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Hedgehog Hall of Fame: University Hospitals - 100 Days Free Campaign

16th August 2013

Company: University Hospitals Coventry & Warwickshire NHS Trust (UHCW) Campaign: 100 Days Free Campaign Category: Internal Communications Campaign of the Year - South - WINNER Objective The reduction and prevention of pressure ulcers is a national quality indicator and the 2012/2013 NHS Operating Framework identifies the incidence of newly acquired Category Grade 2, 3 and 4 pressure ulcers as a key indicator of poor care and therefore will be monitoring them as an area for improvement. The majority of pressure ulcers are avoidable and can be prevented when the correct systems and practices are put into place. Therefore, we recognised the need for a dedicated awareness-raising campaign that would increase the Trust’s understanding of pressure ulcer prevention, decreasing the numbers seen and improving patient care. Our aim was to work with the Tissue Viability Team to conduct a Trust-wide internal communications campaign in order to eliminate all avoidable grade 2, 3 and 4 pressure ulcers within UHCW, thereby improving patient care with the knock-on benefit of reducing costs to the Trust. Strategy & Target Audience We knew that the most effective way to treat this issue was to target those who are directly responsible for the prevention of pressure ulcers. Therefore, our campaign focused on reaching nursing staff and allied health professionals who have a role in assessing risk factors and repositioning patients. As tissue viability is a complex area of patient care, it requires in-depth knowledge and a patient-centred, holistic approach. Therefore, we also targeted registered nurses, midwives, healthcare support workers, newly qualified staff, and nursing and medical students to ensure an overall increase of awareness at UHCW. In order to reach as many of the staff as possible across the Trust, we conducted a campaign that included various communication channels, such as monthly teaching days, newsletters and student learning packs. We also created an accreditation for wards that remained free from hospital-acquired avoidable pressure ulcers for 100 days, which was called the ‘100 Days Free’ accreditation. Action Communications and Tissue Viability representatives sat down and came up with a practical plan with tactical suggestions in order to achieve the target. This included the 100 Days Free campaign and using power training to give updates to staff directly on wards. Wards and departments that remained free from hospital-acquired avoidable pressure ulcers for 100 days, achieved ‘100 Days Free’ accreditation. This acted as a kite mark of quality, symbolising that the ward or department had reached a high standard in pressure ulcer prevention. On top of this, the Tissue Viability Team, led by Vanessa McDonagh, who is a Clinical Nurse Specialist for Tissue Viability and Pressure Ulcer Prevention, led on the clinical implementation side of the campaign by holding various internal initiatives to raise awareness of the prevention of pressure ulcers. In addition, Vanessa ensured the Tissue Viability Team were shown how to ‘power train’ and were given teaching resources to help staff achieve ‘100 Days Free’ accreditation. UHCW developed the concept of power training, which involves giving 10-minute ‘shots’ of training at a time that suits the demands of the ward or department. This is a convenient way to train any number of staff at any given time. The team planned and delivered monthly teaching days to increase the Trust’s understanding of pressure ulcer prevention. A wide range of staff take part in these teaching days, including registered nurses, midwives, healthcare support workers, allied health professionals and nursing and medical students. In addition, the team works with all staff at the Trust to keep their knowledge up-to-date with various resources including newsletters that they have developed and student learning packs that target students and newly-qualified staff. Results To date, 705 staff have received power training from the Tissue Viability Team during the ‘100 Days Free’ campaign. The team’s next step will be to check the competency of staff using the ‘Check and Challenge’ tool. Staff will be asked specific questions relating to their knowledge of pressure ulcer prevention by the Tissue Viability Team to help ensure the shared knowledge is maintained. Up to November 2012, 28 wards at UHCW NHS Trust had celebrated 100 days free from grade 3 or 4 pressure ulcers. Figures collated after the 100 days campaign show that pressure ulcers of all grades reduced by 69.5 per cent during the 100 days, for grade 3 and 4 ulcers by 78 per cent and for grade 4 ulcers 93 per cent. We also compared the first quarter of 2012 with the first quarter of 2011 for a like-for-like comparison of the costs of pressure ulcers to the Trust, to see if there had been a change due to the campaign. For the first quarter of 2011, we found that pressure ulcers cost the Trust a total of £805,000. Pressure ulcers had reduced significantly by the first quarter of 2012, with a cost reduction for the Trust of £629,000. A considerable amount of time and progress has already been made by Vanessa and the rest of UHCW’s Tissue Viability Team to raise awareness of pressure ulcer prevention in the past three years. As a consequence of this work, the Trust is at the forefront of prevention of pressure ulcers within the region. 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