Loading...
Prevention and management of PU and its implications to patient outcomes, length of hospitalisation and trust budget
De Veyra, Alberto III Custodio
De Veyra, Alberto III Custodio
Citations
Altmetric:
Affiliation
University Hospitals Birmingham NHS Foundation Trust
Other Contributors
Publication date
2025-05-30
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
I. Introduction
At present, the University Hospitals Birmingham NHS Foundation Trust (UHB) is not yet implementing any form of skin tone assessment which puts its patients at risk especially those with dark skin tones. In addition, a more intentional use of information, language, terminology and illustrative images on dark skin tones during staff training should be applied to equip staff in ensuring that care is tailored to the individual and their needs on all acute sites of UHB namely Queen Elizabeth Hospital Birmingham (QEHB), Birmingham Heartlands Hospital (BHH), Good Hope Hospital (GHH) and Solihull Hospital (SH).
A total of 5,787 and 21,994 PU was reported in GHH and the whole of UHB, respectively between April 2023 and July 2024. In Ward 29 of GHH alone which has 24-bed capacity, a total of 85 PU was reported during the above-mentioned dates. This number could be less than the actual as only an average of 72.2% of skin assessments were completed within that span. The lack of formal training and competence on skin tone assessment may have contributed to this underreporting as the focus on identifying ‘redness’ for instance which may differ in presentation depending on skin tone, has created a bias that mean patients with dark skin tones may not receive accurate diagnosis and care.
II. Problem statement:
Inaccurate daily skin assessments that could lead to the development and poor management of Moisture Associated Skin Damage (MASD) and Pressure Ulcers (PU) among patients in Ward 29.
III. Aims:
The aim of this project is to equip Ward 29 staff with the necessary knowledge, skills and tools on PU categorisation to all patients of different skin tones to facilitate a more accurate skin assessment.
The following objectives are crucial towards the fulfilment of the QI project aim:
•To ensure that roles and responsibilities between Nurses/Nursing Associates and HCAs on skin assessment and recording are clearly defined, properly communicated, and reinforced.
•To facilitate staff training/refresher course on PU categorisation and skin tone assessment.
•To introduce a paper form skin assessment chart with PU categorisation guide and skin tone assessment tool that can be transposed on Prescribing Information and Communication System (PICS).
IV. Goal:
To improve Ward 29's overall performance on completed skin assessments on PICS from 72.2% to 80% and reduce the number of Trust-Acquired Pressure Ulcers (TAPU) within the Department in 12 months.
V. Change Idea
This QI project seeks to prioritise two change ideas such as (1) facilitating staff training/refresher course on PU categorisation and skin tone assessment and (2) introducing a paper form skin assessment chart with PU categorisation guide and skin tone assessment tool that can be transposed on Prescribing Information and Communication System (PICS) in Ward 29 of GHH. Among the different factors that lead to the inaccurate daily skin assessments in Ward 29 as shown in the fishbone diagram, the lack of staff training and paper form chart on PU categorisation and skin tone assessment contribute to most of the problem. Using the Pareto principle, there is a high probability of gaining the biggest improvement by tackling these two issues alone which are also less complicated to deal with than the other factors.
Citation
De Veyra, A.I.C (2025) 'Prevention and management of PU and its implications to patient outcomes, length of hospitalisation and trust budget' University Hospitals Birmingham NHS Foundation Trust.
Type
Report