NHS Forth Valley – Pressure Ulcers

Pressure ulcers are caused when an area of skin and the tissues below are damaged because of being placed under pressure sufficient to impair its blood supply. The European Pressure Ulcer Advisory Panel defines them as:

“An area of localised damage to the skin and underlying tissue caused by pressure, shear, friction and/or a combination of these.” (EPUAP, 1999)

Typically, they occur in a person confined to bed or a chair by an illness and as a result they are sometimes referred to as ‘bedsores’, or ‘pressure sores’. All patients are potentially at risk of developing a pressure ulcer. However, they are more likely to in people who are seriously ill, have a neurological condition, impaired mobility, impaired nutrition, or poor posture or a deformity (NICE, 2014).

Prevention and Management

Pressure ulcers present a major health care challenge. It has been recognized that pressure ulcers place a huge financial burden on the health care system and additionally result in a poor quality of life for the patient with an increased risk of morbidity. It is also known that many pressure ulcers are avoidable.

Efforts to reduce occurrence of pressure ulcers need to focus on prevention rather than cure. If we are to manage rates of pressure ulceration best practice needs to be employed using guidelines, educational support and provision of appropriate equipment.

Nice guidance (2104) recommends using a validated scale to support clinical judgement when assessing pressure ulcer risk.

An assessment of pressure ulcer risk for adults being admitted to secondary care or care homes in which NHS care is provided or receiving NHS care in other settings (such as primary and community care and emergency departments) should be undertaken on admission, or on the 1^st visit in the community setting (NICE, 2014).

The following documents are available to clinicians to assist in pressure ulcer prevention and management:

Prevention and Management of Pressure Ulcers Standard October 2020

Pressure Ulcer assessment

Grading Tool: Scottish Adaptation of the European Pressure Ulcer Advisory Panel

In NHS Forth Valley we currently use the Braden Risk Assessment Tool, this is found in all Acute FV Risk assessment Documentation booklets and within community Risk assessment found on MORSE.

Trials are underway in several areas using the PURPOSE T Risk assessment tool with will be rolled out to all areas in the near future.

Please see further information on the PURPOSE T Risk assessment tool:

Preformed illustrated care plans

Therapeutic Equipment

Identifying the correct piece of equipment for a patient can be complex.

The Tissue Viability Team deals with advice and guidance for clinicians regarding equipment for tissue viability purposes only. Equipment required for functional, or health reasons are not sourced through our team.

Refer to an occupational therapist for functional need or contact the nursing staff for a health need.