DATA MANAGEMENT
“There is a pressing need for more tissue viability nurses to be involved in the data collection process.”
ing into the trust with pressure ulcers and how many are developing them whilst in the trust’s care.
“Our figures are also much better than the majority of other trusts because most are either still using some kind of paper-based system to record their data or don’t actu- ally count them at all.
“Because of this I feel that we need to show people that there is a real need to start counting if they are not already doing so and, if they are, to begin using the tools on the Department of Health website, be- cause in the future data will be required in this area. It is better to be proactive and ahead of the game, because getting in- volved in that process will help them and their patients, through the quality of data across all trusts improving and becoming more comparable.
“Investigations can be very stressful for the clinicians in- volved and because a team of clinicians can do everything right and a pressure ulcer still appear, it needs to viewed in the correct way.”
Collier explained: “Sometimes there is a barrier, because the systems to do this are not always in place. For example, when I began working at the United Lincolnshire Hospitals NHS Trust in 2002 it became clear very quickly that there was no inter- nal system in place which allowed staff to record the number of incidents of pressure ulcers.
“Because paper-based systems are very laborious, my colleagues and I developed an electronic pressure ulcer notification tool - which is accessible in every clinical area - and since 2004 that tool has been providing data which has been used to identify both pressure ulcer prevalence and incidence data on a monthly and an- nual basis.
“Any tool is only as good as the data be- ing entered and I would not want to claim that we manage to get 100% compliance all of the time; but we do now have a much better idea of how many people are com-
“By comparable I don’t mean in the sense of a league table – because incidence rates are not in themselves comparable, due to every single trust being different in terms of size and the nature of its patients – but in the sense of just introducing some uniformity into the way incidence is reported.”
To this end, there is some other work go- ing on at the Department of Health which is due to be rolled out over the course of year.
Collier explained: “This is about empow- ering nurses by enabling them to col- lect meaningful data in a meaningful way, whilst also – through work with the Patient’s Association and the CQC – em- powering patients to actually play a part in their own care, by providing them with the information which will enable them to protect their own skin.”
He hopes that this two-pronged approach
will both better educate patients and give them more confidence to speak up and ask whether they need to be turned. It will also give meaning to the data collection that nurses are carrying out.
Collier said: “After all, why should a nurse have to collect data and then not be given any feedback on it? If this happens then there is no motivation; but if data is be- ing used effectively, through the use of relevant quality indicators, then there is a point to collecting that data, which then in turn helps to inform an overall improve- ment in the care patients receive.
“That is not to say the quality of care given now is not good but there is always room for improvement in any aspect of the health service.”
The subject of improving the performance of tissue viability services has become even more pressing in recent years due to the attention which is now given to pressure ulcers, he said.
“Pressure ulcers, quite rightly, are viewed as a very bad thing and whilst I would not want people to become complacent and think that they do not matter – we are car- ing for vulnerable adults after all – I would want any investigations into their source to be carried out correctly and in the right context.
“Investigations can be very stressful for the clinicians involved and because a team of clinicians can do everything right and a pressure ulcer still appear, it needs to viewed in the correct way.
“I want people to think about the preven- tion of ulcers as being a good thing, instead of just dreading their appearance and the perceived allegations of neglect which peo- ple assume will follow.
“If a patient has an open abdomen then all of the nurses and doctors want to be in- volved in that because it is challenging and they can see an end point to that problem.
“However, pressure ulcers don’t appear to be viewed in the same way and I would like to see more people being proactive in work- ing to limit their oc- currence as much as possible.”
Mark Collier
FOR MORE INFORMATION The online tool can be found by searching ‘pressure ulcers’ at
www.dh.gov.uk
national health executive Mar/Apr 11 | 47
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