There has been a dramatic reduction in pressure ulcers suffered by patients on Mulberry ward at Barnet Hospital thanks to a new system introduced by nursing teams.

Using something called the Waterlow assessment to gauge a patient’s risk of developing ulcers, staff have been able to reduce occurrences from around three per month to just three per year.

All patients admitted to Mulberry ward now undergo the Waterlow assessment within six hours of admission. The assessment looks at several different factors including mobility, nutritional status, other health issues and age to give each patient a score which is used along with clinical judgement to assess a patient’s risk of developing pressure ulcers. In addition, patients aged over 80 are provided with an alternating pressure relieving mattress.

The project has been so successful that it is now being rolled out to other wards.

Swift assessment of the risk and providing patients, families and carers with the relevant information has played an important role in helping to reduce the risk of ulcers.

Ongoing staff training has also been key. ‘Bring a chair’ training sessions have meant staff haven’t needed to leave the ward to receive education. Instead, the educator has come to them to deliver practical solutions in a timely manner and free up staff to deliver on-going care. Bay ‘huddles’ take place daily so that staff can be updated about at-risk patients.

The emergency department (ED) team have also come on board with the project, ensuring the most at-risk patients also have access to alternating pressure relieving mattresses while they are in the ED and staff have access to training.

Anybody can get a pressure ulcer and risk factors include immobility, underlying health conditions, nutritional status, and age.  

Sarah Dionissiou, a tissue viability clinical nurse specialist, led the project, assisted by improvement advisor Penny Soteris, using quality improvement methods. They were both supported by ward manager Amy Petchey.

Siobhan Reid, a tissue viability nurse based at Barnet Hospital, said: “Pressure ulcers can have a huge effect on a patient’s quality of life. They cause pain and discomfort and can potentially lead to sepsis and death. It is so important to try to prevent them as much as possible. They are not 100% preventable but this project has shown we can do much better. Getting the fundamentals right is a big part of nursing care.”