Pressure-Ulcer-Article

Since the new Pressure Ulcer (PU) report form was launched across the province last February as part of the Let’s take the pressure off! campaign, we’re seeing evidence that awareness of this important patient safety issue is growing across BC.

BC PSLS data shows a noticeably higher volume of PU reporting from all health authorities, with nursing staff, physiotherapists, occupational therapists and other healthcare professionals reporting PUs more often than they did before the new form became available.

Much of the credit for this change goes to the hard-working skin and wound specialists from across BC. So, how did they do it?

To learn more, we spoke to Rosemary Hill, Enterostomal Therapist, Vancouver Coastal Health (VCH), and Marine Chan, Skin & Wound Care Specialist, Fraser Health (FH). Both have a similar passion for PU prevention and value interdisciplinary learning across healthcare sectors.

“There’s a great deal of sensitivity around the issue of pressure ulcers, so we need to keep talking about it,” Rosemary says.

“At the same time, it’s really important that we don’t shape the occurrence and reporting of pressure ulcers as something punitive against staff. We want staff to know we’re interested in collecting PU data in PSLS because we want to improve patient safety, not point fingers.”

For Rosemary and her colleagues, educating VCH staff about PUs is important. They’ve spent time at facilities along the Sunshine Coast and up north in Bella Bella and Bella Coola to speak with staff about PU identification, reporting and prevention.

“One of the most important things we teach is how to use the Braden Scale PU risk assessment tool and what to do when a patient has a score of 18 or below, meaning they are at significant risk of developing a PU,” Rosemary says. “It’s great that we can personally go to these sites because face-to-face teaching really works best. We’re also developing videos about PU prevention. I’m very pleased with how well staff are picking this up and taking it so seriously.”

At FH, staff education is also a key focus, particularly in acute care settings, with the goal of helping staff develop a better understanding of the serious nature of PUs. Marine, who works in the community and visits clients in their homes or at health clinics, says it’s not unusual for a client to notice a PU after a recent stay in hospital. 

“Sometimes when I ask a client, Do you know how this happened?, they will say, I don’t know but I was recently discharged from hospital,” Marine says.

“So we’re focusing specifically on teaching acute care staff how to detect early signs of a PU and prevent it from getting worse. We don’t want patients going home with a wound that they did not have before they were admitted to the hospital. A pressure ulcer acquired during a hospital stay could take months or years to heal.”

For Rosemary and Marine, cross-functional education is effective for teaching staff about PU prevention in a supportive way. But, with thousands of front-line staff, they do admit it will take time.

Pressure button2“We’re still getting the word out about the band-aid form at VCH,” Rosemary says, referring to the icon used for the PU report in BC PSLS. “Some staff will say, Oh, I didn’t know there was a place to report PUs in PSLS! I’m very passionate about this initiative. When I receive a referral or phone call from a concerned nurse, I drop everything and go. I want staff to feel comfortable contacting me and knowing that I will respond quickly.”

Marine adds, “Prevention is the key. Once a PU occurs, it can be challenging for some clients because they might not have an adequate mattress at home, or they might not have the proper equipment to manage a PU. People need to live their lives, so I’m very thankful we can educate hospital staff, prevent PUs from happening in acute care and reduce the occurrence of PUs in the community.”

Thank you to Rosemary and Marine and all skin and wound specialists throughout BC!

The new specialized form for reporting pressure ulcers was launched provincially on February 14, 2014, as part of the Let’s take the pressure off! campaign. Since then, we’ve seen a noticeable increase in the volume of pressure ulcer reporting from across the province, which tells us there is greater awareness of this issue in all sectors of BC healthcare, thanks to the hard work of people like Rosemary and Marine.

To learn more, please contact Rosemary or Marine at rosemary.hill@vch.ca  and marine.chan@fraserhealth.ca

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