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Reducing Category 3 pressure ulcers developed in the Milton Keynes District Nursing service

This improvement story focusses on the reduction of Category 3 pressure ulcers developed in the Milton Keynes District Nursing service. Kristina Thomson and her team Milton Keynes District Nursing service also produced a Quality Improvement (QI) poster about this project that won an Improvement Academy Award in May 2022

Currently, the service provides care at home for frail and vulnerable patients across 7 Primary Care Networks (PCNs) in Milton Keynes. Over the past year the service has worked to create a learning system where staff can reflect on practice, develop skills, and ensure that they provide consistent, high level care across all nine District Nursing teams.

Milton Keynes District Nursing Service in workshops.jpg

Due to a large number of factors involved in the prevention of pressure ulcers, the team decided to track the development of Category 3 pressure ulcers in service as a measure for high quality care. The main aim of this work was to reduce Category 3 pressure ulcers developed in the service by 10% by the end of June 2022. But the team also wanted to achieve more than this. They planned to:

create a safe, supportive environment where staff could reflect and learn new skills and knowledge to improve practice
reduce variation in practice across the 9 teams working in Milton Keynes
Encourage staff of all grades to use data to inform and improve their practice

The team set up workshops to help them reflect, learn, mentor and encourage better and flexible working across the teams. This along with earlier identification and intervention resulted in a drop of 25% in Category 3 Pressure Ulcers. Monitoring improvement in Process measures, like ensuring all patients have their a SSKIN risk recorded also gave teams reassurance that they are going in the right direction.

Lessons were also learnt along the way. They discovered the importance of taking time to understand the system they were using, getting data out of traditional performance reports and into formats that makes sense to operational teams, making time for reflection and doing more to get service users and carers involved.

Kristina Thomson, Service manager said "the team have worked incredibly hard and without them none of this would have been possible."