Hospital trials open the way to end scourge of bed-sore deaths

Published on Sunday 6 February 2011 13:42

Bed sores linked to the deaths of hundreds of hospital patients in Scotland could be prevented with new measures which have wiped out the problem in trials.

The sores, which can cause infection down to the bone, are more common in elderly patients, but can also affect younger people and children.

Now a pilot project has found that carrying out a system of checks on vulnerable patients can dramatically cut cases of bed sores - also known as pressure ulcers - and the extra costs hospitals have to bear. One ward at Borders General Hospital has gone 150 days without any sores reported.

It is hoped that the system can now be rolled out across Scotland to prevent more unnecessary suffering and deaths.

Bed sores can be caused by lack of movement, the skin being left moist and under pressure from the surface it is touching.

Figures in September revealed that 78 people died as a direct result of infected bed sores between 2005 and 2009.

In another 566 cases, the problem was mentioned as the underlying cause or contributory factor on death certificates. NHS Quality Improvement Scotland, which has been developing methods to cut the number of patients being struck by bed sores, hopes Scotland can follow the example of Wales, where some wards have gone more than 300 days without any bed sores.

Susan Baxter, who has led the project, said one of the main ways of stopping pressure ulcers was encouraging patients to move position.

"Another factor is nutritional status. If someone is not well-nourished, that can compromise skin integrity through lack of vitamins," she said.

"Incontinence is also a factor. Also, the surface that somebody is on, such as a mattress or a pressure-relieving cushion, is important, as well as having appropriate footwear that does not cause friction."

Ms Baxter said the team was now trying to make sure knowledge about how to prevent bed sores was translated into practice.

Working with colleagues in the United States and Wales, they have developed a "care bundle" that consists of a series of checks and measures which are carried out at the patient's bedside.

They include checks on the surface the patient was resting on, skin inspections, keeping the patient moving, checking incontinence and nutrition. The frequency of the checks would vary depending on a patients' needs, but could be as often as every two hours.

Ms Baxter said that if adopted across Scotland, the checks would definitely bring down deaths linked to pressure ulcers.

Liberal Democrat health spokesman Ross Finnie said: "Pressure sores cause huge amounts of pain and discomfort for affected patients. But they are easily preventable with the appropriate care." Health secretary Nicola Sturgeon said: "The National Tissue Viability programme has delivered impressive results in NHS Borders and elsewhere in Scotland and has demonstrated the potential to have a significant impact on patient care and experience.

"I expect all boards to continue to improve the quality of care in the prevention and treatment of pressure ulcers for patients both in hospital and at home."