Monday, July 19, 2010

Decubitus Ulcer Treatment Pioneer

How one nurse helped stop killer bedsores

It sounds obvious today, but it took the work of an innovative nurse in the 1950s working with a group of elderly patients to realise it.

Bedsores, also known as pressure ulcers or decubitus ulcers, are lesions caused by a number of factors including unrelieved pressure.

The elderly and infirm are particularly vulnerable, with bony areas of the body particularly prone.

Relieving pressure

Before Doreen Norton carried out her research, nurses had over a hundred remedies on offer - but none worked.

Martin Johnson, professor of nursing at the University of Salford, said the work of nurses like Doreen had changed the face of patient care.

Her work, and that of countless other nurses over the last 50 years, is being celebrated next week by the Royal College of Nursing at its annual research conference in Cardiff.

Professor Johnson said that, before Ms Norton's paper, bedsores or pressure ulcers were a major killer of hospital patients and nothing seemed to help.

"If one had a bedsore on the sacrum (at the base of the spine) or the heel, there were about 150 different prescriptions that ward sisters would issue to remedy this. None of these were very successful.

"She was able to show that really the only successful way of treating pressure sores was to remove the pressure - really obvious!

"This had an immediate implication that the nurses had to turn the patients at least every two hours.

"And this was a study that that was based on science rather than just what people thought."

Kate Gerrish, professor of nursing at Sheffield City Hospitals and Sheffield Hallam University, said that the bedsore study had been seminal, reversing the practices of years for nurses like herself.

"Looking back, what we did was horrifying.

"I was taught to do certain things for bedsores that have subsequently been shown to be harmful to patients.

"When we were trying to prevent pressure sores we would put all sorts of things on their skin - including menthylated spirits and soap, and we would massage the areas.

"All that has been proved to be detrimental to patients."

Innovator

As well as altering the approach to bed sores, Ms Norton, who died two years ago, also helped design the King's Fund bed, an adjustable bed used in many hospital wards.

She said she had "always had a feeling for mechanical things", and her first job had been in engineering in her father's refrigeration engineering firm.

Dr Peter Carter, chief executive and general secretary, of the RCN agreed: "Nurses spend more time with patients than any other health professionals and so really understand patient needs.

"Due to this, over the last 50 years, nursing research has been instrumental in bringing about significant healthcare advancements. "

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