‘Pressure Ulcer Prevention in a Pandemic’

“Pressure ulcer prevention and management is an art as well as a science. Different people with similar
conditions need different care and that care should be holistic and tailored to the individual.”
Linda Nazarko OBE Consultant Nurse West London NHS Trust

Before the pandemic, I never got home visits, because I’m not bed-ridden. Previously, only people who are bed-ridden got home visits. Nowadays, I’ve been getting home visits from carers and district nurses, since the pandemic. I even received my Covid-19 vaccination, Astra Zeneca, by way of home visits.

“Pressure ulcers remain a concerning and mainly avoidable harm associated with healthcare delivery.”
National Pressure Ulcer Prevalence and Quality of Care Audit, November 2020

I became a PURSUN researcher during the pandemic in 2020. I used to attend annual Spina Bifida Clinics before the pandemic from 2013. However, since the pandemic, I’ve had no success in booking Spina Bifida Clinics, due to the surge and resurge of Covid-19 cases. In addition to the PURSUN research, the Spina Bifida Clinics also help me to improve the way that I take care of myself.

“The overall prevalence of PUs recorded, in terms or proportion of patients with 1 or more PUs, was 9.04%…The audit sought to understand not just the number of pressure ulcers that were present, but the care that was being delivered to the patients to prevent pressure ulcers occurring….Findings regarding implementation of preventative actions vary considerably between organisations and even between sites within organisations. Identification of these areas is important to the individual organisations as it allows them to focus quality improvement efforts into the areas that may make a difference.”
Stop the Pressure: National Pressure Ulcer Prevalence and Quality of Care Audit 2020

By December 2020, concerns about foot amputation were being raised by District Nurses, Tissue Viability Nurse and Podiatry. Since then, I’ve been wearing splints and callipers to protect my feet from any further damage. My feet have been x-rayed and scanned. I’ve also been prescribed antibiotics for my infected heel bone. Before the pandemic, I used to order and pick up my prescriptions from the Lloyds Pharmacy but ever since the pandemic they’ve been delivered to my house.

I received assistance from my sister with groceries because online shopping was fully booked during the first three months of the pandemic.

She stayed with me for three months but then had to leave after that because I was at risk of losing my Housing Benefit under assisted living, if she stayed any longer. Carers have been restricted on admission. There is more chance of emergency admission to the hospital.

“A phased approach will be used to develop Pressure Ulcer surveillance in the NHS.. Clinicians with responsibility for Pressure Ulcer reporting (most likely tissue viability nurses) will need to ensure their organisations are aware of and prepared for the new surveillance system. As part of this, systems will need to understand the difference between surveillance reporting and clinical incident reporting. The purpose of surveillance reporting is to capture the full incidence and prevalence of Pressure Ulcers across a system to drive quality improvement at organisational level. The purpose of clinical incident reporting is to support learning from mistakes so action can be taken to keep patients safe.”
A new national Pressure Ulcer Surveillance system using The Model Hospital System, November 2021

Pressure ulcer prevention in a pandemic taught me how to:

  • network with colleagues who are working to improve the measurement, reporting and prevention of pressure ulcers and harm
  • Reflect on national developments and learning including learning from Stop the Pressure: National Pressure Ulcer Prevalence and Quality of Care Audit
  • Learn from outstanding practice in pressure ulcer reporting
  • Implementing the new national Pressure Ulcer Surveillance system and learning from pilot sites
  • Change the way you view pressure ulcers – eliminating the focus on a voidability
  • Developing effective training and education of frontline staff that will empower frontline teams to take ownership for improving care processes and preventing pressure ulcers
  • Understand how you can reduce pressure ulcers and harm from pressure ulcers
  • Improve sustainability in the reduction of pressure ulcers during Covid-19
  • Understand plans for a new national pressure ulcer data system to support quality improvement
  • Understand the factors that increase the risk of pressure ulcer development, and explore effective risk assessment tools
  • Develop a better understanding of pressure ulcer prevention at the end of life
  • Reflect on a case study in reducing pressure ulcers in Covid-19 patients
  • Improve Nutrition and Hydration
  • Learn from Clinical Negligence claims related to pressure ulcers
  • Ensure you are up to date with the latest evidence and definitions
  • Self assess and reflect on your own practice
  • Supports CPD professional development and acts as revalidation evidence.
  • group approval for revalidation purposes

“We continue to have a challenge with patients developing pressure ulcers, and also a challenge with having some standardisation and consistency of care. There is considerable variation of about what happens in practice, in particular, underuse of evidence based care and overuse of ineffective interventions.”
Jacqui Fletcher OBE Clinical Lead, The National Wound Care Strategy Programme, November 2021


About Daniella-Jade Lowe

Hello, My name is Daniella Jade Lowe. I am a PURSUN researcher and I am working on marketing myself as an Accessibility Consultant. Journalism and Politics are my passion. I have a BA degree in History and Politics. What type of disability do you have? At birth, I was diagnosed with Spina Bifida and Hydrocephalus which are neurological conditions. As a result, I use a wheelchair for mobility. What is disability to you? The only disability is a bad attitude. I have a disability. It doesn’t completely define me; it just enhances me in a way which differentiates and strengthens me. My disability should be viewed as an ability: to see the world in a different way. I don’t really like the term because sometimes it indirectly implies someone is dysfunctional or helpless. The most important thing is to never make assumptions. Someone with a disability can be very, physically, fit and strong, highly intelligent and articulate. What has been your experience from the time you remember till now? - positive and negative experiences. My life as a wheelchair user has been generally okay. Wheelchair Accessibility is frustrating. I was teased a little in school. Other than that, life is great. How do you cope with: -daily activities - your disability, do you have times when you are down - people's reactions towards you. I have carers, a Social worker, District Nurses, a GP, and extended family in this country. I am also in contact with a local disability charity in Yorkshire. I also have a friendly landlord. How do you keep yourself motivated? I must stay organised and practice good time management. I also prioritise my plans. What is your word or advice - to those with disabilities? - to the society Don’t let people put you in a box. You have a voice, use it. 10. Tell us about your platforms if you have any- Blog: The View from Where I Sit Facebook: Daniella Jade Lowe Instagram: @daniellajadelowe/@theviewfromwheresitblog Thank you!