- Led by Cornwall Partnership NHS Foundation Trust, in partnership with Plymouth University, the University of Southampton, Cedar NHS Wales, Livewell SouthWest, Torbay and South Devon NHS Foundation Trust, Somerset Partnership NHS Foundation Trust and Catalyst Health Care.
- Aimed to empower patients, carers and clinicians to improve pressure ulcer prevention and management in the community setting.
- Introduced continuous pressure monitoring using mattress and chair sensors to visually identify body areas under sustained pressure and inform adjustments.
- Ran between November 2017 and May 2020.
Around half a million people in the UK develop at least one pressure ulcer each year. Many of these occur in the community setting and become long-term, non-healing wounds, leading to significant discomfort. The risk of pressure ulcers is increased by chairs and mattresses unsuitable for patients who are immobile and infrequently change position.
The PROMISE (pressure reduction through continuous monitoring in the community setting) quality improvement project set out to address this issue by implementing the use of mattress and chair sensors in patients’ homes. These continuously measure and visually identify the areas of the body under sustained pressure on a display monitor, helping patients, carers and clinicians to better understand the positions and support surfaces likely to reduce the risk of pressure ulcers.
Cornwall Partnership NHS Foundation Trust led the delivery of PROMISE to 107 patients by specially trained staff across four clinical adopter sites: three tissue viability teams and one district nurse team in South West England.
Continuous pressure monitoring was demonstrated to achieve good clinical outcomes, reduce the number of pressure ulcers and increase patient concordance. It resulted in significant (57%) ulcer healing rates, and helped to identify factors that influence these, such as ulcer size and duration, nutrition and sedative use.
Patient and practitioner experiences of using continuous pressure monitoring were overwhelmingly positive, with increased understanding of individuals’ needs and goals resulting in improved quality of life.
This empowering, innovative approach to enhancing patient-centred care has become standard practice for the tissue viability adopter sites, and further use within district nursing and multidisciplinary teams is currently being explored.
For more information about this project, please contact Nicci Aylward-Wotton, Tissue Viability Nurse Consultant, Cornwall Partnership NHS Foundation Trust.