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Reduction of hospital-acquired pressure ulcers is a patient and nursing priority. Although evidence-based interventions to prevent such ulcers are well known, reducing this healthcare burden has proven consistently difficult. Via case studies, this article describes how a bundle approach to pressure ulcer prevention may be adapted for use within different clinical areas. It illustrates how collaborative learning may facilitate the spread of improvement work across a health board and build improvement skills within nursing. [ABSTRACT FROM AUTHOR]

Bedrails are used extensively in both the hospital and community care settings to protect vulnerable people from falling out of bed. However, there is evidence of indiscriminate bedrail use and some inadvertent use of bedrails as a form of restraint, which in turn may compromise patient safety, dignity and autonomy. This article describes a night-time bedrail audit undertaken in one integrated NHS trust to determine the numbers and types of bedrails in use, the patient demographic, locations where bedrails were used and, importantly, why staff decided to use them. The information collected was used to inform local policy development and improve practice. The implications of the audit findings for practice are discussed, and a new decision aid for the use of bedrails is presented. [ABSTRACT FROM AUTHOR]