Next up in our World Stop the Pressure Day spotlight is Kimberley Bignall. Kimberley is a Paediatric Tissue Viability Nurse, helping to improves the care for vulnerable children across the county, reducing their risk of pressure ulcers and other skin damage. Here she tells us more.
"The number of children with complex needs requiring health and care in the community setting has increased and will continue to do so over time, as more children with multiple complexities are being looked after at home. "These children often have medical devices and severely limited mobility, which place them at higher risk of developing pressure ulcers.
"Nationally, paediatric teams are often left behind when it comes to training and resources to help with pressure ulcer prevention, wound management and dressing selection. My role as paediatric tissue viability (TV) nurse has been introduced for two days a week to offer support to the paediatric workforce, including community nurses, occupational therapists, physios, speech and language teams and school staff across south and north Notts and Bassetlaw."
Balancing day-to-day care and future planning
"I took up this role in July 2020 and I am really just getting started. My first priority has been to design and deliver TV training to support staff skills and knowledge, particularly in pressure ulcer prevention and management.
"I have spent the majority of my time so far developing training sessions and facilitating these either face-to-face or online. I also developed a training needs questionnaire, and I am currently gathering up all the responses. This will enable me to prioritise the specific areas of training required by individual teams.
"My day-to-day work also includes checking whether any paediatric TV referrals have come in. I contact the teams involved and offer advice, and if a joint visit is needed, I will then plan this into my ledger. Our referrals mainly consist of assessing patients for any equipment needs, ordering pressure reducing equipment or assessing patients with existing pressure damage to manage the wound and provide the appropriate pressure reducing equipment as needed.
"Children with complex needs require many different types of equipment such as stand aids, wheelchairs, and medical devices such as oxygen tubing, tracheostomies, peg tubing, spinal braces and foot splints. These can all cause some form of pressure damage or moisture associated skin damage if not managed correctly or if the child outgrows the equipment."
Specialist clinical support for teams working with families
"I’m often asked for specialist support by the teams working with families and a huge part of my role is to offer them TV clinical supervision. When I carry out joint visits staff can learn from my practice and take that learning on to their other cases.
"I have also spent time talking to paediatric healthcare staff online, which I hope means the teams feel supported, with a direct contact for TV advice. In addition to facilitating training for the paediatric healthcare teams, I have also given a training session for schools and visited schools to assess patients and offer advice."
Improving access to information
"One of the first projects in my role is to develop a pressure ulcer prevention information booklet to provide patients, families, carers with patient specific pressure ulcer prevention advice. This is almost completed and will cover advice on re-positioning patients regularly, moisture, nutrition, and how pressure ulcers develop. Staff can also write in their own tailored instructions for individual patients. I also developed an information booklet prior to my new role which has a video that staff are handing out to families and carers, and this is also a good resource for staff to update their knowledge on pressure ulcer prevention.
"There is still a lot to do and I am working hard to deliver the best evidence-based care and advice to support the paediatric teams, families and carers. I already receive multiple referrals a week plus lots of calls for advice, and I expect demand to grow as my role becomes better known. Our shared aim is to improve quality of life by reducing harm and distress for children and those around them."
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