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Impact Assessment on a Newly Implemented Service Utilising Recovery Nurses as Transfer Nurses, Incorporating a Literature Review of Pressure Ulcer Reduction Strategies, i.e. Mattress and Overlay Types, for Patients on Hospital Trolleys

Published online by Cambridge University Press:  06 December 2012

Sarah Dawkins
Sarah Dawkins*
Affiliation:
Sarah Dawkins Health Consultancy Ltd, Brough, East Yorkshire, UK
*
Correspondence to: S. Dawkins, Senior Registered Nurse and Owner, Sarah Dawkins. Tel: 07791 841195; E-mail: sarahdawkinshealthconsultancy@gmail.com
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Abstract

A new service was implemented as a pilot scheme. It utilised Recovery Nurses as transfer Nurses, to return patients to a ward following surgery, thereby reducing patient wait times on hospital trolleys. Patient wait times, on hospital trolleys raised concerns for tissue viability, which had implications for increased in-patient length of stay and costs. An impact assessment of the new service was undertaken to identify and analyse the direct and indirect impacts of the pilot scheme.

A systematic review of Government literature over the preceding two decades highlighted patient experience and pressure ulcer reduction was high on their agenda. There was little published literature around overlays and mattress types for hospital trolleys as preventative measures for pressure ulcers, yet pressure area care can be traced back to 1962.

The lack of nationally agreed guidelines to assess the suitability of the standard hospital trolley still remains a problem, and research was not able to provide clear, discrete answers to clinicians, to aid decision making. Hospital trolley mattresses need to have the same value placed upon them as bed mattresses and pressure-relieving devices and more risk management strategies need to be utilised for pressure sore prevention, where trolleys are concerned.

Keywords

Recovery NursePressure ulcer preventionHospital trolleyMattressOverlays
Type
Original Article
Information
British Journal of Anaesthetic & Recovery Nursing , Volume 13 , Issue 3-4 , August 2012 , pp. 58 - 64
Copyright
Copyright © British Association of Anaesthetic and Recovery Nursing 2012

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References

Australian Wound Management Association (2001). Clinical Practice Guidelines for the Prediction and Prevention of Pressure Ulcers. West Leederville WA: Cambridge Publishing. Retrieved 26 March 2012 from http://www.awma.com.au/publications/2007/cpgpppu_v_pocket.pdf.Google Scholar
Aveyard, H. Doing a Literature Review. Maidenhead: Open University Press, 2007.Google Scholar
Berczuk, C (2008). The Lean Hospital The Hospitalist [online]. Retrieved 12 April 2012 from http://www.the-hospitalist.org/details/article/186537/The_Lean_Hospital.html.Google Scholar
Berlowitz, DR, Wilking, SVB. The short-term outcome of pressure sores. Journal of the American Geriatrics Society 1990; 38(7): 748–752.Google Scholar
Burtonshaw-Gunn, SA. Essential Tools for Management Consulting: Tools, Models and Approaches for Clients and Consultants. Chichester, UK: Wiley, 2010.Google Scholar
Bulfone, G, Marzoli, L, Quattrin, R, Fabbro, C, Palese, A. A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres. Journal of Perioperative Practice 2012; 22(2): 50–56.Google Scholar
Cowan, E (2010). Human Resource Service Centre: Managing Performance – Management for Performance (MPS) [online]. Edith Cowan Australia University (ECU). Retrieved 15 June 2012 from http://www.hr.ecu.edu.au/mps/html/mps-smart-eg.cfm.Google Scholar
Department of Health (DoH). The Health of the Nation: A Strategy for Health in England. London: HMSO, 1992.Google Scholar
DoH. A first Class Service – Quality in the New NHS. London: HMSO, 1998.Google Scholar
DoH. The NHS Plan: A Plan for Investment, a Plan for Reform. London: HMSO, 2000.Google Scholar
DoH. Essence of Care: Patient Focused Benchmarking for Health Practitioners. London: HMSO, 2001a.Google Scholar
DoH. A Framework for Lifelong Learning in the NHS. London: HMSO, 2001b.Google Scholar
DoH. High Quality Care for All: NHS Next Stage Review Final Report. London: HMSO, 2008.Google Scholar
DoH. Essence of Care. London: HMSO, 2010a.Google Scholar
DoH. Equity and Excellence: Liberating the NHS. London: HMSO, 2010b.Google Scholar
European Pressure Ulcer Advisory Panel (EPUAP) (1998). Pressure ulcer prevention guidelines EPUAP Oxford. Retrieved 16 March 2012 from www.epuap.org.Google Scholar
European Pressure Ulcer Advisory Panel (EPUAP)/National Pressure Ulcer Advisory Panel (NPUAP). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Washington, DC: European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel, 2009.Google Scholar
Hartley, L. Reducing pressure damage in the operating theatre. British Journal of Perioperative Nursing 2003; 13(6): 249–254.Google Scholar
Health Professional Council (HPC). Standards of Conduct, Performance & Ethics. London: HPC, 2008.Google Scholar
Healthcare Quality Improvement Partnership (HQIP) (2009). Template Policy and Strategy. Retrieved 30 March 2012 from http://www.hqip.org.uk/template-policy-strategy/.Google Scholar
HM Government (2011). IA Toolkit: how to do an impact assessment. Retrieved 6 April 2012 from http://www.bis.gov.uk/assets/biscore/better-regulation/docs/i/11-1112-impact-assessment-toolkit.pdf.Google Scholar
Maylor, M, Torrance, C. Pressure sore survey Part 2: Nurses' Knowledge. Journal of Wound Care 1999; 8(2): 49–52.Google Scholar
McInnes, E, Jammali-Blasi, A, Bell-Syer, S, Dumville, J, Cullum, N. Preventing pressure ulcers – are pressure-redistributing support surfaces effective? A Cochrane systematic review and meta-analysis. International Journal of Nursing Studies 2011; 49(3): 345–359.Google Scholar
Morris, L. Clinical practice benchmarking: implications for tissue viability. British Journal of Nursing (suppl) 2002; 11(12): S30–S36.CrossRefGoogle ScholarPubMed
Moore, Z, Price, P. Nurses’ attitudes, behaviours and perceived barriers towards pressure ulcer prevention. Journal of Clinical Nursing 2004; 13(8): 942–951.Google Scholar
Morton-Cooper, A. Action Research in Health Care. Oxford: Blackwell Science Ltd, 2000.Google Scholar
National Institute for Clinical Excellence (NICE). Pressure Ulcer Risk Assessment and Prevention. London: NICE, 2001.Google Scholar
NICE. The Use of Pressure Relieving Devices (beds, mattresses and overlays) for the Prevention of Pressure Ulcers in Primary and Secondary Care. London: RCN, 2005.Google Scholar
National Patient Safety Agency (NPSA). Seven Steps to Patient Safety. London: NPSA, DoH, 2004.Google Scholar
Newton, RR, Rudestam, KE. Your Statistical Consultant: Answers to Your Data Analysis Questions. London: Sage, 1999.Google Scholar
NHS Institute for Innovation and Improvement (2006–2011). High impact action: your skin matters. Retrieved 7 August 2012 from http://www.institute.nhs.uk/building_capability/general/your_skin_matters.html.Google Scholar
Nixon, J, Brown, J, McElvenny, D, Mason, S, Bond, S. Prognostic factors associated with pressure sore development in the immediate post-operative period. International Journal of Nursing Studies 2000; 37(4): 279–289.Google Scholar
Norton, D, McLaren, R, Exton-Smith, AN. An Investigation of Geriatric Nursing Problems in Hospital. Edinburgh: Churchill Livingstone, 1962.Google Scholar
Nursing and Midwifery Council (NMC). The NMC Code of Professional Conduct: Standards for Conduct, Performance and Ethics. London: NMC, 2004.Google Scholar
O'Mahoney, J. Management Consultancy. Oxford: Oxford University Press, 2010.Google Scholar
Pham, BA, Teague, L, Mahoney, Jet al. Support surfaces for intraoperative prevention of pressure ulcers in patients undergoing surgery: a cost effectiveness analysis. Surgery 2011; 150(1): 122–132.Google Scholar
Reddy, M, Gill, SS, Rochon, PS. Preventing pressure ulcers: a systematic review. Journal of American Medical Association 2006; 296(8): 974–984.Google Scholar
Royal College of Nursing (RCN). Clinical Practice Guidelines. Pressure Ulcer Risk Assessment and Prevention. Recommendations 2001. London: RCN, 2001.Google Scholar
Shewchuk, D, Padula, C, Osborne, E. Prevention and early detection of pressure ulcers in patients undergoing cardiac surgery. Association of Perioperative Registered Nurses Journal 2006; 84(1): 75–96.Google Scholar
Tarpey, A, Gould, D, Fox, C, Cockling, M. Evaluating support surfaces for patients in transit through the accident and emergency department. Journal of Clinical Nursing 2000; 9(2): 189–198.Google Scholar
Thompson, D. An evaluation of the Waterlow pressure ulcer risk-assessment tool. British Journal of Nursing 2005; 14(8): 455–459.Google Scholar
Wallace, M. Review: alternative-foam mattresses and some operating-table overlays reduce pressure ulcers more than standard surfaces. Evidence Based Nursing 2009; 12(3): 81.Google Scholar
Zwarenstein, M, Goldman, J, Reeves, S (2009). Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. The Cochrane Library: Evidence Based Medicine. Retrieved 1 April 2012 from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000072.pub2/abstract;jsessionid=2601751E1E40E2ED422D6504725EFF30.d01t04.Google Scholar