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Pressure Ulcers - a public health nursing and AHP issue? by Ruth May

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Ruth May

What has #stopthepressure, a campaign to prevent pressure ulcers, and public health nursing got in common?

You may wonder? You may think I've lost the plot but hopefully, in the next five minutes, I can convince you that public health nursing and the allied health professions are part of the jigsaw to #stopthepressure.

#stopthepressure is a perfect example of where nurses and AHPs make a difference through ‘personalised care and population health’ (the name of our national programme on public health). Excellent fundamental care for individual patients is self-evidently vital including prevention, protection and health improvement and every practitioner can make a difference. Prevent, protect and improve applies at community level too. Protecting those people living in their homes and making sure wider community carers and the public themselves understand what is important in protecting from pressures sores is also vital.

We now know, after working on this for two years, that more people are assessed as having a pressure ulcer in their own homes than we ever thought possible. District nurses report visiting patients and asking questions about any sores. We have examples where the reply has been, 'yes, my heel is sticky' or ‘my back sore’ which turned out to be grade 3's! So we can identify early and prevent things getting worse but we also need to do more to prevent people becoming a patient with a pressure ulcer in the first place.

So what are we doing?

NHS Midlands and East launched #stopthepressure in 2012 and its since gone national and about to go international too!  The core to the campaign is about improvement in assessing, treating, and preventing pressure ulcers, alongside educating and supporting professionals. There is of course the SSKIN...

Surface, Skin inspection, Keep patients moving, Incontinence and Nutrition/hydration: A guide for health professionals. Equally, one developed by and for carers and the public: SKINS.  And then the one that students in Lincoln developed for all student nurses: Student SSKIN

So great personalised care and more ‘population education and engagement’ on keeping active hydration and nutrition and the protective effects, using Making Every Contact Count (MECC) with older people and carers will make a real difference.

I could go and on about the resources available. Look for yourself on

It's my belief that if we get these aspects right for patients then, yes, we will reduce the prevalence and incidence of pressure ulcers and in doing so improve the care patients receive.

Indeed we have. In the Midlands and East by 50%, so that's 500 patients a month now not developing a pressure ulcer.

Writing this blog reminds me on one of most enjoyable roles ever.. I was a Director of Public Health and Director of Nursing when the 'eat five a day' campaign started... Yep that ages me 🙂 maybe it's time to reconsider what more we can do on this? How can we join this work together?

So please public health nursing/AHP community join us in becoming a pressure ulcer champion and #stopthepressure.

Ruth May is Regional Chief Nurse for NHS England Midlands and East



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