Health written question – answered at on 17 September 2007.
To ask the Secretary of State for Health
(1) what training healthcare staff receive on the prevention, detection and treatment of pressure sores; and what part of this training is a mandatory requirement;
(2) if he will make it his policy to introduce mandatory reporting of incidents of pressure ulcers; and if he will make a statement;
(3) what guidance and standards his Department has issued in respect of the prevention, management and treatment of pressure sores for all care settings; and how many care homes, nursing homes, hospitals and primary care trusts meet such guidance and standards.
Education and training of healthcare staff, including the prevention, detection and treatment of pressure ulcers, is the responsibility of their employers. Tissue viability is a vital component of nursing care for patients, and one in which there is a strong body of evidence about effective treatment.
Nurses receive training in this during their preparation for registration, and as part of their continuing professional development. They have access to specialist tissue viability nurses who provide training as well as expert advice in the care of individual patients. To reinforce the necessity for continuing learning, regulatory bodies, such as the Nursing and Midwifery Council, require healthcare professionals to maintain competence in their field of practice as a condition of their continued registration.
There are no central plans to require healthcare staff to report incidents of pressure sores. However, National Institute for Health and Clinical Excellence (NICE) guidance on tissue viability requires that pressure ulceration over grade 2 be treated as a local clinical incident. Tissue viability is considered a nurse-sensitive indicator and is viewed by trusts as an important pointer to the quality of patient care.
"Essence of Care", published in 2003, sets benchmarks for pressure ulcers in health and social care settings, and helps healthcare professionals to devise appropriate care plans. NICE has published detailed clinical guidelines on pressure ulcer management in primary and secondary care. It is the responsibility of local health bodies to ensure that this guidance is implemented.
In respect of care homes, regulation 13(6) of the Care Home Regulations 2001, states:
"The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse."
In addition, there are other general training requirements in regulation 18 to ensure staff receive training appropriate to the work they perform, including, where relevant, the prevention and treatment of pressure sores.
Under regulation 17 of the Care Homes Regulations 2001, care homes for adults are required to keep a record for each service user, which includes the incidence of pressure sores and of treatment provided to the service user.
The requirements in the regulations are further clarified in the National Minimum Standards. The relevant standards are standard 30 in the Care Homes for Older People standards and standard 35 in the Care Homes for Adults standards. As at
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