7 10 11 Pressure ulcers can lead to increased mortality, morbidity and reduced quality of life for the patient. 6 They are a common occurrence, particularly in patients whose mobility is limited due to illness, severe physical disability or increasing frailty. Pressure ulcers are an unwanted and often avoidable complication of care 6–9 that affect over 700 000 UK patients per year. 5 Factors increasing the likelihood of these pressure ulcers occurring are immobility, incontinence and poor nutritional status. 3 4 However, pressure ulcers can also develop deeper, below the surface of the skin, badly damaging the muscle or bone underneath. 2 Commonly, these conventional pressure ulcers occur on the sacrum or heel and it is estimated that this accounts for around 70% of pressure ulcers in adults.
1Ĭonventional pressure ulcers occur where there is a bony prominence and there is compression of the skin or underlying tissue with an external surface. Knowledge concerning the prevention of pressure ulcers is readily available, and an in-depth review into the effectiveness of current practice was undertaken by Niederhauser et al. In year 1, pressure ulcers were reduced by 36%, and in year 2 by 33%, demonstrating an estimated cost saving during the lifespan of the Collaborative of £513 000, and a reduction in the number of bed days between 220 and 352. The Breakthrough Series Collaborative Model from the Institute for Healthcare Improvement provided the framework for this Collaborative. Because of this, a 2-year Pressure Ulcer Collaborative was implemented, involving secondary care, community services, care homes and the ambulance service, with the aim of reducing the percentage of pressure ulcers developed by patients within their care. In early 2015, it was identified that for the North East and North Cumbria region the incidence of pressure ulcers was higher than the national average. However, it is acknowledged that a significant number of these are avoidable. The impact on patients can be considerable, due to increased pain, length of hospital stay and decreased quality of life. In 2004, pressure ulcers were estimated to cost the NHS £1.4–£2.4 billion per year, which was 4% of the total NHS expenditure. The occurrence of pressure ulcers costs the National Health Service (NHS) more than 3.8 million every day. In the UK, over 700 000 patients are affected by pressure ulcers each year, and 180 000 of those are newly acquired each year.
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