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Working towards clinical excellence Pressure ulcer prevention and management in primary and secondary care.

Journal of Wound Care 2012 September
One of the most important indicators of effective practice is the number and severity of preventable pressure ulcers that develop in health-care settings. The key to pressure ulcer prevention is assessment, which should seek to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Given the humanitarian and financial costs of pressure ulcers, and the fact that they are largely avoidable, the current health-care reforms in the UK are making pressure ulcer prevention a key policy and professional target. Quality improvement must be demonstrated throughout health-care service delivery; it should incorporate measurement of privacy, dignity, patient safety, the patient experience and clinical outcomes, and not just concentrate on pressure ulcer prevalence or incidence audits. The key drivers should focus on metrics that have the greatest all-round impact, such as the delivery of evidence-based practice, the timing of risk assessment, and the implementation of consistent preventive care. This supplement describes the improvements made at South Tees Hospitals NHS Foundation Trust following a shift from a target-based approach, to a greater emphasis on patient safety and quality of care. This supplement aims to provide a detailed illustration of how healthcare clinicians, industry and service providers have worked collaboratively to improve patient outcomes and provide safe, effective, cost-effective pressure ulcer prevention and management strategies that are acceptable to patients in the South Tees Hospitals NHS Foundation Trust, UK. It will demonstrate how a productive working partnership between key clinicians and industry led to an improvement in services and a reduction in the incidence of pressure ulcers. It achieved this through intensive and sustained staff education, sound clinical leadership, and by monitoring and measuring progress, with the ultimate aim being to have the right care for the right patient at the right time.

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