Pressure ulcers represent a significant cost burden in the UK, both to patients and to health care provider organisations. Without concerted effort, this cost is likely to increase in the future as the population ages. It is estimated that between 80-90% of pressure ulcers acquired in NHS care settings can be avoided and the National Reporting and Learning System review into deaths and severe harm themes undertaken in 2011/12 demonstrated that pressure ulcers were the largest portion of patient safety incidents accounting for 19% of all reports. Research by Hogan et al in 2012 suggests that pressure ulcers are also accountable for 2% of preventable deaths.
Previous studies have estimated the cost of pressure ulcers in the UK as £1.4 – 2.1bn, approximately 4% of the total 2004 NHS expenditure with the individual cost of treating a pressure ulcer between £1,064 (grade 1) to £10,551 (grade 4).
It is estimated in this report that the NHS could save £ around £40m per year on the cost of treating pressure ulcers if incidence could be reduced by 25%. A 25% reduction would spare approximately 30,000 patients per year from obtaining a pressure ulcer.
It is for these reasons that I chose to look into the economic impact of pressure ulcers as part of my Florence Nightingale Leadership Scholarship.
In undertaking the Florence Nightingale Foundation Leadership Scholarship I have gained further expertise and experience on a national and international platform, linking both agendas. I have also explored further the impact of pressure ulcers on the UK’s health and care systems.
Through a variety of leadership development events, I have improved my leadership skills, presented to international audiences and learnt a lot about myself as a leader. Through the Windsor Leadership Course and Windsor Chief Executives Working Group, I had the opportunity to reflect on my own leadership experience and learn from a group of my peers helping me to learn how to be a more successful leader. The RADA ‘Communication Skills for Leaders’ course helped me to develop my communication style by taking me out of my comfort zone, building my confidence and building my influencing skills. Presenting to the Leadership School in Pavia, Italy and the European Wounds Management Association gave me the opportunity to present to an international audience, gaining experience and confidence in my presentation and leadership skills.
Through study events, I have increased my knowledge on the subject of pressure ulcers and their associated costs and improved patient care by educating others on how and why pressure ulcer prevalence rates need to and can be reduced. Attending events such as the European Pressure Ulcers Advisory Panel’s Annual Meeting and the Faculty for Wound Care Nurses Advanced Educational Forum gave me the opportunity to learn from other European Countries and how they are reducing the prevalence rates of pressure ulcers and allowed me to present the methods we have used in the UK to other European health care leaders.
During the course of my scholarship I travelled to Maastrict, the Welsh Wound Innovation Centre in Wales and had a webinar with the New Jersey Hospital Association to learn from the successes of each in pressure ulcer care and prevention to learn what we could apply in England to help reduce the prevalence of pressure ulcers.
I have been involved with several research studies looking into LPZ audits, the impact of nurse staffing levels on patient outcomes and data collection methods.
As a result of the work I have undertaken during my Florence Nightingale Leadership Scholarship, I have a renewed ambition to take the Stop the Pressure challenge global and have made some great contacts through the various learning events I have undertaken as a part of this scholarship.
ACKNOWLEDGEMENTS
Firstly, and most importantly, I must thank the Florence Nightingale Foundation for the opportunity to undertake this analysis by awarding me the Leadership Scholarship. In particular I am truly grateful to Liz Robb OBE, Chief Executive, Florence Nightingale Foundation, for her support and guidance throughout this project.
I would like to thank my sponsor the Burdett Trust for Nursing.
I would also like to thank Bryan Sanderson CBE, who mentored me through this scholarship and provided immeasurable support in helping me to widen my perspectives, narrow my research topic and challenged me to step out of my comfort zone.
Without the support of my colleagues in NHS England and Monitor, I would not have been able to complete this scholarship. Without their funding, patience and flexibility, it would have been impossible to attend the study events as well as doing my day job.
And lastly, but certainly not least, I must thank my husband Nigel and my daughter Lucie for their continued patience when I am away from home.