NICE issues guidance on pressure ulcer prevention and management

Patients ‘at risk’ of developing pressure ulcers should be repositioned at least every six hours and those considered ‘at high risk’ should have their position changed at least every four hours, according to new guidance. The updated guidance on preventing and managing pressure ulcers, produced by the National Institute for Health and Care Excellence (NICE), stresses the importance of risk assessment, adjusting patients’ positions, and the use of high-specification foam mattresses. Challenges specific to heel pressure ulcers are highlighted, as are the need for individualised care plans and the importance of training staff in pressure ulcer prevention. The guidance comes as NHS-wide targets are being finalised concerning minimising the proportion of patients with pressure ulcers in category two, three and four. These targets are expected to be introduced next year in the NHS Outcomes Framework. Four nurses, including Mark Collier, were among the 13 healthcare professionals who advised NICE on the guidelines. Mr Collier, a nurse consultant in tissue viability at United Lincolnshire Hospitals NHS Trust, said: ‘Risk assessments should be carried out on admission and at regular intervals. That is crucial. Assessments should be with validated tools such as the Waterlow tool. There should be ongoing assessments, especially when there are early signs of damage, such as discolouring or tissue hardening.’