Medical device-related pressure ulcers: a clear case of iatrogenic harm.

There is growing evidence that medical device-related pressure ulcers (MDRPUs) are an increasing healthcare concern. Prevention and management is complicated, as they are caused by devices that are often an essential part of treatment. All clinical staff have a duty of care to do no harm. Damage caused by medical devices is iatrogenic, that is, caused through treatment, and may be exacerbated by a lack of assessment and care. This paper details a proposal to reduce the incidence of MDRPU in one UK healthcare trust. Drivers for change are identified, local organisational culture is explored and the potential impact of the change is outlined. Kotter's eight-step method for managing change and Prochaska's transtheoretical model are used to underpin the proposed change. These models were chosen due to their clearly structured approaches to change management and will enable flexible engagement with stakeholders. The article lists the resources required, sets out a possible action plan for creating change and suggests nurse-sensitive indicators and outcomes. MDRPUs are a significant and increasingly recognised issue that is within the power of healthcare teams to resolve. There is a need for collaborative working between health professionals, patients and their families to develop a solution.