Tissue Viability Nurse Consultancy Services 

90 mins £250 or free, on sign up of two courses.

This covers, the main aspects of pressure ulcer prevention benchmarked next to the KLOEs, and fundamental standards set by CQC and the NICE guidelines; it also covers National initiatives, safeguarding updates, investigation and creating a ‘culture of change’. Aimed at senior staff, directors and owners.

2hrs 

This is one of the most popular training sessions and is geared for Carers, Nurses, and all staff that have access to residents skin, including Allied health professionals.
It covers:-

• Basic anatomy and physiology of the skin and pressure ulcer development.
• How to categorise pressure ulcers, moisture lesions and medical device pressure ulcers. Including many case examples.
• Principles of prevention in line with National gold standards, NICE Guidelines and European pressure ulcer prevention panel (EPUAP 2014)
• Grey areas, e.g end of life, vascular disease, non compliance. How to document.
• Care planning and documentation aSSKINg, react to red. Examples of gaps in care.
• What to do with early identification.
• How to measure and monitor.

4hrs 

This training incorporates pressure ulcer prevention and principles of CQC journey to outstanding. This training is more focused towards senior staff and tissue viability link nurses or senior carers.
Includes basic wound management and dressings.

4hrs 

There are many different dressings available and without basic understanding of wound healing it can be very confusing to know where to start in dressing choice. The course will cover:

• Understand stages of wound healing
• Atypical wounds - Chronic and Acute
• 4 principles of wound bed management – TIME concept (Tissue, Infection, Moisture, Edge.
• Why might a wound get ‘Stuck’ or be ‘Non-Healing’.
• Selecting the appropriate dressing.
• Dressing types.
• Psychosocial impacts of living with a wound.
• Legal aspects of wound management.

On completion delegates will have an improved understanding of wound management.
They will understand the principles of assessment and the phases of healing; and have increased confidence in the management of wounds.

Combined wound management and Dressings with Pressure Ulcer Prevention courses available as full day. Please enquire to discuss your needs.

• Introductions and objectives.
• Anatomy and Physiology of the skin – Pathophysiology - Leg ulcer formation.
• Differentiation of venous and arterial leg ulcers. Symptoms and symptom control.
• Patient experience. Psychosocial factors of living with a leg ulcer.
• How to assess a leg ulcer – strategies and tools.
• Grey Areas.
• Treatment regimes benchmarked to national consensus guidelines.

4hrs 

This course is for registered nurses only that have completed ‘Leg Ulcers Anatomy and Physiology’.

• Understand the related Anatomy and physiology of leg ulcer formation.
• Understand the pathophysiology and differentiation of venous and arterial leg ulcers.
• Critically appraise leg ulcer assessment strategies and tools.
• Explore the legal, professional, policy and ethical dimensions in leg ulcer management.
• Discuss holistic factors which may impact on healing, concordance and to prevent recurrence.
• Use an evidence based approach to diagnostic tools and application of compression therapy within scope of professional practice.
• Treatment regimes.
• Case Studies – using the evidence.
• Doppler Ultrasound Technique – Finding Pedal Pulses.
• Compression bandaging.

- Compression therapy must be undertaken by registered nurses only and will require competency assessment by the lead clinical nurse who has already undertaken this skill qualification.

- Competency documentation can be shared in line with the national compression consensus guidelines..

• Combined Course of the above two course: All day 

4hr Including all templates for use in future investigations.

This is an increasingly popular course, and is a very interactive group course with case examples from coroners courts and safeguarding incidents involving Category 3 & 4 pressure ulcers.

Organisations are asked to internally investigate their acquired pressure ulcers. This is to establish if there are any gaps in care delivery.

This should be done in line with duty of candour and transparency. For quality improvement monitoring investigating our pressure ulcers also allows us to identify themes and patterns in our work areas that may need more focused work. I have completed my root cause analysis training at the National Patient Safety Agency (NPSA) in 2009 and have been involved in hundreds of RCAs both internally and externally as an expert witness and CQC Specialist advisor.
From my experience and the research, I have collated emerging themes and transferred this to my training sessions; where will go through:-

• What is and RCA?
• Why we investigate.
• Who to involve.
• How we complete a RCA.
• How to carry out thematic analysis.
• What to do following a RCA.
• Analysis of mock case examples and completing an RCA together as a group.

This helps facilitate a healthy work environment and staff inclusion in quality improvement.

This will prepare you for future investigations in pressure ulcers, but may be transferred to all harms; in identifying themes and changing cultures.
All documentation and templates will be made available to you on completion of the course.

2hrs 

Fungating wounds are a complication of cancer and may develop in patients with advanced disease.
Gentle care of the fungating wound will help prevent and treat these symptoms. Understanding of what a cancerous tumour may begin as, through to symptom control. Will help your staff feel confident in the treatment of these challenging wounds.

Areas covered in the training:

• Tissue type in the wound bed.
• Types of cancers.
• Exudate level and type.
• Odour.
• Pain level.
• Care of the surrounding skin.
• Effects on daily activities of living.
• Frequency of dressing change.
• A patient’s overall physical, psychological and emotional status.
• Presence of infection.
• Case examples and scenario assessments.

All day - Full report with recommendations benchmarked to the KLOEs.

This full day ‘Mock’ inspection will be based on compliance to the national guidelines on tissue viability, including policies and procedures; but also looking at gold standard initiatives such as react to red or aSSKINg. Documentation is key but also learning to identify any gaps through audit is critical to compliance. Using the SSKIN audit I can help identify the “why’s” behind any potential gaps. Assessing culture can be difficult in-house but with an objective and experienced eye in monitoring in-house cultures I can advice on any emerging themes and patterns.

Daily price dependent on time required, travel and quality or governance needs, please enquire.

Wherever you are on your Quality Improvement (QI) Journey I can act as an advisory on a consultancy basis. This will be bespoke to your organisation, but involves a free initial consultation to discuss your challenges or needs to see if I can assist.
Once signed up I will share all documentation and help design your project driver diagram. Having worked as a Clinical Project Lead for many years in practice and with the academic science network in North West London I have an understanding on how to launch, implement and measure QI change programmes. Using the PDSA model I can help your organisation implement a lasting piece of work. Examples could be the SSKIN bundle or the new pressure ulcer risk assessment tool ‘Purpose T’, increasingly being used in all Acute and long term care settings.

• All documentation as part of the project plan to be included if required, including: a besopoke project driver diagram, aSSKINg care plan and audit.

• All course attendees will receive certification as part of their PDP and revalidation.

• All above courses available with feedback forms and perception audits pre/post training, to use as a demostratable improvement measurement report.

*Purpose T documentation use will need to be requested from Leeds University.