NHS trusts could be unfairly penalised over the prevalence of pressure ulcers unless nationally agreed guidance on recording and measuring the condition is introduced, tissue viability nurses have warned.
The NHS operating framework for 2012-13 introduced a payment under the national commissioning for quality and innovation (CQUIN) scheme to reward collection of data submitted through the NHS safety thermometer audit tool.
Trusts will fail to receive the payment if they provide poor data on a number of indicators, including the prevalence of pressure ulcers.
However, a recent survey of 145 tissue viability nurses working in England found numerous ways of categorising and recording pressure ulcers.
The research by Jacqui Fletcher, a National Institute for Health and Clinical Excellence fellow, and Carol Dealey, senior research fellow at University Hospitals Birmingham Foundation Trust, found the categories of ulcers recorded as serious incidents varied. Respondents also disagreed on which ulcers could be deemed unavoidable.
“There are huge discrepancies in what people do [so] we are taking as a benchmark of quality something that’s totally inconsistent. There is a risk trusts could be unfairly penalised under the CQUIN measure,” Ms Fletcher said.
“We would like to see nationally agreed definitions and standards for the way we collect and collate data.”
Data from the audit tool will be published alongside pressure ulcer information from hospital episode statistics and national incident reporting.
Chair of health services research at Southampton University Peter Griffiths said the introduction of a national CQUIN should act as a stimulus for “sorting these issues out rapidly and improve the situation”.
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