Your skin matters - one of the High Impact Actions
The aim of the high impact action – Your skin matters is ‘no avoidable pressure ulcers in NHS provided care’ – but which ones are avoidable? We know that pressure ulcers represent a major burden of sickness and reduced quality of life for patients. They create significant difficulties for patients, carers and families, as well as increasing time in hospital and, therefore, cost to the NHS.
Click on the small images, above, to access the video case studies.
Nursing homes were the focus for further improvement in reducing pressure ulcers in the community at Newham PCT, which recruited two specialist nurses to work with them on reducing the prevalence and impact of pressure ulcers among this vulnerable patient group.
Kettering General Hospital NHS Foundation Trust
A programme of change focusing on continence care has helped reduce the incidence of skin damage by 80%. In the absence of a dedicated continence specialist, the tissue viability team worked differently to maximise the support they were able to give staff. A selection protocol for continence products was devised to ensure the right product is available and used.
East Kent Hospitals NHS Foundation Trust
Pressure relieving mattresses are considered to be an important tool in preventing and treating pressure ulcers – and this is why wards can be less then willing to part with them for fear of having a patient in need and no equipment to support them. East Kent introduced a range of measures to ensure they were available for those patients who were in most need.
Abertawe Bro Morgannwy University Health Board
Nurses working in the plastic surgery unit were all too familiar with the dire consequences of pressure ulcers, so have developed a zero tolerance approach to hospital-acquired pressure ulcers. The practice has spread throughout the trust and pressure ulcers are now an extremely rare event.
The literature review was commissioned by the NHS Institute to take forward previous work in assessing the costs and benefits of high impact actions by nurses and midwives.
This literature review updates the High Impact Actions for Nurses and Midwives: Rapid Review of Economic Data conducted by Pricewaterhouse Coopers in November 2009.
This report details the findings from the literature review and will be used to inform both the case studies and economic modelling.
Return on investment (ROI)
On field visits the NHS Institute team obtained a detailed understanding of the approach that has been taken by clinicians, who was involved, the impact (costs and benefits), and the data available to evidence this impact (pre and post implementation measures wherever possible).
Additional data have been secured through ongoing liaison with key informants including business managers, health informatics and audit staff. Modelling Modelling has been undertaken to generate a costs to benefits ratio.
The modelling utilises the following data:
- Data from the literature review on the scale of the problem nationally, and the associated costs of the problem (i.e. potential savings);
- Data from the literature review on impact;
- Data from the sites on impact and the costs of implementation.
The first two bullet points are used as face validity checks for the data secured through field work and to provide proxy indicators where field data are unavailable. An excel workbook of their cost benefit calculation including all underpinning assumptions is provided.
The opportunity estimator allows you to calculate the potential cost savings associated with making improvements in the High Impact Actions . It utilises information from the literature reviews that are available in each High Impact Actions section. The opportunity estimator will give you an indication of potential savings, if you want to carry out a more thorough Return on Investment (ROI) analysis there are tools available at www.institute.nhs.uk/roi
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