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The prevention of pressure damage is a topic that concerns all of us working in wound care. As patient advocates we strive to provide best care and argue for resources and recognition of the problem. Despite evidence such as the Bennett et al paper, (2004) that estimated the cost of pressure damage in the UK is in excess of £2.1 billion, the true cost of pressure ulcers go unnoticed. One of the main reasons for this has been our relative failure at publicising the issue. True, there are countless articles written in the healthcare journals on the prevention, management and treatment of pressure ulcers but how many people in the street even consider the problem? How many people recognise they are at risk, and how many women entering a maternity unit would consider they might leave the unit not only with a "little bundle of joy" but also a wound that might take months to resolve? If we are to raise the profile of pressure ulcer prevention and therefore the pivotal role that our personal endeavours have in their prevention and management we need to engage with those with the greatest voice and those whom if affects the most; the general public. This approach not only supports what we as clinicians have been trying to achieve, but is part of the recent NICE guidance (CG29) that has as a central element the need to inform and work with patients and carers. The Tissue Viability Society, the Wound Care Society and Tissue Viability Nurses Association have joined forces in supporting an awareness campaign designed to inform the public about the problem, raise awareness and provide patient access to appropriate specialist advice and services. The campaign is not purely focussed at primary or secondary care, but is designed to be accessible to anyone who is at personal risk of pressure damage or who is caring for someone in that category. Even the title of the campaign has been considered at great length. "Your Turn" not only refers to the need to reposition for pressure relief, but has been chosen to prompt patients and carers to take ownership of the problem, and empower individuals to play their part in pressure damage prevention. "Your Turn" is not going to be a "quick-fix" approach, but a long-term campaign. Developing the campaign strategy has been a drawn out and difficult process but the first steps are now underway. The "Your Turn" website was launched this week. www.your-turn.org.uk provides basic information on what pressure ulcers are, how they affect individuals and how they can be avoided. It also prompts the viewer to seek further specialist advice if they have concerns. This is only the first part of a campaign that will eventually involve all of us. It is hoped that media attention, (and we will be targeting newspapers, magazines and journals) will prompt the inclusion of pressure damage prevention in future Government healthcare strategy. From this perspective, the campaign is similar to the raised media profile that MRSA has achieved in recent times. All of those involved in helping to set up the campaign are aware that there could be a backlash from making the public aware of the issue. Dr Mike Clark, whom many of you will know personally and is recognised as a world authority on pressure ulcer prevention and management has agreed to be spokesman for the campaign. Strategies have already been developed to deal with possible negative coverage and the ground has already been prepared in the House of Commons with links to key politicians through a number of recent meetings and receptions. As clinicians we all recognise that an assertive, empowered patient can be challenging but look how our colleagues in infection control have highlighted the role of hand washing through "clean hands" campaigning and how even the most stubborn healthcare practitioner has responded to patients saying "when did you last wash your hands?" If we only achieve half the success and coverage that campaign has generated we will not only reduce the number of pressure ulcers that occur but will have put tissue viability nursing on the political map and secured its future. The above report on the Your-Turn campaign was initially prepared by the Tissue Viability Nurses Association and is currently available on the TVNA and the TVS web-sites. Reference Bennett G, Dealy C, Posnett J, (2004) The cost of pressure ulcers in the UK. Age and Ageing. 33, 3,230-235
The first few months of 2006 have seen 60 new pressure ulcer references added to MEDLINE. The following list is offered to help guide readers of the Newsletter towards these latest publications on pressure ulcers. Anderson J, Hanson D, Langemo D, Hunter S, Thompson P. The evolution of support surfaces. Advances in Skin & Wound Care 2006;19(3):130-2. Bogie KM, Wang X, Triolo RJ. Long-term prevention of pressure ulcers in high-risk patients: a single case study of the use of gluteal neuromuscular electric stimulation. Archives of Physical Medicine & Rehabilitation 2006;87(4):585-91. Boyce DE, Shokrollahi K. Reconstructive surgery. BMJ 2006;332(7543):710-2. Charles E. [Support surfaces for burned patients]. Revue de L'Infirmiere 2006(117):37-8. Cock KA. Anti-embolism stockings: are they used effectively and correctly? British Journal of Nursing 2006;15(6):S4-12. Courtney BA, Ruppman JB, Cooper HM. Save our skin: initiative cuts pressure ulcer incidence in half. Nursing Management 2006;37(4):36, 40 passim. Demiot C, Fromy B, Saumet JL, Sigaudo-Roussel D. Preservation of pressure-induced cutaneous vasodilation by limiting oxidative stress in short-term diabetic mice. Cardiovascular Research 2006;69(1):245-52. Diehl M. [Quality assurance in pediatric home nursing. An important standard for preventative nursing care]. Kinderkrankenschwester 2006;25(3):121-2. Duimel-Peeters IG, Hulsenboom MA, Berger MP, Snoeckx LH, Halfens RJ. Massage to prevent pressure ulcers: knowledge, beliefs and practice. A cross-sectional study among nurses in the Netherlands in 1991 and 2003. Journal of Clinical Nursing 2006;15(4):428-35. Edlich RF, Winters KL, Long WB, 3rd, Gubler KD. Scientific basis for the selection of absorbent underpads that remain securely attached to underlying bed or chair. Journal of Long-Term Effects of Medical Implants 2006;16(1):29-40. Edwards JL, Pandit H, Popat MT. Perioperative analgesia: a factor in the development of heel pressure ulcers? British Journal of Nursing 2006;15(6):S20-5. Evans SM, Berry JG, Smith BJ, Esterman A, Selim P, O'Shaughnessy J, et al. Attitudes and barriers to incident reporting: a collaborative hospital study. Quality & Safety in Health Care 2006;15(1):39-43. Feuchtinger J, de Bie R, Dassen T, Halfens R. A 4-cm thermoactive viscoelastic foam pad on the operating room table to prevent pressure ulcer during cardiac surgery. Journal of Clinical Nursing 2006;15(2):162-7. Finucane TE. Rhetoric of research: promoting nutrition products for pressure ulcers.[comment]. Journal of the American Geriatrics Society 2006;54(5):859; author reply 859-60. Giesbrecht E. Pressure ulcers and occupational therapy practice: a Canadian perspective. Canadian Journal of Occupational Therapy - Revue Canadienne d Ergotherapie 2006;73(1):56-63. Gonsalkorale M, Rithalia SV. Perfusion confusion.[comment]. Journal of Wound Care 2006;15(2):72-3; author reply 73. Grey JE, Harding KG, Enoch S. Pressure ulcers. BMJ 2006;332(7539):472-5. Hampton S, Collins F. Treating a pressure ulcer with bio-electric stimulation therapy. British Journal of Nursing 2006;15(6):S14-8. Hayashi T, Murazumi M, Mol W, Yamamoto Y. Surgical management of ischial and perineal pressure ulcers with urethrocutaneous fistulae. Journal of Wound Care 2006;15(2):55-7. Healy B, Freedman A. Infections. BMJ 2006;332(7545):838-41. Hill CM. Integrating clinical experiences into the concept mapping process. Nurse Educator 2006;31(1):36-9. Hiser B, Rochette J, Philbin S, Lowerhouse N, Terburgh C, Pietsch C. Implementing a pressure ulcer prevention program and enhancing the role of the CWOCN: impact on outcomes. Ostomy Wound Management 2006;52(2):48-59. Jackson P. Commentary on Defloor T & Grypdonck MFH (2005) Pressure ulcers: validation of two assessment scales. Journal of Clinical Nursing 14, 373-382.[comment]. Journal of Clinical Nursing 2006;15(2):240-1. Karadag M, Gumuskaya N. The incidence of pressure ulcers in surgical patients: a sample hospital in Turkey. Journal of Clinical Nursing 2006;15(4):413-21. Kellogg VA, Havens DS. The Shift Coupon: an innovative method to monitor adverse events. Journal of Nursing Care Quality 2006;21(1):49-55. Kirsner RS. Skin care: from skin health to ulcer prevention., Ostomy Wound Management 2006;52(1):23-4. Konetzka RT, Norton EC, Sloane PD, Kilpatrick KE, Stearns SC. Medicare prospective payment and quality of care for long-stay nursing facility residents. Medical Care 2006;44(3):270-6. Kottner J, Mertens E, Dassen T. [Decubitus ulcer prevalence in Germany: new data, new knowledge]. Pflege Zeitschrift 2006;59(1):30-3. Lahmann NA, Halfens RJ, Dassen T. Pressure ulcers in German nursing homes and acute care hospitals: prevalence, frequency, and ulcer characteristics. Ostomy Wound Management 2006;52(2):20-33. Landi F, Onder G, Cesari M, Zamboni V, Russo A, Barillaro C, et al. Functional decline in frail community-dwelling stroke patients. European Journal of Neurology 2006;13(1):17-23. Langemo DK. When the goal is palliative care. Advances in Skin & Wound Care 2006;19(3):148-54. Lee SK, Posthauer ME, Dorner B, Redovian V, Maloney MJ. Pressure ulcer healing with a concentrated, fortified, collagen protein hydrolysate supplement: a randomized controlled trial. Advances in Skin & Wound Care 2006;19(2):92-6. Lepisto M, Eriksson E, Hietanen H, Lepisto J, Lauri S. Developing a pressure ulcer risk assessment scale for patients in long-term care. Ostomy Wound Management 2006;52(2):34-46. Mason S, Barrow H, Phillips A, Eddison G, Nelson A, Cullum N, et al. Brief report on the experience of using proxy consent for incapacitated adults. Journal of Medical Ethics 2006;32(1):61-2. Maylor ME. Complications of adapting pressure ulcer risk assessment scales. British Journal of Nursing 2006;15(6):S26-31. Meaume S, Colin D, Barrois B, Bohbot S, Allaert FA. [Value of corpitolinol 60 in geriatric decubitus prevention protocols. (GIPPS study)]. Soins; La Revue de Reference Infirmiere 2006(704):19-22. Mills B, Walters G. Measuring and managing nursing quality. Nursing Management (Harrow) 2006;13(1):20-5. Niezgoda JA, Mendez-Eastman S. The effective management of pressure ulcers. Advances in Skin & Wound Care 2006;19 Suppl 1:3-15. O'Connor T. Easing the pressure of wound care. Nursing New Zealand (Wellington) 2006;12(2):12-3. Olshansky K. The chair: low-tech device helps prevent pressure ulcers. Advances in Skin & Wound Care 2006;19(2):68. Olyaee Manesh A, Flemming K, Cullum NA, Ravaghi H. Electromagnetic therapy for treating pressure ulcers.[update of Cochrane Database Syst Rev. 2001;(1):CD002930; PMID: 11279778]. Cochrane Database of Systematic Reviews 2006(2):CD002930. Paleg G. Pediatric seating and support. Rehab Management 2006;19(1):55-6. Posthauer ME. Hydration: does it play a role in wound healing? Advances in Skin & Wound Care 2006;19(2):74-6. Reynolds TM, Stokes A, Russell L. Assessment of a prognostic biochemical indicator of nutrition and inflammation for identification of pressure ulcer risk. Journal of Clinical Pathology 2006;59(3):308-10. Rosen J, Mittal V, Degenholtz H, Castle N, Mulsant BH, Hulland S, et al. Ability, incentives, and management feedback: organizational change to reduce pressure ulcers in a nursing home. Journal of the American Medical Directors Association 2006;7(3):141-6. Ryan JM. Teamwork keeps the pressure off: the role of the occupational therapist in the prevention of pressure ulcers. Home Healthcare Nurse 2006;24(2):97-102. Sanada H. [Evaluation and management of pressure ulcers in the elderly]. Nippon Ronen Igakkai Zasshi - Japanese Journal of Geriatrics 2006;43(2):137-46. Sansam KA. Controversies in the management of traumatic spinal cord injury. Clinical Medicine 2006;6(2):202-4. Schoonhoven L, Grobbee DE, Donders AR, Algra A, Grypdonck MH, Bousema MT, et al. Prediction of pressure ulcer development in hospitalized patients: a tool for risk assessment. Quality & Safety in Health Care 2006;15(1):65-70. Scott JR, Gibran NS, Engrav LH, Mack CD, Rivara FP. Incidence and characteristics of hospitalized patients with pressure ulcers: State of Washington, 1987 to 2000. Plastic & Reconstructive Surgery 2006;117(2):630-4. Seago JA, Williamson A, Atwood C. Longitudinal analyses of nurse staffing and patient outcomes: more about failure to rescue. Journal of Nursing Administration 2006;36(1):13-21. Sener G, Sert G, Ozer Sehirli A, Arbak S, Gedik N, Ayanoglu-Dulger G. Melatonin protects against pressure ulcer-induced oxidative injury of the skin and remote organs in rats. Journal of Pineal Research 2006;40(3):280-7. Sener G, Sert G, Ozer Sehirli A, Arbak S, Uslu B, Gedik N, et al. Pressure ulcer-induced oxidative organ injury is ameliorated by beta-glucan treatment in rats. International Immunopharmacology 2006;6(5):724-32. St Pierre J. Staff nurses' use of report card data for quality improvement: first steps. Journal of Nursing Care Quality 2006;21(1):8-14. Stekelenburg A, Oomens CW, Strijkers GJ, de Graaf L, Bader DL, Nicolay K. A new MR-compatible loading device to study in vivo muscle damage development in rats due to compressive loading. Medical Engineering & Physics 2006;28(4):331-8. Thomas DR. Prevention and treatment of pressure ulcers. Journal of the American Medical Directors Association 2006;7(1):46-59. Tice MA. Wound care in the face of life-limiting illness. Home Healthcare Nurse 2006;24(2):115-8. van Rijswijk L. Ingredient-based wound dressing classification: a paradigm that is passe and in need of replacement. Journal of Wound Care 2006;15(1):11-4. Volker HU, Rolker N, Willy C. [Interface pressure measurement in the treatment of pressure sores. Comparison with subcutaneous pressure values measured in healthy volunteers]. Anaesthesist 2006;55(2):142-7. Warnet S. [An essential step in immobilized patients]. Revue de L'Infirmiere 2006(119):28-9.
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