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Pressure injury focus downgraded in new standards: peak body

Wound experts have taken umbrage with the new edition of the National Safety and Quality Health Care Standards.

The peak body for wound care and management, Wounds Australia, voiced its concerns that the new set of standards will lead to more pressure injuries in Australia.

Wounds Australia chief executive Anne Buck said the peak is disappointed that the Australian Commission on Safety and Quality in Health Care (ACSQHC) has “downgraded” the focus on pressure injury, and says it's worried more patients will develop pressure injuries as a result.

Pressure injury was one of the 10 standards in the first edition, Buck said, while it is now one component of Standard 5.

“It’s no longer a headline standard and, in that sense, we see that as a downgrade.

“Our concern is that will reflect in the focus given to pressure injuries from a whole of service, hospital or care provider approach.”

The chief executive of ACSQHC, Adjunct Professor Debora Picone, said pressure injury remains an important component of the second edition of the National Safety and Quality Health Service (NSQHS) Standards.

Picone said the commission disagrees that the focus on pressure injury has been downgraded in the second edition of the standards.

“In fact, we believe it has been strengthened.

“Health services will still have to meet all the same actions related to pressure injury that were included in the first edition of the standards,” she added. “These are included in the new Comprehensive Care Standard.”

She added the commission conducted extensive public consultation and piloting on the content and structure of the second edition of the standards.

“Any individuals or organisations with an interest in pressure injury or wound management were invited to contribute and participate.

“When the final draft of the second edition of the NSQHS standards was released in late 2016, 82 per cent of responses were strongly in favour of the draft standards, and feedback on the supporting resources has been overwhelmingly positive.”

Buck said Wounds Australia was disappointed it wasn’t more actively consulted on the change in question.

Picone said this is the first time the commission has become aware of Wounds Australia’s concerns and added it is happy to meet with them to discuss their points in more detail.

If that meeting takes place, Buck said Wounds Australia will ask the commission to ensure there is a strong emphasis on monitoring pressure injuries, and that strategies to embed pressure injury prevention remain an important focus through the accreditation process that healthcare service providers have to go through.

“We would be looking at what we can do going forward to make sure we can keep as high a focus on preventing pressure injuries as possible.”

Pressure injuries are a common and costly healthcare complication, the peak body said. Recent surveys have found about one in 10 patients in hospital had a pressure injury.

Buck added reducing pressure injury requires leadership, a sustained focus on quality improvement, and investment in systems and education to enable clinicians to provide best practice in injury prevention for individual patients.

“In a busy clinical unit, preventive pressure injury strategies often compete with other patient needs. A concerted effort backed by strong standards is needed to ensure all patients get best practice care.”

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