presentation on sepsis and PSS from a senior professional to an expert by experience having suffered and recovered from this after a chest infection. This was a stark reminder of the importance of rapid intervention for early signs of infection and the long lasting effects. I for one did not know of the early signs can so often resemble that of a MI or Heart attack. I am now carrying around my sepsis signs card in my wallet as a reminder and to raise awareness with others. It was incredibly moving to hear of Mikes journey and we were very grateful that he could share his journey with us.
Faith Slater and Joe Moody from St Wilfrid’s Hospice spoke on Challenges of pressure ulcer prevention in a hospice environment. Trialing Purpose T. This was the first time Faith and Joe have spoken at an event and we are so grateful they did. Their presentation was the one with the most feedback, specifically from hospice groups looking at trialing the Purpose T tool but also on how to work with the ‘Grey Areas’ of how and if the skin fails at life end and what to do if unable to reposition a patient, also in balancing up the risk factors and quality of life in the terminal stage.
Although there is a lack of guidance and research in this area, organisations are still expected to investigate their deep tissue injuries and unable to attribute skin failure at this stage as probable organ failure as part of the dying process.
The debate was how to ensure a patient is comfortable but also still offering a degree of tissue reperfusion. The general consensus in the room was that of MDT planning, holistic assessment, involving the NOK in repositioning plan and documentation.
This was a fantastic presentation and there was much feedback on other hospices being reassured they are not the only ones experiencing these dilemmas and questions.
Don’t forget if you want to know more about pressure ulcer prevention discussions and share or learn from what others are doing in their organisations, join the facebook PU champion page or follow the international Stop the Pressure Twitter network #stopthepressure