Tissue Viability Good Preventative Practice Helen Harris Tissue

Tissue Viability Good Preventative Practice Helen Harris Tissue Viability Nurse Specialist

What is Tissue Viability? • Management and advice for service users with complex wounds • Management of advanced therapies • Support complex pressure ulcer prevention cases • Responsible for all TV strategy, policy and procedure

Service provision • Anyone with a complex need who is registered with BANES or South Glos GP • 3 community hospitals • Care home support • Approx 437, 000 population

Tissue Viability - Prevention • Pressure ulcers • Incontinence dermatitis • General skin care

Pressure ulcer prevention • Grade 3 and 4 threshold for safeguarding • Multiple grade 2’s considered • Multiple patients in one setting

Good Preventative care • Risk assessment • • • Consider reliability Use clinical judgement Must be re-evaluated when condition changes Must only be a aide memoir Poor predictor in wheelchair users and maternity The clinician who carries out and signs the risk assessment is responsible for devising prevention strategies

Care Planning • Care plan must be implemented for anyone high risk to include – Outcome of risk assessment – The need for additional pressure relief at risk sites – Their mobility and ability to reposition – Co-morbidities – Patient preference

Skin assessment • All risk areas • Any areas of discomfort • Variations in heat / moisture / firmness

Repositioning • Adults at risk should be encouraged to reposition at least every 6 hours and high risk at least every 4 hours • Assist those that can’t • Document the frequency of repositioning required

Equipment • Utilise high specification foam for those patients in hospitals / nursing homes or assessed as high risk in the community • Use heel protectors for those at risk • Utilise dynamic systems for those where static systems are not

Incontinence dermatitis • Severe cases predominantly avoidable in a 24 hours setting • Good continence management • Use of appropriate barrier creams

General Tissue Viability • Good skin management • Use of appropriate moisturisers • Good documentation including evaluation of any treatment or prevention plans • Appropriate and timely referral on taking into consideration patient

Summary • Personalised care planning taking into account patient choice • Evaluation of any care plans in a timely manner • Clear and accurate documentation

Thank you Any questions?