Information regarding Tissue Viability and Infection Control

Request 1

For the financial years 2006-07, 2007-08, 2008-09 and quarters 1 and 2 2009-10:

For each time period how many whole time equivalent Tissue Viability Nurses were employed by the Trust?

Response 1

2006/7      1.0 WTE

2007/8      1.0 WTE

2008/9      1.0 WTE

Request 2 

What nursing grades were the Tissue Viability Nurses employed by the Trust?

Response 2

Band 7

Request 3

What was the average, shortest and longest waiting time for patients to be seen by a Tissue Viability Nurse following receipt of a referral?

Response 3

This information is not routinely collected within the Trust as some referrals are logged manually and other referrals are received informally by the Nurse Specialist.  However, if patients are referred to the Nurse Specialist patients, are initially triaged by telephone, a decision is then made on the priority of the patient concerned. Advice is initially given to clinical staff with a follow-up if necessary or the patient is scheduled for assessment. The usual timescale from referral to assessment is a maximum of 3 working days.

Request 4

How many patients were seen by a Tissue Viability Nurse at the Trust in the given time periods?

Response 4

850 patients were seen between July 2007 and present.  However, this information does not include patients who are referred by clinical staff on an informal basis and may not require treatment.  The electronic data does not provide the information in financial years which would mean manually extracting the data from a paper record which would exceed the cost of compliance.

Request 5

For each time period how many whole time equivalent Infection Control Nurses were employed by the Trust?

Response 5

For the periods requested there were two clinically qualified infection control nurses employed with additional resource being provided by registered nurses that provide infection control support.

2006/7- 5 WTE           

2007/8 - 6 WTE           

2008/9 - 5.49 WTE

Request 6

What nursing grades were the Infection Control Nurses employed by the Trust?

Response 6

2006/7      1 x band 8a, 1 x band 7, 3 x band 6           

2007/8      1 x band 8a, 2 x band 7, 3 x band 6

2008/9      1 x band 8a, 1 x band 7, 4 x band 6

Request 7

What was the average, shortest and longest waiting time for patients to be seen by an Infection Control Nurse following receipt of a referral?

Response 7 

The Trust does not routinely record this information.  However, the Infection Control team visits the laboratory daily (Mon - Fri) to pick up results of specimens sent for testing and then following discussion visit the wards to give advice on the management of patients with confirmed MRSA and C-diff. The Infection Control team has a web based system that links with the pathology department information system that provides results 4 times a day.  The Infection Control team will respond as appropriate if advice is needed by clinical staff.  This system was introduced mid 2007.

Request 8

How many patients were seen by an Infection Control Nurse employed by the Trust over the time period specified?

Response 8

The Infection Control team hold both manual and paper records of patients who are screened for infections.  Unfortunately, the electronic record does specify whether the patient was seen by an Infection Control Nurse as patient management will have either been discussed by telephone with the nurse caring for the patient or the team will have visited the relevant clinical area to see a patient.   Therefore in order to determine whether the Infection Control Nurse has actually seen the patient will be held on the paper record and to extract this information would exceed the cost of compliance.

Request 9

What was the incidence of pressure ulcers at the Trust (preferably expressed as a number per 100,000 bed days)?

Response 9

This data has been collected since 2005. However, prior to October 2008 (when the system for data collection changed) the information was not rigorously collected as pressure ulcer were often misdiagnosed by staff and could lead to inaccurate results, therefore this data has been excluded from our response as the information cannot be verified accurately.  From October 2008 the Trust counted pressure ulcer incidence as a percentage of admissions which identified the real risk of acquiring such an injury if admitted. The Trust counts pressure ulcer incidence as a percentage of admissions which identifies the real risk of acquiring such an injury if admitted.

The Trust implements the European Pressure Ulcer Advisory Panel classification system of pressure ulcer grades as set out in the NICE Clinical Guidelines for the prevention and treatment of pressure ulcers. 

NICE guidance for the prevention and treatment of pressure ulcers can be accessed by the following link:

http://www.nice.org.uk/guidance/index.jsp?action=byID&o=10972.

Additional Information

Grading criteria is as follows:-

Grade 1

Non-blanchable erythema (redness) of intact skin. Discolouration of the skin, warmth, oedema, induration or hardness may also be used as indicators, particularly on individuals with darker skin

Grade 2

Partial thickness skin loss involving epidermis, dermis, or both. The ulcer is superficial and presents clinically as an abrasion or blister

Grade 3

Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia

Grade 4

Extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures with or without full thickness skin loss