Sarah has been a Community Children’s Nurse (CCN) for 7 years. Previous to this she was a sister in an emergency department caring for both adults and children.

Her role as a CCN is varied and can include caring for; acute and chronic conditions, complex medical needs, oncology conditions, skin care and wounds, as well as providing palliative and end of life care to famillies when required.

Sarah is passionate about increasing pressure awareness in children and young people. She has been a Paediatric Tissue Viability Link Nurse for 7 years and is the founding member of The Children’s Tissue Viability Network, a place for nurses and other health care professionals to gain support and share knowledge of Tissue Viability issues affecting children.

Free Paper Presentation (QI category) at The Society of Tissue Viability 2022 Conference

Trialling the role of a Children’s Pressure Champion

Abstract

Clinical background

Working as a children’s nurse in a community trust there were:

• Increased referrals for tissue viability support outside of the commissioned service provisio
• Increasing number of incidences of pressure damage, specifically with children using orthotics

Audited poor engagement with the existing pressure risk assessment tool

The need for a Children’s Pressure Champion was identified and funding was agreed for 7 hours a week to undertake a 6 month project to improve tissue viability awareness and skills in Children’s services.

The Project

• Consultation was held with professionals from a number of children’s community services including special schools, therapies, nurses and medics. This was to gain understanding of current pressure damage prevention, assessment, management and the experience of the child
• An alternative assessment tool (Paediatric Purpose T) was identified; with permission adaptions were made to reflect reported pressure ulcer incidents seen in the trust
• A 3 month trial of the adapted tool within 2 specific caseloads was undertaken
• Electronic Templates and supporting care plans were designed to enable effective documentation
• Training was provided to staff on pressure prevention, the risk assessment tool and how to categorise and treat pressure damage
• A dressings presentation was held to consider options suitable for children on the wound formulary
• Resources such as a staff intranet page and a pressure prevention advice leaflet for parents were created

Results and Conclusion

• 79 Risk Assessments were completed within the 3 month trial. An increase from the 3 recorded previous to this
• 6 children were found to have current pressure damage. 55 were identified as at risk (70% of trial)
• Staff reported increased confidence, which was reflected in higher rates of skin inspection in documentation
• Trial findings used to promote the role of children’s pressure champion at trust level

Conclusion

It is hoped that with more awareness of the risks pressure presents to children and increased engagement with appropriate risk assessment, harm will be reduced and overall patient outcomes improved. The role of a children’s pressure champion is fundamental in educating and supporting staff and in ensuring the specific needs of children are represented within the wider service.