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#WeNurses - Tuesday 11th November 2014 8pm (GMT Standard Time) Pressure ulcer evidence

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Hosted by WeNurses using #WeNurses

This chat is guest hosted by @SarahChapman30

November is Pressure Ulcer Awareness Month so to tie in with this #WeNurses is holding two discussions around pressure ulcers. On Thursday 13th November 2014 we are exploring “Reducing Pressure Ulcers” but before that on Tuesday 11th November we will be revisiting the evidence around pressure ulcers with @SarahChapman30 from @UKCochraneCentr.

We last held a discussion around the evidence behind pressure ulcer risk assessment tools back in March this year “Pressure Ulcers - Risk Assessment?” following a fascinating blog by @sarahchapman30 “Nurses under pressure: do risk assessment tools help prevent pressure ulcers?” (Chapman 2014)

The discussion raised some interesting debate as to whether we should or should not complete pressure ulcer risk assessment tools and why we still use them. So this discussion aims to re-examine this and to see if anyone was brave enough to ditch the structured risk assessments. In addition to this, since the last discussion NICE (2014) have published some new guidance - Pressure ulcers: prevention and management of pressure ulcers which advises the following : “Adults considered to be at risk of developing a pressure ulcer are those who, after assessment using clinical judgement and/or a validated risk assessment tool, are considered to be at risk of developing a pressure ulcer“ Giving the option to use a risk assessment tool and/or clinical judgement .

So with this in mind this discussion aims to ask the following questions:

Does anyone not use pressure ulcer risk assessment tools?
Is this a recent change?
What are our feelings on using clinical judgement alone?
What is the value of the risk assessment tool?
What stops nurses from just using clinical judgement?
Do we feel more confident to use clinical judgement alone now that its part of NICE guidance?

Interestingly @SarahChapman30 has recently written another blog for the RCN in which she outlines the evidence for the use of supplement drinks, repositioning and support surfaces too – this blog will be published this month on This Is Nursing. Sarah is also writing a blog on the latest Cochrane evidence on pressure ulcer management for Evidently Cochrane to be published on 14th November.

About our guest

@SarahChapman30 is a former nurse who now works for @ukcochranecentr, where she tweets about Cochrane Evidence and writes weekly blogs for Evidently Cochrane with the aim of making Cochrane reviews and other evidence more accessible to health practitioners and patients.

References

Chapman, S. (2014) [Online] Nurses under pressure: do risk assessment tools help prevent pressure ulcers? Evidently Cochrane Accessed 3 Nov 2014

NICE (2014) [Online] Pressure ulcers: prevention and management of pressure ulcers Accessed 3 Nov 2014

WeCommunities (2014) [Online] Pressure Ulcers - Risk Assessment? Accessed 3 Nov 2014

WeCommunities (2014) [Online] Reducing Pressure Ulcers Accessed 3 Nov 2014

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I feel like I have been on a bit of a personal journey with pressure ulcer risk assessments since we last examined the evidence back in March. Following that discussion I fed back what i had learned to my colleagues at my clinical workplace; I went in fully armed with the evidence and discussed it with them. I was met with some rather strange looks and even laughter as ditching good old Waterlow in favor of clinical judgement alone seemed like a preposterous suggestion and altogether just too risky! However the more we talked about it the more we all came to realize that actually we do use our clinical judgment when assessing for pressure ulcer risk, so we started to question why we continue to use Waterlow? Some of the reasons we came up with were:

Because our organisation requires us to
We need to prove to CQC inspectors that we assess for pressure ulcer risk
For audit purposes
To support applications for pressure relieving equipment

The conversations we had led to no real change, but I do feel that progress was made. We all questioned our use of Waterlow and now have a very clear idea of why we use it. We also came away having a little more confidence in our clinical judgement having shared stories of when Waterlow just didn't seem to add up to our own assessments using clinical judgement. We have looked at our practice in the context of the evidence and i feel that this is important.

So if it were up to me alone would i ditch the pressure ulcer risk assessment tool? At this point in time i feel that i need more information as i still have a lot of questions. What was interesting for me was that some of my own concerns were echoed in the WeNurses discussion:

I am not sure what the answer to these questions and comments are, but i do know that we are on the right road ... evidence based care is important as so long as we are examining the evidence and this shapes our decisions we can only be headed in the right direction.

So how do you feel following the discussion? Are you ready to ditch Waterlow yet?

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#WeNurses transcript

@WeNurses 11 November 2014 20:00		Hellloooo wonderful tweeting friends and welcome to tonights #WeNurses http://t.co/epeFgCGOBq
@nursingSUni 11 November 2014 20:00		RT @SarahChapman30: Nearly time for our @WeNurses Tweetchat on #pressureulcer prevention http://t.co/rXh4FbiEGu #wenurses
@McIntyreLyn 11 November 2014 20:00		RT @WeNurses: #stopthepressure Pressure Ulcer Evidence #WeNurses with the lovely @SarahChapman30 at 8pm #BeThereOrBeSlightlyLessInform…
@AgencyNurse 11 November 2014 20:01		helloo Teresa here ... with a big bag of popcorn :D #wenurses
@SarahChapman30 11 November 2014 20:01		Hi everyone, and thank you @AgencyNurse @WeNurses for inviting me back! #wenurses
@WeNurses 11 November 2014 20:01		@nursingSUni lurk away .. and feel free to hop in without reading ;D #wenurses
@cherylwilson2 11 November 2014 20:01		RT @WeNurses: Hellloooo wonderful tweeting friends and welcome to tonights #WeNurses http://t.co/epeFgCGOBq
@SarahChapman30 11 November 2014 20:02		I hope some of you lively lot who joined in last time have come back to tell us what's been happening in your clinical areas #wenurses
@LeggeAngie 11 November 2014 20:02		@WeNurses Hello! Angie on the train #wave #WENURSES
@Bartontd 11 November 2014 20:02		RT @WeNurses: Hellloooo wonderful tweeting friends and welcome to tonights #WeNurses http://t.co/epeFgCGOBq
@cherylwilson2 11 November 2014 20:02		@SarahChapman30 @AgencyNurse @WeNurses Hello welcome back #wenurses
@WeNurses 11 November 2014 20:02		So tonights discussion is around pressure ulcers and evidence around risk assessments ... with the lovely @SarahChapman30 #wenurses
@TeamClaytonULHT 11 November 2014 20:02		@WeNurses Evening, Averil here tweeting for #teamclayton at Lincoln County Hospital #WeNurses
@WeNurses 11 November 2014 20:02		@LeggeAngie hi Angela! safe journey a good signal wishes to you :) ##WeNurses
@ShelaghAHP 11 November 2014 20:02		@AgencyNurse hi Tree #wenurses keen to learn about an area of healthcare I don't know too much about ...
@WeNurses 11 November 2014 20:03		RT @cherylwilson2: @SarahChapman30 @AgencyNurse @WeNurses Hello welcome back #wenurses
@Bartontd 11 November 2014 20:03		Evening All #DaveWave #Swansea #wenurses It Wet !
@WeNurses 11 November 2014 20:03		RT @ShelaghAHP: @AgencyNurse hi Tree #wenurses keen to learn about an area of healthcare I don't know too much about ...
@SarahChapman30 11 November 2014 20:03		Thank you. I've dropped in from @UKCochraneCentr, where I've been looking at all our #CochraneEvidence on pressure ulcers #wenurses
@WeNurses 11 November 2014 20:03		Tonights discussion is a bit of a follow on from the discussion we had in March and also because its #stopthepressure November #wenurses
@cherylwilson2 11 November 2014 20:03		@Bartontd #DAVEWAVE #wenurses
@HealthUKTD 11 November 2014 20:03		RT @WeNurses: Hellloooo wonderful tweeting friends and welcome to tonights #WeNurses http://t.co/epeFgCGOBq
@WeNurses 11 November 2014 20:03		So over to you @SarahChapman30 #wenurses
@cherylwilson2 11 November 2014 20:03		RT @WeNurses: So over to you @SarahChapman30 #wenurses
@WeNurses 11 November 2014 20:03		@Bartontd put your spot back in the lounge Dave :) happy #WeNurses'ing looking forward to your input
@SarahChapman30 11 November 2014 20:04		Given that there's no reliable evidence that structured risk assessment reduces PU incidence - does anyone not use them? #wenurses
@WeNurses 11 November 2014 20:04		RT @McIntyreLyn: @WeNurses @STPressure thank you for supporting pressure ulcer November #stopthepressure #wenurses < most welcome
@SarahChapman30 11 November 2014 20:05		Just a remonder to use the #wenurses hashtag please - is that right @WeNurses?
@cherylwilson2 11 November 2014 20:05		@SarahChapman30 we USE #waterlow #wenurses
@TeamClaytonULHT 11 November 2014 20:05		@SarahChapman30 @WeNurses The #Waterlow seems to confirm my perception of risk rather than alert me to it.... #WeNurses
@AgencyNurse 11 November 2014 20:05		@SarahChapman30 i have tried in my clinical role to get people to drop them ..but i get a look of horror and they think i am nuts #wenurses
@AgencyNurse 11 November 2014 20:05		RT @SarahChapman30: Just a remonder to use the #wenurses hashtag please - is that right @WeNurses?
@WeNurses 11 November 2014 20:05		RT @SarahChapman30: Just a remonder to use the #wenurses hashtag please - is that right @WeNurses?
@AgencyNurse 11 November 2014 20:05		@SarahChapman30 yes please #wenurses
@WeNurses 11 November 2014 20:05		#wenurses Pressure Ulcers not your thing? Hop over to #wecomsers, their topic "Self-management Support: exploring what quality means"
@SarahChapman30 11 November 2014 20:05		@TeamClaytonULHT @SarahChapman30 @WeNurses So clinical judgement first? #wenurses
@BrooksCarole 11 November 2014 20:06		#WeNurses Evening all from rainy Worcester! Looking forward to this :)
@SarahChapman30 11 November 2014 20:06		RT @AgencyNurse: @SarahChapman30 yes please #wenurses
@WeNurses 11 November 2014 20:06		RT @McIntyreLyn: @SarahChapman30 @WeNurses that's a really great question #stopthepressue #wenurses
@SarahChapman30 11 November 2014 20:06		@BrooksCarole Hi - welcome :) #wenurses
@WeNurses 11 November 2014 20:06		RT @TeamClaytonULHT: @SarahChapman30 @WeNurses The #Waterlow seems to confirm my perception of risk rather than alert me to it.... #WeNurses
@McIntyreLyn 11 November 2014 20:06		RT @TeamClaytonULHT: @SarahChapman30 @WeNurses The #Waterlow seems to confirm my perception of risk rather than alert me to it.... #WeNurses
@AgencyNurse 11 November 2014 20:06		@cherylwilson2 @SarahChapman30 thats a very big USE cheryl ?? #wenurses
@Lauren_OT 11 November 2014 20:07		@SarahChapman30 #wenurses We use Braden - but no risk ax tool does the full job, clinical reasoning must go alongside!
@rachel_rahs 11 November 2014 20:07		@SarahChapman30 @WeNurses directed ward manager on dementia placement to this info-was dismissed- ‘not trust policy’-frustrating! #WeNurses
@PSMJW 11 November 2014 20:07		@SarahChapman30 @WeNurses How can we know for sure? impossible to evidence how many we prevent through RA and prev treatment? #wenurses
@ShelaghAHP 11 November 2014 20:07		@AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@TeamClaytonULHT 11 November 2014 20:07		@SarahChapman30 @WeNurses Yes any assessment should be tempered with clinical judgement, those with low score can still develop pu #wenurses
@SarahChapman30 11 November 2014 20:07		When we chatted about this lack of good evidence in the spring, some nurses said they would consider dropping using tools. Anyone? #wenurses
@WeNurses 11 November 2014 20:07		thanks for joining @BrooksCarole #littlechirp came prepared! #WeNurses http://t.co/WCpvILm0AX
@AgencyNurse 11 November 2014 20:07		RT @ShelaghAHP: @AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@WeNurses 11 November 2014 20:07		RT @ShelaghAHP: @AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@cherylwilson2 11 November 2014 20:07		@AgencyNurse @SarahChapman30 well Sarah asked who doesnt use #wenurses but use #clinical judgement always #experience
@SarahChapman30 11 November 2014 20:07		RT @Lauren_OT: @SarahChapman30 #wenurses We use Braden - but no risk ax tool does the full job, clinical reasoning must go alongside!
@SarahChapman30 11 November 2014 20:08		RT @ShelaghAHP: @AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@SarahChapman30 11 November 2014 20:08		@ShelaghAHP @AgencyNurse @SarahChapman30 That's a really interesting question. #wenurses
@nursingSUni 11 November 2014 20:08		RT @karendawber: #wenurses work with someone who will bring the best out in you but also push you. Pick your role models and aspire to be l…
@AgencyNurse 11 November 2014 20:08		@ShelaghAHP @SarahChapman30 i don't know .. have shared evidence .. they admit that they use clinical judgment yet don't change #wenurses
@gkscott89 11 November 2014 20:08		@SarahChapman30 @WeNurses using a waterlow assessment can also highlight some risk factors that new nurses may not consider #WeNurses
@WeNurses 11 November 2014 20:08		RT @cherylwilson2: @AgencyNurse @SarahChapman30 well Sarah asked who doesnt use #wenurses but use #clinical judgement always #experience
@WeNurses 11 November 2014 20:09		RT @McIntyreLyn: @TeamClaytonULHT @WeNurses @SarahChapman30 it's usually Braden or Waterlow in my experience #stopthepressure #wenurses
@SarahChapman30 11 November 2014 20:09		@Lauren_OT @SarahChapman30 Yes - nurses abandoning their clinical judgement is a scary thought! #wenurses
@SarahJCoates 11 November 2014 20:09		@TeamClaytonULHT @WeNurses @SarahChapman30 #wenurses our trust has ditched the Waterlow, we use the EPRAT tool now.
@WeNurses 11 November 2014 20:09		RT @SarahChapman30: @Lauren_OT @SarahChapman30 Yes - nurses abandoning their clinical judgement is a scary thought! #wenurses
@cherylwilson2 11 November 2014 20:09		@gkscott89 @SarahChapman30 @WeNurses #useful #tool but just a #tool #wenurses
@WeNurses 11 November 2014 20:09		RT @SarahJCoates: @TeamClaytonULHT @WeNurses @SarahChapman30 #wenurses our trust has ditched the Waterlow, we use the EPRAT tool now.
@stpnottingham 11 November 2014 20:09		RT @WeNurses: Not long now ! Pressure Ulcer Evidence with @sarahchapman30 #stpthepressure http://t.co/uo12wxh7Zr #WeNurses http://t.c…
@AgencyNurse 11 November 2014 20:09		@SarahJCoates @TeamClaytonULHT @WeNurses @SarahChapman30 so you have gone from one tool to another ? #wenurses
@SarahChapman30 11 November 2014 20:09		@cherylwilson2 @AgencyNurse @SarahChapman30 Interesting that the new NICE guideline now allows for this - a change this April. #wenurses
@PSMJW 11 November 2014 20:09		@SarahChapman30 @Lauren_OT @WeNurses We had a great #wenurses about clinical judgement few weeks back :)
@TeamClaytonULHT 11 November 2014 20:10		@SarahJCoates @WeNurses @SarahChapman30 I've never heard of that one... #WeNurses
@WeNurses 11 November 2014 20:10		RT @PSMJW: @SarahChapman30 @Lauren_OT @WeNurses We had a great #wenurses about clinical judgement few weeks back :)
@BrooksCarole 11 November 2014 20:10		RT @karendawber: #wenurses work with someone who will bring the best out in you but also push you. Pick your role models and aspire to be l…
@SarahChapman30 11 November 2014 20:10		@TeamClaytonULHT @SarahChapman30 @WeNurses Good point #wenurses
@NRCUK 11 November 2014 20:10		@cherylwilson2 @AgencyNurse @WeCommissioners @DGFoord @WeNurses is there an @WeHelp for you lot? happy #WeNurses & #wecomsers
@nursingSUni 11 November 2014 20:10		RT @ShelaghAHP: @AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@Jaynebiddiscom1 11 November 2014 20:10		@SarahChapman30 @ShelaghAHP @AgencyNurse #wenurses yes, lots of discussion re waterlow, Braden, bespoke. We use bespoke
@clarahopscotch 11 November 2014 20:10		@SarahChapman30 I think not using a tool would make people nervous - esp in care home environments.#WeNurses
@WeNurses 11 November 2014 20:11		. @PSMJW @SarahChapman30 @Lauren_OT we did .. so how can we put clinical judgement into practice ? How do we empower nurses ? #wenurses
@Bartontd 11 November 2014 20:11		RT @PSMJW: @SarahChapman30 @Lauren_OT @WeNurses We had a great #wenurses about clinical judgement few weeks back :)
@TeamClaytonULHT 11 November 2014 20:11		#Waterlow does prompt staff to develop #SSKIN plan in care plan.. #WeNurses
@SarahChapman30 11 November 2014 20:11		@clarahopscotch @SarahChapman30 Do others think so? Interesting that the tools reassure (nurses or patients?) #wenurses
@PSMJW 11 November 2014 20:11		@SarahJCoates @TeamClaytonULHT @WeNurses @SarahChapman30 Can you share? Not aware of this tool #wenurses
@ShelaghAHP 11 November 2014 20:11		@AgencyNurse @SarahChapman30 so knowledge alone doesn't change behaviour/clinical practice? ... #wenurses
@Drivenbyhealth1 11 November 2014 20:12		RT @SarahJCoates: @TeamClaytonULHT @WeNurses @SarahChapman30 #wenurses our trust has ditched the Waterlow, we use the EPRAT tool now.
@Bartontd 11 November 2014 20:12		RT @WeNurses: thanks for joining @BrooksCarole #littlechirp came prepared! #WeNurses http://t.co/WCpvILm0AX
@Bartontd 11 November 2014 20:12		RT @ShelaghAHP: @AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@AgencyNurse 11 November 2014 20:12		@Jaynebiddiscom1 @SarahChapman30 @ShelaghAHP no evidence to say tools work #wenurses #EBP http://t.co/7cTNwUrCQ3
@Drivenbyhealth1 11 November 2014 20:12		RT @SarahChapman30: @Lauren_OT @SarahChapman30 Yes - nurses abandoning their clinical judgement is a scary thought! #wenurses
@clarahopscotch 11 November 2014 20:12		@SarahChapman30 I think it reassures inspectors more than nurses or patients. #WeNurses
@WeNurses 11 November 2014 20:12		RT @AgencyNurse: @Jaynebiddiscom1 @SarahChapman30 @ShelaghAHP no evidence to say tools work #wenurses #EBP http://t.co/7cTNwUrCQ3
@cherylwilson2 11 November 2014 20:12		RT @AgencyNurse: @Jaynebiddiscom1 @SarahChapman30 @ShelaghAHP no evidence to say tools work #wenurses #EBP http://t.co/7cTNwUrCQ3
@AgencyNurse 11 November 2014 20:12		RT @clarahopscotch: @SarahChapman30 I think not using a tool would make people nervous - esp in care home environments.#WeNurses
@WeNurses 11 November 2014 20:12		RT @clarahopscotch: @SarahChapman30 I think not using a tool would make people nervous - esp in care home environments.#WeNurses
@Drivenbyhealth1 11 November 2014 20:13		RT @cherylwilson2: @AgencyNurse @SarahChapman30 well Sarah asked who doesnt use #wenurses but use #clinical judgement always #experience
@LizAllibone 11 November 2014 20:13		@SarahChapman30 @WeNurses but RA tools are popular & seen to help unregistered staff & standardise practice eg NEWS, Waterlow #WeNurses
@ShelaghAHP 11 November 2014 20:13		@SarahChapman30 @WeNurses @Lauren_OT @SarahChapman30 what happens for patients living at home? #wenurses Is practice same/diff to hosp exper
@SKasaven 11 November 2014 20:13		RT @Lauren_OT: @SarahChapman30 #wenurses We use Braden - but no risk ax tool does the full job, clinical reasoning must go alongside!
@DGFoord 11 November 2014 20:13		.@nursingrahs @SarahChapman30 @WeNurses @Bartontd Most dangerous 6 words in English language: "We've always done it this way" #WeNurses
@HealthUKTD 11 November 2014 20:13		RT @ShelaghAHP: @AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@HealthUKTD 11 November 2014 20:13		RT @clarahopscotch: @SarahChapman30 I think not using a tool would make people nervous - esp in care home environments.#WeNurses
@traceyhardy789 11 November 2014 20:13		@SarahChapman30 I personally think they are useful aid memoir along side cj if used correctly #WeNurses
@Bartontd 11 November 2014 20:13		Let your assessment tools guide your practice - not confine your judgement! #wenurses
@cherylwilson2 11 November 2014 20:13		RT @Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses
@SarahChapman30 11 November 2014 20:14		No evidence that RA tool helps patients & now not mandatory (fromNICE). What keeps people using it? Culture? #wenurses
@SarahChapman30 11 November 2014 20:14		RT @Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses
@ShelaghAHP 11 November 2014 20:14		@AgencyNurse @cherylwilson2 @Jaynebiddiscom1 @SarahChapman30 is emphasis mainly on observation skills then? #wenurses
@AgencyNurse 11 November 2014 20:14		@clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@cherylwilson2 11 November 2014 20:14		RT @SarahChapman30: No evidence that RA tool helps patients & now not mandatory (fromNICE). What keeps people using it? Culture? #wenurses
@SarahChapman30 11 November 2014 20:14		@Bartontd Very important. #wenurses
@SarahChapman30 11 November 2014 20:14		RT @AgencyNurse: @clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@cherylwilson2 11 November 2014 20:14		RT @AgencyNurse: @clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@Lauren_OT 11 November 2014 20:14		RT @Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses
@LeggeAngie 11 November 2014 20:14		@LizAllibone @SarahChapman30 @WeNurses Tools are helpful. But not replacement for clinical judgement #wenurses
@AgencyNurse 11 November 2014 20:14		RT @TeamClaytonULHT: #Waterlow does prompt staff to develop #SSKIN plan in care plan.. #WeNurses
@WeNurses 11 November 2014 20:14		RT @TeamClaytonULHT: #Waterlow does prompt staff to develop #SSKIN plan in care plan.. #WeNurses
@AgencyNurse 11 November 2014 20:15		RT @LeggeAngie: @LizAllibone @SarahChapman30 @WeNurses Tools are helpful. But not replacement for clinical judgement #wenurses
@WeNurses 11 November 2014 20:15		RT @LeggeAngie: @LizAllibone @SarahChapman30 @WeNurses Tools are helpful. But not replacement for clinical judgement #wenurses
@WeNurses 11 November 2014 20:15		quite a few of us not adding #wenurses to our tweets :( Others not following you won't see them nor will they be in the transcript #sad
@TeamClaytonULHT 11 November 2014 20:15		@LindaKeddie Great #wenurses chat going on right now :)
@SarahChapman30 11 November 2014 20:15		@AgencyNurse @clarahopscotch @SarahChapman30 Yes a clear choice - and/or (though tool without judgement dodgy!) #wenurses
@PSMJW 11 November 2014 20:15		@SarahChapman30 I see plenty of incorrect (usually underscored) Waterlows, why can't we get it right? #wenurses
@AgencyNurse 11 November 2014 20:15		RT @WeNurses: quite a few of us not adding #wenurses to our tweets :( Others not following you won't see them nor will they be in the trans…
@Bartontd 11 November 2014 20:15		RT @AgencyNurse: @clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@TeamClaytonULHT 11 November 2014 20:15		RT @Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses
@Bartontd 11 November 2014 20:15		RT @SarahChapman30: No evidence that RA tool helps patients & now not mandatory (fromNICE). What keeps people using it? Culture? #wenurses
@SarahChapman30 11 November 2014 20:15		@WeNurses Please do - I'm only seeing those with #wenurses attached
@HealthUKTD 11 November 2014 20:15		RT @TeamClaytonULHT: #Waterlow does prompt staff to develop #SSKIN plan in care plan.. #WeNurses
@WeNurses 11 November 2014 20:15		RT @BrooksCarole: @ShelaghAHP @cherylwilson2 @Jaynebiddiscom1 @SarahChapman30 what about v sick pts in ITU? any thoughts please? #wenurses
@SKasaven 11 November 2014 20:15		@SarahChapman30 @cherylwilson2 fear of litigation and loss of empowerment #WeNurses
@cherylwilson2 11 November 2014 20:15		@LeggeAngie @LizAllibone @SarahChapman30 @WeNurses agree and I was taught re #pressure you can put anything on it EXCEPT your pt #wenurses
@nursingSUni 11 November 2014 20:15		RT @WeNurses: Hellloooo wonderful tweeting friends and welcome to tonights #WeNurses http://t.co/epeFgCGOBq
@nursingSUni 11 November 2014 20:16		RT @LeggeAngie: @LizAllibone @SarahChapman30 @WeNurses Tools are helpful. But not replacement for clinical judgement #wenurses
@Bartontd 11 November 2014 20:16		RT @ShelaghAHP: @SarahChapman30 @WeNurses @Lauren_OT @SarahChapman30 what happens for patients living at home? #wenurses Is practice same/d…
@Jaynebiddiscom1 11 November 2014 20:16		@AgencyNurse @ClarkRichardJ @WeNurses @SarahChapman30 @ShelaghAHP #wenurses should we assume all patients are at risk, anyway?
@SarahChapman30 11 November 2014 20:16		Sorry if I have missed this but has anyone stopped using a tool recently? #wenurses
@TeamClaytonULHT 11 November 2014 20:16		RT @AgencyNurse: @clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@nursingSUni 11 November 2014 20:16		RT @WeNurses: quite a few of us not adding #wenurses to our tweets :( Others not following you won't see them nor will they be in the trans…
@cherylwilson2 11 November 2014 20:16		RT @WeNurses: quite a few of us not adding #wenurses to our tweets :( Others not following you won't see them nor will they be in the trans…
@AgencyNurse 11 November 2014 20:16		RT @SarahChapman30: Sorry if I have missed this but has anyone stopped using a tool recently? #wenurses
@WeNurses 11 November 2014 20:16		RT @SarahChapman30: Sorry if I have missed this but has anyone stopped using a tool recently? #wenurses
@SKasaven 11 November 2014 20:16		RT @AgencyNurse: @clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@AgencyNurse 11 November 2014 20:16		@SarahChapman30 i think its a no ! #wenurses
@HealthUKTD 11 November 2014 20:16		RT @AgencyNurse: @clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@HealthUKTD 11 November 2014 20:16		RT @SarahChapman30: No evidence that RA tool helps patients & now not mandatory (fromNICE). What keeps people using it? Culture? #wenurses
@AgencyNurse 11 November 2014 20:16		RT @Jaynebiddiscom1: @AgencyNurse @ClarkRichardJ @WeNurses @SarahChapman30 @ShelaghAHP #wenurses should we assume all patients are at risk,…
@stpnottingham 11 November 2014 20:16		@TeamClaytonULHT @WeNurses we use braden in the nottingham area, think it helps stn's and rn's to think about SSKIN #wenurses
@PSMJW 11 November 2014 20:17		RT @Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses
@McIntyreLyn 11 November 2014 20:17		RT @SarahChapman30: Sorry if I have missed this but has anyone stopped using a tool recently? #wenurses
@SarahChapman30 11 November 2014 20:17		@AgencyNurse @SarahChapman30 So what do people think is the value of the RA tool? Confidence has been mentioned. #wenurses
@gkscott89 11 November 2014 20:17		#WeNurses there is always place for an assessment tool but it should never be used to replace clinical judgement!
@cherylwilson2 11 November 2014 20:17		@SarahChapman30 no #still #toolusing #wenurses but emphasize #itsjustaguide #wenurses
@LizAllibone 11 November 2014 20:17		@LeggeAngie @WeNurses @SarahChapman30 I agree. But standardisation of clinical judgement and tools are in vogue #wenurses
@WeNurses 11 November 2014 20:17		Interesting point @Jaynebiddiscom1 Should we assume all at risk ? Levels of risk? #wenurses
@TeamClaytonULHT 11 November 2014 20:17		RT @gkscott89: #WeNurses there is always place for an assessment tool but it should never be used to replace clinical judgement!
@cherylwilson2 11 November 2014 20:17		RT @WeNurses: Interesting point @Jaynebiddiscom1 Should we assume all at risk ? Levels of risk? #wenurses
@SKasaven 11 November 2014 20:17		“@Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses” exactly & nurses need 2 rely on judgement
@HealthUKTD 11 November 2014 20:17		RT @SarahChapman30: Sorry if I have missed this but has anyone stopped using a tool recently? #wenurses
@MrsElrick4 11 November 2014 20:17		@ShelaghAHP @SarahChapman30 @WeNurses @Lauren_OT Previously used Walsall Community PU RA in community #WeNurses
@nursingSUni 11 November 2014 20:17		I'm lurking not shirking I promise #WeNurses and retweeting those that I believe in ie a tool is only as good as the person using it?
@WeNurses 11 November 2014 20:17		RT @SKasaven: “@Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses” exactly & nurses need 2 re…
@Bartontd 11 November 2014 20:17		RT @SKasaven: @SarahChapman30 @cherylwilson2 fear of litigation and loss of empowerment #WeNurses
@pfranklin5 11 November 2014 20:17		RT @LeggeAngie: @LizAllibone @SarahChapman30 @WeNurses Tools are helpful. But not replacement for clinical judgement #wenurses
@WeNurses 11 November 2014 20:18		RT @nursingSUni: I'm lurking not shirking I promise #WeNurses and retweeting those that I believe in ie a tool is only as good as the perso…
@TeamClaytonULHT 11 November 2014 20:18		@WeNurses @Jaynebiddiscom1 Definitely! We've had independent patients develop pressure ulcers thru lack of education #wenurses
@BrooksCarole 11 November 2014 20:18		#WeNurses Where is our expert @ElaineBethell ?
@ShelaghAHP 11 November 2014 20:18		@Jaynebiddiscom1 @AgencyNurse @ClarkRichardJ @WeNurses @SarahChapman30 daft lassie Q ... who is most at risk from PU? #wenurses
@SarahChapman30 11 November 2014 20:18		@nursingSUni This is an excellent point. Also only any good if tool prompts appropriate action! #wenurses
@TeamClaytonULHT 11 November 2014 20:18		RT @nursingSUni: I'm lurking not shirking I promise #WeNurses and retweeting those that I believe in ie a tool is only as good as the perso…
@WeNurses 11 November 2014 20:18		RT @SarahChapman30: @nursingSUni This is an excellent point. Also only any good if tool prompts appropriate action! #wenurses
@Bartontd 11 November 2014 20:18		RT @SKasaven: “@Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses” exactly & nurses need 2 re…
@BrooksCarole 11 November 2014 20:18		RT @AgencyNurse: @clarahopscotch @SarahChapman30 nice guidelines say u can use clinical judgement #wenurses #EBP > http://t.co/06iEaOD3KI
@lynnewalsall 11 November 2014 20:18		RT @SKasaven: “@Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses” exactly & nurses need 2 re…
@WeNurses 11 November 2014 20:18		RT @ClarkRichardJ: #WeNurses Tools are prompts. If these tools need 'dropping' then I'd argue they aren't being used properly
@Jaynebiddiscom1 11 November 2014 20:18		@WeNurses @BrooksCarole @ShelaghAHP @cherylwilson2 @SarahChapman30 #wenurses Some pts, like ITU pt wd b 'high' risk as opposed to 'at' risk?
@WeNurses 11 November 2014 20:19		please ???'? ?????? ???? ??????? add #wenurses so we can all see your tweets :) http://t.co/nX7ZsO13PP
@nursingSUni 11 November 2014 20:19		RT @SarahChapman30: @nursingSUni This is an excellent point. Also only any good if tool prompts appropriate action! #wenurses
@TeamClaytonULHT 11 November 2014 20:19		@SarahChapman30 @WeNurses @AgencyNurse Useful for newly-qualified nurses #WeNurses
@LeggeAngie 11 November 2014 20:19		@LizAllibone @WeNurses @SarahChapman30 and helpful. But we need to empower staff to recognise risk not flagged by tool #WENURSES
@cherylwilson2 11 November 2014 20:19		RT @WeNurses: please ???'? ?????? ???? ??????? add #wenurses so we can all see your tweets :) http://t.co/nX7ZsO13PP
@SarahChapman30 11 November 2014 20:19		RT @WeNurses: RT @ClarkRichardJ: #WeNurses Tools are prompts. If these tools need 'dropping' then I'd argue they aren't being used properly
@claracluck 11 November 2014 20:19		@WeNurses yes tools are ok but do they inhibit prof.judgement and stop staff thinking and analysing situations sufficiently?#wenurses
@PSMJW 11 November 2014 20:19		@WeNurses @Jaynebiddiscom1 Surely the nature of a hospital admission puts you at risk, you are less mobile and and usually poorly #wenurses
@Bartontd 11 November 2014 20:19		RT @SarahChapman30: @nursingSUni This is an excellent point. Also only any good if tool prompts appropriate action! #wenurses
@mjseres 11 November 2014 20:19		RT @ShelaghAHP: @AgencyNurse @SarahChapman30 so how do u get staff 2 stop doing something that adds no value to patient experience #wenurses
@SueJones1981 11 November 2014 20:19		@clarahopscotch @SarahChapman30 #WeNurses I met Ms Norton, the Norton scale put measurement and audit discipline into practice improvement
@BrooksCarole 11 November 2014 20:19		RT @SKasaven: “@Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses” exactly & nurses need 2 re…
@SKasaven 11 November 2014 20:19		RT @LeggeAngie: @LizAllibone @SarahChapman30 @WeNurses Tools are helpful. But not replacement for clinical judgement #wenurses
@AgencyNurse 11 November 2014 20:19		@claracluck so why do we still use them ? #wenurses
@PUNC14Julie 11 November 2014 20:19		RT @WeNurses: please ???'? ?????? ???? ??????? add #wenurses so we can all see your tweets :) http://t.co/nX7ZsO13PP
@ShelaghAHP 11 November 2014 20:19		@MrsElrick4 @SarahChapman30 @WeNurses @Lauren_OT picking up on @agencynurse point is it evidence based? #wenurses would u stop using if not?
@BethSampson67 11 November 2014 20:19		@stpnottingham joining in the #wenurses pressure chat tonight. Thanks for being our voice @milesofsmiles_
@stpnottingham 11 November 2014 20:19		@SarahChapman30 @WeNurses @AgencyNurse think it can prompt thinking about different elements of SSKIN #wenurses
@Bartontd 11 November 2014 20:20		RT @nursingSUni: I'm lurking not shirking I promise #WeNurses and retweeting those that I believe in ie a tool is only as good as the perso…
@SarahChapman30 11 November 2014 20:20		@WeNurses @ClarkRichardJ Does SSKIN act as a sufficient prompt without going through a more time-consuming structured assessment? #wenurses
@Levette22 11 November 2014 20:20		RT @WeNurses: Hellloooo wonderful tweeting friends and welcome to tonights #WeNurses http://t.co/epeFgCGOBq
@WeNurses 11 November 2014 20:20		RT @stpnottingham: @SarahChapman30 @WeNurses @AgencyNurse think it can prompt thinking about different elements of SSKIN #wenurses
@Bartontd 11 November 2014 20:20		RT @WeNurses: Interesting point @Jaynebiddiscom1 Should we assume all at risk ? Levels of risk? #wenurses
@SarahChapman30 11 November 2014 20:20		RT @WeNurses: please ???'? ?????? ???? ??????? add #wenurses so we can all see your tweets :) http://t.co/nX7ZsO13PP
@SarahJCoates 11 November 2014 20:20		#WeNurses two or more factors and patient is at risk. If the criteria is highlighted in red, then this will automatically put them at risk.
@TeamClaytonULHT 11 November 2014 20:20		Tools also justified use of mattresses & cushions - cost implications #WeNurses
@RuthAshmore 11 November 2014 20:20		RT @WeNurses: Nurse offline = Nurse online .. always :) http://t.co/kPuLfV6kB9 #wenurses
@WeNurses 11 November 2014 20:20		RT @SarahJCoates: #WeNurses two or more factors and patient is at risk. If the criteria is highlighted in red, then this will automatically…
@HealthUKTD 11 November 2014 20:20		RT @SarahChapman30: @nursingSUni This is an excellent point. Also only any good if tool prompts appropriate action! #wenurses
@createyourself9 11 November 2014 20:20		#wenurses Tools are a guide but in most Mandatory tools … the lack of EBP has been discussed but litigation is a problem for reliance on CJ
@AgencyNurse 11 November 2014 20:20		RT @ShelaghAHP: @MrsElrick4 @SarahChapman30 @WeNurses @Lauren_OT picking up on @agencynurse point is it evidence based? #wenurses would u s…
@LeggeAngie 11 November 2014 20:20		@claracluck @WeNurses Perhaps the question is why don't staff feel able to say, this pt still risk, despite the tool #WeNurses
@WeNurses 11 November 2014 20:20		RT @createyourself9: #wenurses Tools are a guide but in most Mandatory tools … the lack of EBP has been discussed but litigation is a probl…
@SarahChapman30 11 November 2014 20:21		RT @ShelaghAHP: @MrsElrick4 @SarahChapman30 @WeNurses @Lauren_OT picking up on @agencynurse point is it evidence based? #wenurses would u s…
@PSMJW 11 November 2014 20:21		@SarahChapman30 Does anyone audit accuracy of assessments? Many I see in RCA are incorrect (underscored) #wenurses
@Jaynebiddiscom1 11 November 2014 20:21		@ShelaghAHP @AgencyNurse @ClarkRichardJ @WeNurses @SarahChapman30 #wenurses so should have universal precautions, like infection control?
@HealthUKTD 11 November 2014 20:21		RT @nursingSUni: I'm lurking not shirking I promise #WeNurses and retweeting those that I believe in ie a tool is only as good as the perso…
@HealthUKTD 11 November 2014 20:21		RT @WeNurses: Interesting point @Jaynebiddiscom1 Should we assume all at risk ? Levels of risk? #wenurses
@gkscott89 11 November 2014 20:21		RT @TeamClaytonULHT: Tools also justified use of mattresses & cushions - cost implications #WeNurses
@AgencyNurse 11 November 2014 20:21		@createyourself9 however can we be more confident now that NICE has added "clinical judgement and / or risk assessment" ? #wenurses
@traceyhardy789 11 November 2014 20:22		Visiting pts in their own homes we risk asses all and ensure pressure relieving equipment is in place for those that need #WeNurses
@WeNurses 11 November 2014 20:22		RT @TeamClaytonULHT: Tools also justified use of mattresses & cushions - cost implications #WeNurses
@Jaynebiddiscom1 11 November 2014 20:22		@PSMJW @WeNurses I agree #wenurses
@SarahChapman30 11 November 2014 20:22		@createyourself9 Does the change in the NICE guideline free nurses up from this fear now though? In terms of PU assessment? #wenurses
@Bartontd 11 November 2014 20:22		In a professional clinical context, judgment is viewed as a “professional choice rather than tasks" #wenurses
@SKasaven 11 November 2014 20:22		@LeggeAngie @LizAllibone @WeNurses @SarahChapman30 agree we need 2 be able 2 hav courage 2 say patient still at risk despite tool #wenurses
@WeNurses 11 November 2014 20:22		RT @PSMJW: @SarahChapman30 Does anyone audit accuracy of assessments? Many I see in RCA are incorrect (underscored) #wenurses
@SarahChapman30 11 November 2014 20:22		@AgencyNurse @createyourself9 This looks like a big change I think. #wenurses
@TeamClaytonULHT 11 November 2014 20:22		RT @PSMJW: @SarahChapman30 Does anyone audit accuracy of assessments? Many I see in RCA are incorrect (underscored) #wenurses
@RuthAshmore 11 November 2014 20:22		#WeNurses remember health care is both a science and an art
@SarahChapman30 11 November 2014 20:22		RT @PSMJW: @SarahChapman30 Does anyone audit accuracy of assessments? Many I see in RCA are incorrect (underscored) #wenurses
@McIntyreLyn 11 November 2014 20:22		RT @TeamClaytonULHT: Tools also justified use of mattresses & cushions - cost implications #WeNurses
@Jin_Shei 11 November 2014 20:23		Use the assessment tool for a basis for more information for clinical decisions, not a replacement #WeNurses
@TeamClaytonULHT 11 November 2014 20:23		@PSMJW @WeNurses @SarahChapman30 Yes I've found that too - shows they are useful if scored correctly? #WeNurses
@MrsElrick4 11 November 2014 20:23		@ShelaghAHP @SarahChapman30 @Lauren_OT @AgencyNurse I would consider stopping the use personally & use SSKIN & clinical judgment #WeNurses
@WeNurses 11 November 2014 20:23		Good point @PSMJW @SarahChapman30 What is the evidence re accuracy of PU risk assessment scores ? #WeNurses
@claracluck 11 November 2014 20:23		@AgencyNurse because we fail our notes audits if we don't!! Sad but true,often feels that we are ticking boxes! #wenurses
@SarahChapman30 11 November 2014 20:23		@TeamClaytonULHT I will be blogging #CochraneEvidence on support surfaces etc later this week! #wenurses
@AgencyNurse 11 November 2014 20:23		@MrsElrick4 @ShelaghAHP @SarahChapman30 @Lauren_OT well said, me too #wenurses
@gkscott89 11 November 2014 20:23		@LeggeAngie @WeNurses @claracluck #WeNurses on our ward we encourage all staff to use their clinical judgememnt alongside the assessment
@createyourself9 11 November 2014 20:23		@AgencyNurse Its a move in the right direction but has it yet impacted individual Trust policies & guidelines #WeNurses …. anyone ?
@Justdreamingof 11 November 2014 20:23		@PSMJW @WeNurses @SarahChapman30 we audit pressure ulcer risk assessment care weekly, accuracy and compliance #WeNurses
@AgencyNurse 11 November 2014 20:23		RT @claracluck: @AgencyNurse because we fail our notes audits if we don't!! Sad but true,often feels that we are ticking boxes! #wenurses
@SarahJCoates 11 November 2014 20:23		#WeNurses once we have completed EPRAT, the patient gets an individualised pressure care plan to meet their needs.
@Jaynebiddiscom1 11 November 2014 20:24		@TeamClaytonULHT @WeNurses #wenurses I agree the most powerful tool is knowledgeable staff
@TeamClaytonULHT 11 November 2014 20:24		RT @SarahChapman30: @TeamClaytonULHT I will be blogging #CochraneEvidence on support surfaces etc later this week! #wenurses
@WeNurses 11 November 2014 20:24		RT @Jaynebiddiscom1: @gkscott89 #WeNurses No arguement from me re that. So should we ditch risk assessment?
@SarahChapman30 11 November 2014 20:24		@createyourself9 @AgencyNurse Yes - are any of you required by your Trust to complete structured RA? Who is/isn't? #wenurses
@AgencyNurse 11 November 2014 20:24		@claracluck which is crazy ... we need time to care yet doing stuff that is not evidence based ! #wenurses
@SarahChapman30 11 November 2014 20:24		RT @WeNurses: RT @Jaynebiddiscom1: @gkscott89 #WeNurses No arguement from me re that. So should we ditch risk assessment?
@SarahChapman30 11 November 2014 20:24		RT @AgencyNurse: @claracluck which is crazy ... we need time to care yet doing stuff that is not evidence based ! #wenurses
@TeamClaytonULHT 11 November 2014 20:24		Risk assessment is not harmful, therefore may as well keep it? #WeNurses
@Bartontd 11 November 2014 20:24		RT @SarahJCoates: #WeNurses once we have completed EPRAT, the patient gets an individualised pressure care plan to meet their needs.
@gkscott89 11 November 2014 20:25		RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses
@SP_Duckworth 11 November 2014 20:25		@AgencyNurse @ClarkRichardJ @WeNurses @Jaynebiddiscom1 @SarahChapman30 @ShelaghAHP No, but over treatment in all HC,a maj danger. #WeNurses
@TeamClaytonULHT 11 November 2014 20:25		RT @Jaynebiddiscom1: @TeamClaytonULHT @WeNurses #wenurses I agree the most powerful tool is knowledgeable staff
@AgencyNurse 11 November 2014 20:25		EXCELLENT Q @createyourself9 Have the new NICE guidelines re Pressure Ulcer impacted andy trust policies & guidelines yet ? #wenurses
@SarahChapman30 11 November 2014 20:25		@AgencyNurse @claracluck Exactly - potentially a waste of precious time which could be better spent. #wenurses
@Bartontd 11 November 2014 20:25		RT @SarahChapman30: @TeamClaytonULHT I will be blogging #CochraneEvidence on support surfaces etc later this week! #wenurses
@TeamClaytonULHT 11 November 2014 20:25		RT @SarahJCoates: #WeNurses once we have completed EPRAT, the patient gets an individualised pressure care plan to meet their needs.
@WeNurses 11 November 2014 20:25		RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses
@punc14abaker 11 November 2014 20:25		RT @SarahJCoates: #WeNurses two or more factors and patient is at risk. If the criteria is highlighted in red, then this will automatically…
@TheNursePath 11 November 2014 20:25		@AgencyNurse @Jaynebiddiscom1 @SarahChapman30 @ShelaghAHP @WeNurses AGREE! Should be tools but not Rools. #wenurses http://t.co/eEtmnlZhJd
@createyourself9 11 November 2014 20:25		@AgencyNurse @claracluck #wenurses - still many ticked box exercises in the absence of Evidence but feels safe
@LeggeAngie 11 November 2014 20:25		@createyourself9 @AgencyNurse a policy is mandatory. We have always taught guidelines are for use with judgement. #WeNurses
@ShelaghAHP 11 November 2014 20:25		@MrsElrick4 @WeNurses @SarahChapman30 @Lauren_OT @AgencyNurse so u r demonstrating clinical/professional leadership in doing so? #wenurses
@WeNurses 11 November 2014 20:26		RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses < what are evryone thoughts ?
@cherylwilson2 11 November 2014 20:26		RT @WeNurses: RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses < what are evryone thoughts ?
@SarahChapman30 11 November 2014 20:26		@AgencyNurse @createyourself9 I really want to know this! Link to the NICE guideline, by the way: http://t.co/TArDY76eIL #wenurses
@TeamClaytonULHT 11 November 2014 20:26		RT @WeNurses: RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses < what are evryone thoughts ?
@SarahChapman30 11 November 2014 20:26		RT @WeNurses: RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses < what are evryone thoughts ?
@AgencyNurse 11 November 2014 20:26		@TeamClaytonULHT but in completeing the risk assessment are we keeping nurses away from care ? #wenurses
@PSMJW 11 November 2014 20:26		@TeamClaytonULHT @WeNurses @SarahChapman30 Not sure...if care was optimal it wouldn't matter what the assessment said really? #wenurses
@Bartontd 11 November 2014 20:26		RT @WeNurses: RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses < what are evryone thoughts ?
@stpnottingham 11 November 2014 20:26		As a RMN feel like the use of risk assessments in pu prevention would be really helpful, had very little info at uni #wenurses
@DGFoord 11 November 2014 20:26		.@WeNurses @TeamClaytonULHT Need evidence of positive benefit, not just lack of evidence of harm IMHO #WeNurses
@SarahChapman30 11 November 2014 20:26		@WeNurses @TeamClaytonULHT Potential 'harm' in diverting time/resources? #wenurses
@TheNursePath 11 November 2014 20:26		Open letter to us all. From a grieving woman. #wenurses http://t.co/QTyUFQOqeP
@WeNurses 11 November 2014 20:27		RT @LeggeAngie: @createyourself9 @AgencyNurse a policy is mandatory. We have always taught guidelines are for use with judgement. #WeNurses
@SarahChapman30 11 November 2014 20:27		RT @DGFoord: .@WeNurses @TeamClaytonULHT Need evidence of positive benefit, not just lack of evidence of harm IMHO #WeNurses
@Bartontd 11 November 2014 20:27		RT @createyourself9: @AgencyNurse @claracluck #wenurses - still many ticked box exercises in the absence of Evidence but feels safe
@AgencyNurse 11 November 2014 20:27		RT @DGFoord: .@WeNurses @TeamClaytonULHT Need evidence of positive benefit, not just lack of evidence of harm IMHO #WeNurses
@WeNurses 11 November 2014 20:27		RT @DGFoord: .@WeNurses @TeamClaytonULHT Need evidence of positive benefit, not just lack of evidence of harm IMHO #WeNurses
@SarahChapman30 11 November 2014 20:27		RT @createyourself9: @AgencyNurse @claracluck #wenurses - still many ticked box exercises in the absence of Evidence but feels safe
@TeamClaytonULHT 11 November 2014 20:27		@AgencyNurse Could argue that for ALL paperwork, we've got to make sure we're focusing on that which adds value #wenurses
@PSMJW 11 November 2014 20:27		@sarahchapman #wenurses It's impossible to know how many PUs are prevented which makes evaluating tools/practice so difficult #wenurses
@HealthUKTD 11 November 2014 20:27		RT @WeNurses: RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses < what are evryone thoughts ?
@claracluck 11 November 2014 20:27		@AgencyNurse @WeNurses totally agree, holistic assessment-remember that??seems second to filling in all the forms. #wenurses
@AgencyNurse 11 November 2014 20:28		@TeamClaytonULHT exactly .. so we should look to the evidence surely ? #wenurses (playing devils advocate a little !)
@cherylwilson2 11 November 2014 20:28		@SarahChapman30 @WeNurses #harm of roast catching fire here #overandout see you Thurs #wenurses more #stopthepressure
@gkscott89 11 November 2014 20:28		@WeNurses @TeamClaytonULHT #WeNurses they can prompt some newer nurses to consider different risks regarding PU... worth keeping them!
@stpnottingham 11 November 2014 20:28		@TeamClaytonULHT @gkscott89 yeah definitely! More paperwork can mean less time with pts :( but can act as a prompt #wenurses
@punc14abaker 11 November 2014 20:28		The beginning is where you start, never give up #studentnurse #WeNurses http://t.co/VWusbQfD1H
@AgencyNurse 11 November 2014 20:28		RT @claracluck: @AgencyNurse @WeNurses totally agree, holistic assessment-remember that??seems second to filling in all the forms. #wenurses
@Bartontd 11 November 2014 20:28		RT @DGFoord: .@WeNurses @TeamClaytonULHT Need evidence of positive benefit, not just lack of evidence of harm IMHO #WeNurses
@TeamClaytonULHT 11 November 2014 20:28		@SarahChapman30 @WeNurses Difficult. V high score prompts specialist surface etc. would less experienced staff instigate without #wenurses
@KathEvans2 11 November 2014 20:28		RT @RuthAshmore: #WeNurses remember health care is both a science and an art
@Bartontd 11 November 2014 20:28		RT @PSMJW: @sarahchapman #wenurses It's impossible to know how many PUs are prevented which makes evaluating tools/practice so difficult …
@ShelaghAHP 11 November 2014 20:29		@SarahChapman30 @AgencyNurse @claracluck so how could time b better spent re PU care? #wenurses What emergent practice might take hold?
@LizAllibone 11 November 2014 20:29		@WeNurses how would we document that we used clinical judgement if audited? Completion of a score is often what counts #WeNurses
@GibbinsDonna 11 November 2014 20:29		RT @TeamClaytonULHT: #Waterlow does prompt staff to develop #SSKIN plan in care plan.. #WeNurses
@traceyhardy789 11 November 2014 20:29		Must also differentiate between moisture lesion and PU and assess continence alongside PU risk tool #WeNurses
@TeamClaytonULHT 11 November 2014 20:29		RT @gkscott89: @WeNurses @TeamClaytonULHT #WeNurses they can prompt some newer nurses to consider different risks regarding PU... worth kee…
@AgencyNurse 11 November 2014 20:29		RT @ShelaghAHP: @SarahChapman30 @AgencyNurse @claracluck so how could time b better spent re PU care? #wenurses What emergent practice mig…
@WeNurses 11 November 2014 20:29		RT @ShelaghAHP: @SarahChapman30 @AgencyNurse @claracluck so how could time b better spent re PU care? #wenurses What emergent practice mig…
@Justdreamingof 11 November 2014 20:29		@PSMJW @WeNurses @SarahChapman30 not always, can be delegated to staff to increase ownership and improve compliance #wenurses
@claracluck 11 November 2014 20:29		@LeggeAngie @WeNurses I'm happy to object but it all comes back to audits and if we've not recorded it we haven't done it!! #wenurses
@HealthUKTD 11 November 2014 20:29		RT @DGFoord: .@WeNurses @TeamClaytonULHT Need evidence of positive benefit, not just lack of evidence of harm IMHO #WeNurses
@Bartontd 11 November 2014 20:29		RT @punc14abaker: The beginning is where you start, never give up #studentnurse #WeNurses http://t.co/VWusbQfD1H
@TeamClaytonULHT 11 November 2014 20:29		@AgencyNurse Agreed. More research needed #WeNurses
@SarahChapman30 11 November 2014 20:30		@gkscott89 @WeNurses @TeamClaytonULHT This was suggested last chat too - helpful to junior nurses? But does that justify it? #wenurses
@gkscott89 11 November 2014 20:30		@stpnottingham @TeamClaytonULHT no reason you cant complete the assessment with the patient and get their input! #WeNurses
@Bartontd 11 November 2014 20:30		@punc14abaker Well said #wenurses
@Jaynebiddiscom1 11 November 2014 20:30		@TheNursePath @AgencyNurse @SarahChapman30 @ShelaghAHP @WeNurses #wenurses Also about informing patients, carers, public of the risk?
@BrooksCarole 11 November 2014 20:30		#wenurses, surely need the tool as evidence that risk assesment has been completed?
@TeamClaytonULHT 11 November 2014 20:30		RT @gkscott89: @stpnottingham @TeamClaytonULHT no reason you cant complete the assessment with the patient and get their input! #WeNurses
@SarahChapman30 11 November 2014 20:30		@TeamClaytonULHT @AgencyNurse Cochrane reviews nearly all contain that plea! #wenurses
@traceyhardy789 11 November 2014 20:30		RT @TeamClaytonULHT: Risk assessment is not harmful, therefore may as well keep it? #WeNurses
@WeNurses 11 November 2014 20:30		GOOD Q @LizAllibone How can we document and audit clinical judgement ? #wenurses
@createyourself9 11 November 2014 20:30		#WeNurses irony is if we accept lack of evidence +NICE and policies in Trusts did change there would still be a form to prove CJ took place
@TeamClaytonULHT 11 November 2014 20:30		@gkscott89 @stpnottingham Good point #WeNurses
@Bartontd 11 November 2014 20:30		RT @gkscott89: @WeNurses @TeamClaytonULHT #WeNurses they can prompt some newer nurses to consider different risks regarding PU... worth kee…
@SarahChapman30 11 November 2014 20:30		RT @WeNurses: GOOD Q @LizAllibone How can we document and audit clinical judgement ? #wenurses
@clarahopscotch 11 November 2014 20:30		@traceyhardy789 I found this a useful skill learnt on a study day. Saves me a lot of time and paperwork! #WeNurses
@AgencyNurse 11 November 2014 20:30		RT @traceyhardy789: Must also differentiate between moisture lesion and PU and assess continence alongside PU risk tool #WeNurses
@WeNurses 11 November 2014 20:30		RT @traceyhardy789: Must also differentiate between moisture lesion and PU and assess continence alongside PU risk tool #WeNurses
@BrooksCarole 11 November 2014 20:30		RT @RuthAshmore: #WeNurses remember health care is both a science and an art
@PSMJW 11 November 2014 20:31		Working in a trust that still gets HAPU at grades 1-3 reg, I would feel very uneasy at simply dropping the tool. #wenurses @SarahChapman30
@stpnottingham 11 November 2014 20:31		@TeamClaytonULHT @gkscott89 empowerment ?? #WeNurses
@TeamClaytonULHT 11 November 2014 20:31		RT @SarahChapman30: @TeamClaytonULHT @AgencyNurse Cochrane reviews nearly all contain that plea! #wenurses
@AgencyNurse 11 November 2014 20:31		RT @BrooksCarole: #wenurses, surely need the tool as evidence that risk assesment has been completed?
@WeNurses 11 November 2014 20:31		RT @BrooksCarole: #wenurses, surely need the tool as evidence that risk assesment has been completed?
@TeamClaytonULHT 11 November 2014 20:31		RT @stpnottingham: @TeamClaytonULHT @gkscott89 empowerment ?? #WeNurses
@AgencyNurse 11 November 2014 20:31		RT @createyourself9: #WeNurses irony is if we accept lack of evidence +NICE and policies in Trusts did change there would still be a form t…
@WeNurses 11 November 2014 20:31		RT @createyourself9: #WeNurses irony is if we accept lack of evidence +NICE and policies in Trusts did change there would still be a form t…
@TeamClaytonULHT 11 November 2014 20:31		RT @traceyhardy789: Must also differentiate between moisture lesion and PU and assess continence alongside PU risk tool #WeNurses
@HealthUKTD 11 November 2014 20:31		RT @traceyhardy789: Must also differentiate between moisture lesion and PU and assess continence alongside PU risk tool #WeNurses
@MrJaniR 11 November 2014 20:31		Sorry to butt in on your pressure ulcer talk #WeNurses but could we do one of these chats later on preventing stress and burnout in HCWs?
@TeamClaytonULHT 11 November 2014 20:31		RT @WeNurses: GOOD Q @LizAllibone How can we document and audit clinical judgement ? #wenurses
@SP_Duckworth 11 November 2014 20:31		@Jaynebiddiscom1 @AgencyNurse @ClarkRichardJ @WeNurses @SarahChapman30 @ShelaghAHP Interventions and assemnts: not evidenced. #wenurses
@SarahChapman30 11 November 2014 20:31		@PSMJW @SarahChapman30 Does it feel safe because you're doing an extra thing (in addition to CJ) - even if not evidence-based? #wenurses
@AgencyNurse 11 November 2014 20:32		@createyourself9 i was just about to tweet the same thing !!! You are right .. we would have to document clinical judgment #wenurses
@MandyHollis3 11 November 2014 20:32		MT @SarahChapman30: Given no reliable evidence that structured risk assessment reduces PU incidence - does anyone not use them? #wenurses
@TeamClaytonULHT 11 November 2014 20:32		RT @ShelaghAHP: @SarahChapman30 @AgencyNurse @claracluck so how could time b better spent re PU care? #wenurses What emergent practice mig…
@LeggeAngie 11 November 2014 20:32		@WeNurses @LizAllibone document variation from guideline and why. Like school - show your thinking #wenurses
@TeamClaytonULHT 11 November 2014 20:32		RT @PSMJW: @sarahchapman #wenurses It's impossible to know how many PUs are prevented which makes evaluating tools/practice so difficult …
@traceyhardy789 11 November 2014 20:32		@TeamClaytonULHT @WeNurses think it's helps to prompt the nurse take action #WeNurses
@Jaynebiddiscom1 11 November 2014 20:32		@gkscott89 @WeNurses #wenurses if we are all using risk assessments, should we not all use same one, then? What do you use?
@PSMJW 11 November 2014 20:32		@WeNurses @TeamClaytonULHT It can be harmful if not used correctly.... #wenurses
@WeNurses 11 November 2014 20:32		RT @PSMJW: Working in a trust that still gets HAPU at grades 1-3 reg, I would feel very uneasy at simply dropping the tool. #wenurses @Sar…
@SKasaven 11 November 2014 20:32		@traceyhardy789 @AgencyNurse agree lots of misdiagnosis re moisture lesions...access to Tissue viability service helps #wenurses
@HealthUKTD 11 November 2014 20:32		RT @BrooksCarole: #wenurses, surely need the tool as evidence that risk assesment has been completed?
@WeNurses 11 November 2014 20:32		RT @LeggeAngie: @WeNurses @LizAllibone document variation from guideline and why. Like school - show your thinking #wenurses
@SarahChapman30 11 November 2014 20:33		RT @LeggeAngie: @WeNurses @LizAllibone document variation from guideline and why. Like school - show your thinking #wenurses
@ShelaghAHP 11 November 2014 20:33		@SarahChapman30 @Libbyextra @AgencyNurse how much time is spent listening 2/learning with carers about PU care/Treat person @ home #wenurses
@PSMJW 11 November 2014 20:33		I have changed my mind about 5 times already.., #wenurses Keen to see some alternative tools other than Waterlow....
@Bartontd 11 November 2014 20:33		RT @createyourself9: #WeNurses irony is if we accept lack of evidence +NICE and policies in Trusts did change there would still be a form t…
@MandyHollis3 11 November 2014 20:33		MT @WeNurses: 2nights discussion is around pressure ulcers & evidence around risk assessments ... with the lovely @SarahChapman30 #wenurses
@TeamClaytonULHT 11 November 2014 20:33		@PSMJW @WeNurses True, underscoring could cause complacency in some #WeNurses
@AgencyNurse 11 November 2014 20:34		@PSMJW you arent the only one .... its a tricky subject !! #wenurses
@TeamClaytonULHT 11 November 2014 20:34		RT @traceyhardy789: @TeamClaytonULHT @WeNurses think it's helps to prompt the nurse take action #WeNurses
@SarahChapman30 11 November 2014 20:34		@LeggeAngie @WeNurses @LizAllibone Seems a lot of this is so nurses are seen to be addressing the risk, whether effective or not? #wenurses
@HealthUKTD 11 November 2014 20:34		RT @createyourself9: #WeNurses irony is if we accept lack of evidence +NICE and policies in Trusts did change there would still be a form t…
@Justdreamingof 11 November 2014 20:35		@WeNurses we fought to be recognised as profession & must base practice on evidence & knowledge. Can't assume everyone has good CJ #wenurses
@gkscott89 11 November 2014 20:35		@Jaynebiddiscom1 @WeNurses #WeNurses I think a standardised tool would be great! Like the NEWS, for repatriating patients it would be ideal!
@LizAllibone 11 November 2014 20:35		@LeggeAngie @WeNurses yes -but if we drop the tool we have to document our use of sound clinical judgment as it will be audited. #WeNurses
@traceyhardy789 11 November 2014 20:35		@WeNurses @TeamClaytonULHT not sure we should have standard ones but risk assessments appropriate for area of work #WeNurses
@TeamClaytonULHT 11 November 2014 20:35		@SarahChapman30 @WeNurses @LeggeAngie @LizAllibone Agreed. Protecting accountability #WeNurses
@AgencyNurse 11 November 2014 20:35		do other professional use all these tools ? How do they document and monitor effective clinical judgement ? #WeNurses @SarahChapman30
@jorycroftmalone 11 November 2014 20:35		@WeNurses @Jaynebiddiscom1 @gkscott89 #WeNurses No! -but assessment needs to be linked to action
@SarahChapman30 11 November 2014 20:36		So am I right in thinking the change in NICE guidance isn't making you feel confident about dropping RA tool? #wenurses
@LeggeAngie 11 November 2014 20:36		@SarahChapman30 @WeNurses @LizAllibone If you don't document variation - how do we know what didn't work? Negative results useful #wenurses
@gkscott89 11 November 2014 20:36		@mccarthy_ph @Jaynebiddiscom1 @WeNurses I agree totally! #WeNurses
@clarahopscotch 11 November 2014 20:36		I've had residents non-compliant with turns/continence care/ bed rest despite risk. Maybe this needs to be taken into account? #WeNurses
@WeNurses 11 November 2014 20:36		RT @SarahChapman30: So am I right in thinking the change in NICE guidance isn't making you feel confident about dropping RA tool? #wenurses
@AgencyNurse 11 November 2014 20:36		RT @SarahChapman30: So am I right in thinking the change in NICE guidance isn't making you feel confident about dropping RA tool? #wenurses
@MandyHollis3 11 November 2014 20:36		RT @Lauren_OT: @SarahChapman30 #wenurses We use Braden - but no risk ax tool does the full job, clinical reasoning must go alongside!
@SarahChapman30 11 November 2014 20:36		Has anyone sought to make a change and been blocked? Or had problems? #wenurses
@TeamClaytonULHT 11 November 2014 20:36		Assessment tools not meaningful to HCSWs who are key players in #PUP #WeNurses
@AFTaylorDN 11 November 2014 20:36		@SarahChapman30 #wenurses We've just moved from Walsall to Braden. Surely tools prompt practice as minim.Is research asking the right Qs?
@jorycroftmalone 11 November 2014 20:36		@WeNurses @PSMJW @SarahChapman30 #WeNurses evidence says it is best to use a risk assessment tool - doesn't really matter which one though!
@AgencyNurse 11 November 2014 20:37		@clarahopscotch yes i have seen the same - and Risk assess says low risk however i know at high risk #wenurses
@esesesse 11 November 2014 20:37		RT @TheNursePath: Open letter to us all. From a grieving woman. #wenurses http://t.co/QTyUFQOqeP
@createyourself9 11 November 2014 20:37		#wenurses Orgs feel safe that assessment has taken place and know who has done it CJ is still too risky Who can do it? Says who? Competence?
@WeNurses 11 November 2014 20:37		RT @SarahChapman30: Has anyone sought to make a change and been blocked? Or had problems? #wenurses
@TeamClaytonULHT 11 November 2014 20:37		@SarahChapman30 @WeNurses If the teaching hospitals led the way I think DGHs would follow suit #WeNurses
@LeggeAngie 11 November 2014 20:37		@LizAllibone @WeNurses why do you have to drop tool to use clinical judgement? Why not use both? #wenurses
@HealthUKTD 11 November 2014 20:37		RT @SarahChapman30: So am I right in thinking the change in NICE guidance isn't making you feel confident about dropping RA tool? #wenurses
@gkscott89 11 November 2014 20:37		@jorycroftmalone @WeNurses @Jaynebiddiscom1 #WeNurses we action our assessments in our careplans using SSKIN which works for our team
@TeamClaytonULHT 11 November 2014 20:37		@mccarthy_ph @Jaynebiddiscom1 @gkscott89 @WeNurses Yes, like NEWs... #WeNurses
@SarahChapman30 11 November 2014 20:37		@AFTaylorDN @SarahChapman30 That's important - good research must ask right questions, measure right outcomes & with right tools #wenurses
@Jaynebiddiscom1 11 November 2014 20:37		@jorycroftmalone @WeNurses @gkscott89 #wenurses yes, and documentation should allow that with ease
@AgencyNurse 11 November 2014 20:38		@SarahChapman30 yes .... pointed clinical workplace at the evidence and they thought that it was too "risky" to change #wenurses
@gkscott89 11 November 2014 20:38		RT @TeamClaytonULHT: Assessment tools not meaningful to HCSWs who are key players in #PUP #WeNurses
@createyourself9 11 November 2014 20:38		@TeamClaytonULHT Thats all about training and down to the leader t(ward/unit mgr) to make them meaningful - if indeed they are …. #WeNurses
@AgencyNurse 11 November 2014 20:38		RT @AFTaylorDN: @SarahChapman30 #wenurses We've just moved from Walsall to Braden. Surely tools prompt practice as minim.Is research asking…
@WeNurses 11 November 2014 20:38		RT @AFTaylorDN: @SarahChapman30 #wenurses We've just moved from Walsall to Braden. Surely tools prompt practice as minim.Is research asking…
@MrsElrick4 11 November 2014 20:38		#wenurses Policies have regular reviews therefore NICE guidelines need to be acknowledged to rid us of PU RAs
@LizAllibone 11 November 2014 20:38		@SarahChapman30 @WeNurses There's a "cover yourself" culture. Many care pathways use waterlow as a standard daily tool. Use both #WeNurses
@AgencyNurse 11 November 2014 20:38		RT @BrooksCarole: @LizAllibone @AgencyNurse @LeggeAngie @WeNurses quite, and how will our judgement be judged? < #wenurses
@TeamClaytonULHT 11 November 2014 20:38		RT @AFTaylorDN: @SarahChapman30 #wenurses We've just moved from Walsall to Braden. Surely tools prompt practice as minim.Is research asking…
@AgencyNurse 11 November 2014 20:39		RT @createyourself9: #wenurses Orgs feel safe that assessment has taken place and know who has done it CJ is still too risky Who can do it?…
@SarahChapman30 11 November 2014 20:39		@LeggeAngie @LizAllibone @WeNurses NICE allows you to use both but takes longer of course #wenurses
@mixed_nats 11 November 2014 20:39		RT @Bartontd: Let your assessment tools guide your practice - not confine your judgement! #wenurses
@gkscott89 11 November 2014 20:39		@TeamClaytonULHT perhapse some sort of training for them so they understamlnd the implications of the assessment during handover #WeNurses
@Bartontd 11 November 2014 20:39		Tools guide professional judgement, by providing data, that enable diagnosis and subsequent therapeutic clinical interventions #wenurses
@traceyhardy789 11 November 2014 20:39		RT @AFTaylorDN: @SarahChapman30 #wenurses We've just moved from Walsall to Braden. Surely tools prompt practice as minim.Is research asking…
@WeNurses 11 November 2014 20:39		RT @SarahChapman30: @LeggeAngie @LizAllibone @WeNurses NICE allows you to use both but takes longer of course #wenurses
@WeNurses 11 November 2014 20:39		RT @McIntyreLyn: @SarahChapman30 #WeNurses I think that there is some confusion over what the NICE guidance is saying? #stopthepressure
@TeamClaytonULHT 11 November 2014 20:39		@createyourself9 Good point - could be incorporated in #PUPCAs @gkscott89? #WeNurses
@McIntyreLyn 11 November 2014 20:39		RT @BrooksCarole: #wenurses, surely need the tool as evidence that risk assesment has been completed?
@HealthUKTD 11 November 2014 20:39		RT @AFTaylorDN: @SarahChapman30 #wenurses We've just moved from Walsall to Braden. Surely tools prompt practice as minim.Is research asking…
@SarahChapman30 11 November 2014 20:40		@WeNurses @McIntyreLyn @SarahChapman30 Can you expand on that please? #wenurses
@TeamClaytonULHT 11 November 2014 20:40		@gkscott89 Lol, just what @createyourself9 said #WeNurses
@nursesmithy 11 November 2014 20:40		#WeNurses are we afraid to over score with tools?
@Bartontd 11 November 2014 20:40		RT @AgencyNurse: RT @BrooksCarole: @LizAllibone @AgencyNurse @LeggeAngie @WeNurses quite, and how will our judgement be judged? < #wenurses
@gkscott89 11 November 2014 20:40		@TeamClaytonULHT i love this idea! Maybe do some short sessions for them when we can #WeNurses
@WeNurses 11 November 2014 20:40		RT @nursesmithy: #WeNurses are we afraid to over score with tools?
@AgencyNurse 11 November 2014 20:40		RT @nursesmithy: #WeNurses are we afraid to over score with tools?
@Justdreamingof 11 November 2014 20:40		@clarahopscotch @WeNurses we have 'skin bundle' for pts at risk & if refuse reposition/cont care documented on bundle so evidence #wenurses
@TeamClaytonULHT 11 November 2014 20:40		RT @gkscott89: @TeamClaytonULHT i love this idea! Maybe do some short sessions for them when we can #WeNurses
@stpnottingham 11 November 2014 20:40		@gkscott89 @mccarthy_ph @Jaynebiddiscom1 @WeNurses can be confusing when pts are transferred from other hospitals using diff RA! #WeNurses
@PSMJW 11 November 2014 20:40		@jorycroftmalone @WeNurses @SarahChapman30 But what's the evidence that the tools are effective? Are we just doing it to doc? #wenurses
@nursingSUni 11 November 2014 20:40		RT @nursesmithy: #WeNurses are we afraid to over score with tools?
@SarahChapman30 11 November 2014 20:40		RT @AgencyNurse: do other professional use all these tools ? How do they document and monitor effective clinical judgement ? #WeNurses @Sar…
@McIntyreLyn 11 November 2014 20:40		RT @AFTaylorDN: @SarahChapman30 #wenurses We've just moved from Walsall to Braden. Surely tools prompt practice as minim.Is research asking…
@TeamClaytonULHT 11 November 2014 20:41		@nursesmithy @WeNurses Our TVNs advocate overscoring if in doubt #WeNurses
@Jaynebiddiscom1 11 November 2014 20:41		@gkscott89 @jorycroftmalone @WeNurses #wenurses yes, we use SSKIN bundle too.
@gkscott89 11 November 2014 20:41		@TeamClaytonULHT @createyourself9 sharing ideas and good practice :) #WeNurses
@MandyHollis3 11 November 2014 20:41		RT @SarahJCoates: @TeamClaytonULHT @WeNurses @SarahChapman30 #wenurses our trust has ditched the Waterlow, we use the EPRAT tool now.
@nursingSUni 11 November 2014 20:41		RT @MandyHollis3: RT @Lauren_OT: @SarahChapman30 #wenurses We use Braden - but no risk ax tool does the full job, clinical reasoning must g…
@PSMJW 11 November 2014 20:41		RT @SarahChapman30: Has anyone sought to make a change and been blocked? Or had problems? #wenurses
@HealthUKTD 11 November 2014 20:41		RT @nursesmithy: #WeNurses are we afraid to over score with tools?
@createyourself9 11 November 2014 20:41		@Justdreamingof @clarahopscotch @WeNurses #wenurses — skin bundle sounds like something from a horror film :-0
@TeamClaytonULHT 11 November 2014 20:41		RT @gkscott89: @TeamClaytonULHT @createyourself9 sharing ideas and good practice :) #WeNurses
@AgencyNurse 11 November 2014 20:41		@nursesmithy maybe not overscore but have certainly revisitied when my clinical judgement says too low #wenurses
@LeggeAngie 11 November 2014 20:41		@LizAllibone @WeNurses what is more important? The patient or the audit? #wenurses
@Lauren_OT 11 November 2014 20:41		@SarahChapman30 I think its a safety net to have a risk ax tool to sit with your reasoning,its the borderline zones that bother me #wenurses
@Justdreamingof 11 November 2014 20:42		@PSMJW @WeNurses @SarahChapman30 no TV nurses in my whole NHS trust! #beingserious #wenurses
@TeamClaytonULHT 11 November 2014 20:42		@gkscott89 @createyourself9 That's the great thing about Twitter and @WeNurses #WeNurses
@WeNurses 11 November 2014 20:42		RT @LeggeAngie: @LizAllibone @WeNurses what is more important? The patient or the audit? #wenurses < GREAT Q !!
@gkscott89 11 November 2014 20:42		@Jaynebiddiscom1 @jorycroftmalone @WeNurses i think this is fantastic, especially when it comes to reassessing patients #WeNurses
@SarahChapman30 11 November 2014 20:42		@PSMJW @jorycroftmalone @WeNurses @SarahChapman30 No reliable evidence that the tools are effective. #wenurses
@Jaynebiddiscom1 11 November 2014 20:42		@stpnottingham @gkscott89 @mccarthy_ph @WeNurses #wenurses oh, wouldn't it be lovely to standardise?
@AgencyNurse 11 November 2014 20:42		@LeggeAngie @LizAllibone @WeNurses i would say the patient ... but surely the audit helps us care for the patients ? #wenurses
@PSMJW 11 November 2014 20:42		@AgencyNurse @SarahChapman30 Some tools are used so rigidly and explicitly they take away the ability to use CJ #wenurses
@nursingSUni 11 November 2014 20:42		RT @SarahChapman30: @WeNurses @McIntyreLyn @SarahChapman30 Can you expand on that please? #wenurses
@SarahChapman30 11 November 2014 20:43		@DGFoord @nursingrahs @SarahChapman30 @WeNurses @Bartontd YES! I used to hate that as student nurse! #wenurses
@TeresaChinn 11 November 2014 20:43		RT @PSMJW: @AgencyNurse @SarahChapman30 Some tools are used so rigidly and explicitly they take away the ability to use CJ #wenurses
@WeNurses 11 November 2014 20:43		RT @PSMJW: @AgencyNurse @SarahChapman30 Some tools are used so rigidly and explicitly they take away the ability to use CJ #wenurses
@TeamClaytonULHT 11 November 2014 20:43		@WeNurses @LeggeAngie @LizAllibone Audits give feedback which improves patient experience? #wenurses (both important?)
@WeNurses 11 November 2014 20:43		RT @TeamClaytonULHT: @WeNurses @LeggeAngie @LizAllibone Audits give feedback which improves patient experience? #wenurses (both important?)
@SarahChapman30 11 November 2014 20:43		@PSMJW @AgencyNurse @SarahChapman30 That's an interesting point #wenurses
@BrooksCarole 11 November 2014 20:43		#wenurses @Lauren_OT @SarahChapman30 can understand that
@sarah_searz 11 November 2014 20:43		RT @SarahChapman30: @PSMJW @jorycroftmalone @WeNurses @SarahChapman30 No reliable evidence that the tools are effective. #wenurses
@gkscott89 11 November 2014 20:43		@Jaynebiddiscom1 @stpnottingham @mccarthy_ph @WeNurses think it would solve some communication issues between trusts on transfer #WeNurses
@SP_Duckworth 11 November 2014 20:43		@ClarkRichardJ @Jaynebiddiscom1 @AgencyNurse @WeNurses @SarahChapman30 @ShelaghAHP No. But we accept the EB paradigm or we don't ..#wenurses
@claracluck 11 November 2014 20:43		@ShelaghAHP @SarahChapman30 @AgencyNurse we need to let experienced staff take the lead and teach junior staff by example!#WeNurses
@Bartontd 11 November 2014 20:43		#Nursing #Medicine are NOT exact sciences that predict with certainty intervention outcomes - tools merely guide prof decisions #wenurses
@traceyhardy789 11 November 2014 20:43		@McIntyreLyn @WeNurses we have a mandatory training session from assessing to reporting to all community nurses #WeNurses
@Jaynebiddiscom1 11 November 2014 20:44		@TeamClaytonULHT @mccarthy_ph @gkscott89 @WeNurses so, do you mean use a numerical score system like NEWS? #wenurses
@LeggeAngie 11 November 2014 20:44		@AgencyNurse @LizAllibone @WeNurses How? The audit just spots where standards are not met #wenurses
@createyourself9 11 November 2014 20:44		@WeNurses @LeggeAngie @LizAllibone #wenurses patient care and safety is the most important and that is measured ++ So whats being measured?
@DGFoord 11 November 2014 20:44		.@DrDKilroy @WeNurses @TeamClaytonULHT That's a good discipline to have! Risk Registers can be hungry beasts #WeNurses
@SP_Duckworth 11 November 2014 20:44		@ClarkRichardJ @Jaynebiddiscom1 @AgencyNurse @WeNurses @SarahChapman30 @ShelaghAHP ... dangers in picking & choosing. #WeNurses
@AgencyNurse 11 November 2014 20:44		@SarahChapman30 @DGFoord @nursingrahs @Bartontd is that whats stopping us from ditching RAs we have always done it this way ? #WeNurses
@TeamClaytonULHT 11 November 2014 20:44		@Jaynebiddiscom1 @mccarthy_ph @gkscott89 @WeNurses No I meant it's a nationwide tool -all using same parameters #wenurses
@PSMJW 11 November 2014 20:44		RT @Justdreamingof: @PSMJW @WeNurses @SarahChapman30 no TV nurses in my whole NHS trust! #beingserious #wenurses
@gkscott89 11 November 2014 20:44		RT @TeamClaytonULHT: @WeNurses @LeggeAngie @LizAllibone Audits give feedback which improves patient experience? #wenurses (both important?)
@nursingSUni 11 November 2014 20:45		“@clarahopscotch: @nursingSUni Definitely. For some it is merely a paper exercise. Although I agree that it can act as a prompt.” #WeNurses
@AgencyNurse 11 November 2014 20:45		@LeggeAngie @LizAllibone @WeNurses and from there surely improvements should be made ? #wenurses
@PSMJW 11 November 2014 20:45		@Justdreamingof @WeNurses @SarahChapman30 I'm dead shocked at that! #wenurses
@McIntyreLyn 11 November 2014 20:45		RT @PSMJW: @AgencyNurse @SarahChapman30 Some tools are used so rigidly and explicitly they take away the ability to use CJ #wenurses
@AgencyNurse 11 November 2014 20:45		@LeggeAngie @LizAllibone @WeNurses (i do think the pt more important but just exploring the audit!!) #wenurses
@TeamClaytonULHT 11 November 2014 20:45		RT @PSMJW: @AgencyNurse @SarahChapman30 Some tools are used so rigidly and explicitly they take away the ability to use CJ #wenurses
@nursingSUni 11 November 2014 20:45		MT @PSMJW: @Justdreamingof @WeNurses @SarahChapman30 Do your ward sisters carry this out?” #WeNurses
@Bartontd 11 November 2014 20:45		Tunnel Vision - look up - assessment tools are simply tools - lets talk about Clinical Decision Making with all that implies #wenurses
@MandyHollis3 11 November 2014 20:45		MT @Bartontd: Tools guide prof judgement, by providing data, that enable diagnosis & subsequent therapeutic clinical interventions #wenurses
@LeggeAngie 11 November 2014 20:46		@AgencyNurse @LizAllibone @WeNurses should be, yes. But ok to put individual care over that where you know it's right #wenurses
@Justdreamingof 11 November 2014 20:46		@createyourself9 @clarahopscotch #WeNurses lol! Seeing on correct mattress/cushion, not soiled, heel pressure reduced, if repositioned & how
@stpnottingham 11 November 2014 20:46		@gkscott89 @Jaynebiddiscom1 @mccarthy_ph @WeNurses totally agree! Helps looking through past documentation #WeNurses
@sarah_searz 11 November 2014 20:46		Training before using the tool, people tick boxes without assessing properly! #wenurses
@Bartontd 11 November 2014 20:46		RT @SarahChapman30: @DGFoord @nursingrahs @SarahChapman30 @WeNurses @Bartontd YES! I used to hate that as student nurse! #wenurses
@AFTaylorDN 11 November 2014 20:46		@traceyhardy789 @WeNurses yes, as do we; pressure relief hot topic in #communitynursing #wenurses
@WeNurses 11 November 2014 20:46		GOOD Q @LizAllibone How can we document and audit clinical judgement ? #wenurses
@SarahChapman30 11 November 2014 20:46		RT @sarah_searz: Training before using the tool, people tick boxes without assessing properly! #wenurses
@nursingSUni 11 November 2014 20:46		#WeNurses @PSMJW: @Justdreamingof @WeNurses @SarahChapman30 Sorry for all the Q's.do you have TV link nurses? With extra level of training?
@LindaKeddie 11 November 2014 20:46		RT @TeamClaytonULHT: Assessment tools not meaningful to HCSWs who are key players in #PUP #WeNurses
@AgencyNurse 11 November 2014 20:46		RT @sarah_searz: Training before using the tool, people tick boxes without assessing properly! #wenurses
@WeNurses 11 November 2014 20:46		RT @sarah_searz: Training before using the tool, people tick boxes without assessing properly! #wenurses
@MandyHollis3 11 November 2014 20:47		RT @PSMJW: @SarahChapman30 Does anyone audit accuracy of assessments? Many I see in RCA are incorrect (underscored) #wenurses good Q
@TeamClaytonULHT 11 November 2014 20:47		@WeNurses @LizAllibone Explain rationale for decisions in care plan? #WeNurses
@SarahChapman30 11 November 2014 20:47		@sarah_searz This is a risk isn't it? #wenurses
@AgencyNurse 11 November 2014 20:47		@sarah_searz i think people assess and tick the boxes because they have to :)) #wenurses
@AgencyNurse 11 November 2014 20:47		RT @TeamClaytonULHT: @WeNurses @LizAllibone Explain rationale for decisions in care plan? #WeNurses
@WeNurses 11 November 2014 20:47		RT @TeamClaytonULHT: @WeNurses @LizAllibone Explain rationale for decisions in care plan? #WeNurses
@caej90 11 November 2014 20:47		@WeNurses Cochrane recently released evidence to show no difference in outcome between RA&CJ #wenurses http://t.co/PsURFpKxPR
@HealthUKTD 11 November 2014 20:47		RT @sarah_searz: Training before using the tool, people tick boxes without assessing properly! #wenurses
@sarah_searz 11 November 2014 20:47		Reassessment just as important,holistic not just looking at skin Also medication and nutrition, nursing/trained assessment, #wenurses
@SarahChapman30 11 November 2014 20:47		RT @CJohnston1903: @WeNurses Cochrane recently released evidence to show no difference in outcome between RA&CJ #wenurses http://t.co/PsURF…
@Lauren_OT 11 November 2014 20:48		RT @WeNurses: GOOD Q @LizAllibone How can we document and audit clinical judgement ? #wenurses
@DGFoord 11 November 2014 20:48		@Bartontd They are arts, which require many 1,000s of hours dedication to become a 'master' at #WeNurses
@nursingSUni 11 November 2014 20:48		#wenurses just added the hashtag to some tweets to make sure they get included @WeNurses #justhelping ????
@WeNurses 11 November 2014 20:48		MT @CJohnston1903: #EBP Cochrane recently released evidence to show no difference in outcome between RA&CJ #wenurses http://t.co/rfuBN1VGfz
@LizAllibone 11 November 2014 20:48		@sarah_searz @WeNurses yes because the box ticking gets audited! #wenurses
@LeggeAngie 11 November 2014 20:48		@WeNurses @LizAllibone no audit. Qualitative review #wenurses
@WeNurses 11 November 2014 20:48		@nursingSUni thank you :D #wenurses
@Bartontd 11 November 2014 20:48		Pressure Ulcers - a "Nursing Diagnosis" - resolved by "Nursing Interventions" - based on Professional "Nursing Evidence" #wenurses
@SarahChapman30 11 November 2014 20:48		In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@BrooksCarole 11 November 2014 20:49		@MandyHollis3 @PSMJW @SarahChapman30 have to agree Mandy #wenurses
@nursingSUni 11 November 2014 20:49		@AgencyNurse @sarah_searz yes but there has to some #accountability to this decision making process #legal document for care? #wenurses
@Justdreamingof 11 November 2014 20:49		@sarah_searz @WeNurses if nurses can't assess or add up using set tool, how can we trust their clinical judgement? #Controversial #wenurses
@AgencyNurse 11 November 2014 20:49		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@WeNurses 11 November 2014 20:49		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@TeresaChinn 11 November 2014 20:49		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@sarah_searz 11 November 2014 20:49		@AgencyNurse they have to? If they tick it they are responsible for the outcome #wenurses
@SarahChapman30 11 November 2014 20:49		Here's the Cochrane review on PU risk assessment tools http://t.co/kpa7wHOiRc #wenurses
@LeggeAngie 11 November 2014 20:49		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@TeamClaytonULHT 11 November 2014 20:49		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@PSMJW 11 November 2014 20:49		@sarah_searz @SarahChapman30 Lack of formal standardised training also means bad habits get handed on as acceptable practice #wenurses
@AgencyNurse 11 November 2014 20:50		@sarah_searz aren't we responsible for the outcome with or without the document though ? #wenurses
@nursingSUni 11 November 2014 20:50		RT @SarahChapman30: Here's the Cochrane review on PU risk assessment tools http://t.co/kpa7wHOiRc #wenurses
@BrooksCarole 11 November 2014 20:50		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@fionaDmurphy 11 November 2014 20:50		RT @WeNurses: MT @CJohnston1903: #EBP Cochrane recently released evidence to show no difference in outcome between RA&CJ #wenurses http://t…
@AgencyNurse 11 November 2014 20:50		RT @SarahChapman30: Here's the Cochrane review on PU risk assessment tools http://t.co/NTI9NypdWi #wenurses #EBP
@WeNurses 11 November 2014 20:50		RT @SarahChapman30: Here's the Cochrane review on PU risk assessment tools http://t.co/oUSgIEkXnZ #wenurses #EBP
@Jaynebiddiscom1 11 November 2014 20:50		@mccarthy_ph @TeamClaytonULHT @gkscott89 @WeNurses #wenurses Yes, talking same lingo is better than having to translate. MUST is universal
@HealthUKTD 11 November 2014 20:50		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@sarah_searz 11 November 2014 20:50		@LizAllibone @WeNurses and audits are about people, and they come first #WeNurses
@nursingSUni 11 November 2014 20:50		RT @sarah_searz: Training before using the tool, people tick boxes without assessing properly! #wenurses
@TeamClaytonULHT 11 November 2014 20:50		RT @Jaynebiddiscom1: @mccarthy_ph @TeamClaytonULHT @gkscott89 @WeNurses #wenurses Yes, talking same lingo is better than having to translat…
@nicolacullum 11 November 2014 20:51		@jorycroftmalone @WeNurses @PSMJW @SarahChapman30 Balzer paper explains why current research approaches won't answer question #WeNurses
@McIntyreLyn 11 November 2014 20:51		@stpnottingham great examples of student nurses getting involved in PU awareness and prevention -such as Lincoln #wenurses #stopthepressure
@SP_Duckworth 11 November 2014 20:51		@AgencyNurse @sarah_searz Nurses as Fordists?! #wenurses
@TeamClaytonULHT 11 November 2014 20:51		RT @WeNurses: RT @SarahChapman30: Here's the Cochrane review on PU risk assessment tools http://t.co/oUSgIEkXnZ #wenurses #EBP
@createyourself9 11 November 2014 20:51		@LizAllibone Does a pilot fill forms during the journey whilst using CJ and decision making? Maybe. CJ such an interesting topic #wenurses
@WeNurses 11 November 2014 20:51		10 mins to go @SarahChapman30 ... how are we going to wrap this up ? Still so many questions ! #wenurses
@ProfJuneG 11 November 2014 20:51		RT @CJohnston1903: @WeNurses Cochrane recently released evidence to show no difference in outcome between RA&CJ #wenurses http://t.co/PsURF…
@sarah_searz 11 November 2014 20:51		@PSMJW @SarahChapman30 then be the change and don't follow the crowd #WeNurses
@nursingSUni 11 November 2014 20:51		RT @AgencyNurse: @sarah_searz aren't we responsible for the outcome with or without the document though ? #wenurses
@McIntyreLyn 11 November 2014 20:51		RT @Jaynebiddiscom1: @TeamClaytonULHT @WeNurses #wenurses I agree the most powerful tool is knowledgeable staff
@McIntyreLyn 11 November 2014 20:51		RT @RuthAshmore: #WeNurses remember health care is both a science and an art
@WeNurses 11 November 2014 20:51		RT @sarah_searz: @LizAllibone @WeNurses and audits are about people, and they come first #WeNurses
@nicolacullum 11 November 2014 20:51		@jorycroftmalone @WeNurses @PSMJW @SarahChapman30 For me a #lightbulbmoment #WeNurses
@Masey_uk 11 November 2014 20:51		RT @SarahChapman30: In case you've not seen it, my blog on #CochraneEvidence on PU risk assessment tools: http://t.co/5FtKJltUGh #wenurses
@SarahChapman30 11 November 2014 20:51		@nicolacullum Hi Nicky - thanks for joining. Please use #wenurses hashtag or most won't see your tweets
@Bartontd 11 November 2014 20:51		Professional Nursing narrative on PUs is so much more than what the data the tools offer & what NICE dictates #wenurses #Devils #Advocate
@nursingSUni 11 November 2014 20:51		RT @McIntyreLyn: @stpnottingham great examples of student nurses getting involved in PU awareness and prevention -such as Lincoln #wenurses…
@sarah_searz 11 November 2014 20:51		@Justdreamingof @WeNurses it states used alongside clinical judgement #WeNurses
@TeamClaytonULHT 11 November 2014 20:51		RT @sarah_searz: @LizAllibone @WeNurses and audits are about people, and they come first #WeNurses
@Drivenbyhealth1 11 November 2014 20:51		RT @ShelaghAHP: @AgencyNurse hi Tree #wenurses keen to learn about an area of healthcare I don't know too much about ...
@nursingSUni 11 November 2014 20:52		RT @WeNurses: 10 mins to go @SarahChapman30 ... how are we going to wrap this up ? Still so many questions ! #wenurses
@stpnottingham 11 November 2014 20:52		RT @RuthAshmore: #WeNurses remember health care is both a science and an art
@nicolacullum 11 November 2014 20:52		@SarahChapman30 Gotcha but I have to go in a minute :( #WeNurses
@SarahChapman30 11 November 2014 20:52		RT @nicolacullum: @jorycroftmalone @WeNurses @PSMJW @SarahChapman30 No evidence tht they make a difference http://t.co/kpa7wHOiRc #wenurses
@Bartontd 11 November 2014 20:52		RT @DGFoord: @Bartontd They are arts, which require many 1,000s of hours dedication to become a 'master' at #WeNurses
@WeNurses 11 November 2014 20:52		RT @Bartontd: Professional Nursing narrative on PUs is so much more than what the data the tools offer & what NICE dictates #wenurses #Devi…
@MandyHollis3 11 November 2014 20:52		Great conversation #wenurses particularly relevant debate in context of growing use of clinical systems
@CarpHardwick 11 November 2014 20:52		RT @CJohnston1903: @WeNurses Cochrane recently released evidence to show no difference in outcome between RA&CJ #wenurses http://t.co/PsURF…
@WeNurses 11 November 2014 20:52		RT @MandyHollis3: Great conversation #wenurses particularly relevant debate in context of growing use of clinical systems
@PSMJW 11 November 2014 20:52		@SarahChapman30 can we ask when Pt's do dev damage, how we investigate? What tools are used to review care? #wenurses
@TeamClaytonULHT 11 November 2014 20:52		@WeNurses @SarahChapman30 Consensus seems to be RA still has a place & function #WeNurses
@LeggeAngie 11 November 2014 20:52		@createyourself9 @LizAllibone do pilots use checklists? Yes. #WeNurses
@Bartontd 11 November 2014 20:52		@DGFoord As always - well said Dave #wenurses
@LizAllibone 11 November 2014 20:52		@WeNurses how would a Trust convince CQC that it used consistent, high standard clinical judgement alone and not a tool? #wenurses
@Jaynebiddiscom1 11 November 2014 20:52		@mccarthy_ph @TeamClaytonULHT @gkscott89 @WeNurses #wenurses so standardised RA plus clinical judgement?
@nicolacullum 11 November 2014 20:52		@Bartontd @WeNurses Interesting - please explain? #WeNurses
@SarahChapman30 11 November 2014 20:52		A reminder to use #wenurses hashtag - just saw we're missing some of your tweets.
@Justdreamingof 11 November 2014 20:52		@PSMJW #WeNurses @SarahChapman30 Yup! My ward staff complete pressure ulcer prevention book. Trust looking at TV role but has been for yrs!!
@sarah_searz 11 November 2014 20:53		@AgencyNurse yes but that why you do it right and assess properly with clinical judgement too #WeNurses
@clarahopscotch 11 November 2014 20:53		@PSMJW @sarah_searz @SarahChapman30 Yes, I'm fed up of having the foam heel dressing argument lately.#WeNurses
@TeamClaytonULHT 11 November 2014 20:53		@Jaynebiddiscom1 @mccarthy_ph @gkscott89 @WeNurses I think so #WeNurses
@TeamClaytonULHT 11 November 2014 20:53		RT @Jaynebiddiscom1: @mccarthy_ph @TeamClaytonULHT @gkscott89 @WeNurses #wenurses so standardised RA plus clinical judgement?
@AgencyNurse 11 November 2014 20:53		@LizAllibone @WeNurses through the quality of care and prevalence (or lack of) pressure ulcers ? #wenurses
@LeggeAngie 11 November 2014 20:53		@LizAllibone @WeNurses incident reporting trend #WeNurses
@traceyhardy789 11 November 2014 20:54		@Bartontd A plumber wouldn't be able to the the job without tools but needs knowledge to fix a tap too.. same for nurses #WeNurses
@AgencyNurse 11 November 2014 20:54		@sarah_searz its tricky isn't it ... really not sure !! #wenurses
@nicolacullum 11 November 2014 20:54		@LizAllibone @WeNurses Presumably profs would have to demonstrate were not negligent given a patient's circs and condition #WeNurses
@LeggeAngie 11 November 2014 20:54		@LizAllibone @WeNurses but not convinced good idea to stop tool. Use both. #wenurses
@SarahChapman30 11 November 2014 20:54		@clarahopscotch @PSMJW @sarah_searz @SarahChapman30 I'll be blogging #CochraneEvidence on such matters soon! #wenurses
@PSMJW 11 November 2014 20:54		@clarahopscotch @sarah_searz @SarahChapman30 Yes! Same. We have so many bilateral heels.... And increase in device related #wenurses
@sarah_searz 11 November 2014 20:54		@clarahopscotch @PSMJW @SarahChapman30 that it relieves pressure? Old wives tale #WeNurses
@caej90 11 November 2014 20:54		@SarahChapman30 sorry! Always guilty of this #wenurses
@DGFoord 11 November 2014 20:54		.@WeNurses @LizAllibone I recall rather good #WeNurses chat on clinical judgement with @Toribird79 & @Becky_Whiteman http://t.co/Vp4WB6rZro
@sarah_searz 11 November 2014 20:54		RT @SarahChapman30: @clarahopscotch @PSMJW @sarah_searz @SarahChapman30 I'll be blogging #CochraneEvidence on such matters soon! #wenurses
@AgencyNurse 11 November 2014 20:55		RT @DGFoord: .@WeNurses @LizAllibone I recall rather good #WeNurses chat on clinical judgement with @Toribird79 & @Becky_Whiteman http://t.…
@WeNurses 11 November 2014 20:55		RT @DGFoord: .@WeNurses @LizAllibone I recall rather good #WeNurses chat on clinical judgement with @Toribird79 & @Becky_Whiteman http://t.…
@nicolacullum 11 November 2014 20:55		@LizAllibone @WeNurses Evidence of logical documented assessments of risk #WeNurses
@Bartontd 11 November 2014 20:55		@nicolacullum @WeNurses There is a discussion on Prof Clinical judgement to be had here - not Nurses simply following algorithms #wenurses
@Justdreamingof 11 November 2014 20:55		@sarah_searz @WeNurses 110% use of both tool + CJ as together give best assessment, if tools say low risk but CJ high, go with CJ #wenurses
@SKasaven 11 November 2014 20:55		“@sarah_searz: Reassessment just as important,holistic not just looking at skin,medication &nutrition ....&continence..well said #wenurses
@SarahChapman30 11 November 2014 20:55		Fantastic chat and only 5 minutes left! #wenurses
@WeNurses 11 November 2014 20:55		well, we all got there, tricky we know when your fingers just want to fit it all in! #WeNurses http://t.co/MgpDC9EKaL
@createyourself9 11 November 2014 20:55		@Bartontd @nicolacullum @WeNurses Has this been done already? #WeNurses
@WeNurses 11 November 2014 20:55		RT @nicolacullum: @LizAllibone @WeNurses Evidence of logical documented assessments of risk #WeNurses
@SarahChapman30 11 November 2014 20:56		So is anyone rethinking their use of PU RA tools in the light of tonight's chat? #wenurses
@McIntyreLyn 11 November 2014 20:56		RT @WeNurses: 11 mins klaxon Tonights #WeNurses starts at 8pm Pressure ulcer evidence http://t.co/R3hH6DkxQ8
@AgencyNurse 11 November 2014 20:56		RT @SarahChapman30: So is anyone rethinking their use of PU RA tools in the light of tonight's chat? #wenurses
@WeNurses 11 November 2014 20:56		RT @SarahChapman30: So is anyone rethinking their use of PU RA tools in the light of tonight's chat? #wenurses
@McIntyreLyn 11 November 2014 20:56		RT @SarahChapman30: Nearly time for our @WeNurses Tweetchat on #pressureulcer prevention http://t.co/rXh4FbiEGu #wenurses
@nicolacullum 11 November 2014 20:56		@Bartontd @WeNurses Completely agree #WeNurses
@DionneDaniel5 11 November 2014 20:56		RT @Bartontd: Professional Nursing narrative on PUs is so much more than what the data the tools offer & what NICE dictates #wenurses #Devi…
@DionneDaniel5 11 November 2014 20:56		RT @sarah_searz: @LizAllibone @WeNurses and audits are about people, and they come first #WeNurses
@SarahChapman30 11 November 2014 20:56		RT @Bartontd: Professional Nursing narrative on PUs is so much more than what the data the tools offer & what NICE dictates #wenurses #Devi…
@Bartontd 11 November 2014 20:56		@traceyhardy789 Well said - tasks, skill, knowledge, experience #wenurses
@WeNurses 11 November 2014 20:56		RT @Bartontd: @traceyhardy789 Well said - tasks, skill, knowledge, experience #wenurses
@clarahopscotch 11 November 2014 20:57		@SarahChapman30 Brilliant! Look forward to it :) #WeNurses
@TeamClaytonULHT 11 November 2014 20:57		@CJohnston1903 @Bartontd Docs have little knowledge of #PU - nurses domain. More education needed at med school? #WeNurses
@DionneDaniel5 11 November 2014 20:57		RT @WeNurses: MT @CJohnston1903: #EBP Cochrane recently released evidence to show no difference in outcome between RA&CJ #wenurses http://t…
@Bartontd 11 November 2014 20:57		RT @createyourself9: @Bartontd @nicolacullum @WeNurses Has this been done already? #WeNurses
@WeNurses 11 November 2014 20:57		with 3 mins left - what are your take away points ? #wenurses
@HealthUKTD 11 November 2014 20:57		RT @SarahChapman30: So is anyone rethinking their use of PU RA tools in the light of tonight's chat? #wenurses
@AgencyNurse 11 November 2014 20:57		RT @WeNurses: with 3 mins left - what are your take away points ? #wenurses
@SarahChapman30 11 November 2014 20:58		RT @WeNurses: with 3 mins left - what are your take away points ? #wenurses
@nicolacullum 11 November 2014 20:58		Key issue has to be regular and frequent assessment of skin and tissue in pressure areas @WeNurses @SarahChapman30 #WeNurses @Bartontd
@Bartontd 11 November 2014 20:58		@createyourself9 @nicolacullum @WeNurses Almost certainly :o) #wenurses
@McIntyreLyn 11 November 2014 20:58		@MandyHollis3 excellent discussion - the hour goes so quick. Thank you Sarah and We Nurses #WeNurses #stopthepressure
@WeNurses 11 November 2014 20:58		RT @McIntyreLyn: @MandyHollis3 excellent discussion - the hour goes so quick. Thank you Sarah and We Nurses #WeNurses #stopthepressure
@McIntyreLyn 11 November 2014 20:58		RT @sarah_searz: @LizAllibone @WeNurses and audits are about people, and they come first #WeNurses
@ShelaghAHP 11 November 2014 20:58		@SarahChapman30 what one change would you wish your nursing colleagues to make re PU care? #wenurses
@nicolacullum 11 November 2014 20:58		@WeNurses @SarahChapman30 @Bartontd How are tissues responding to pressure? Are we happy? #WeNurses
@createyourself9 11 November 2014 20:58		@clarahopscotch @SarahChapman30 Clinical judgement is an amazingly interesting and complex topic - would be great chat! #WeNurses
@TeamClaytonULHT 11 November 2014 20:58		@WeNurses Nationwide standardised risk assessment + clinical judgement #WeNurses
@McIntyreLyn 11 November 2014 20:58		RT @SarahChapman30: Fantastic chat and only 5 minutes left! #wenurses
@LizAllibone 11 November 2014 20:58		@SarahChapman30 @WeNurses thanks Sarah & YES! I'll pass this on to my new Clinical Nurse Educator Network @NurseEdUK #WeNurses great debate
@mccarthy_ph 11 November 2014 20:58		Great debate #WeNurses thank you! Now back to my holiday :)
@stpnottingham 11 November 2014 20:58		@TeamClaytonULHT @CJohnston1903 @Bartontd could make it mdt training? Help communication skills and reduce barriers #wenurses
@TeamClaytonULHT 11 November 2014 20:58		RT @mccarthy_ph: Great debate #WeNurses thank you! Now back to my holiday :)
@SarahChapman30 11 November 2014 20:58		@mccarthy_ph Enjoy! Thanks for joining us #wenurses
@clarahopscotch 11 November 2014 20:58		@SarahChapman30 I'm definitely going to bring it up in my next supervision. #WeNurses
@nursingSUni 11 November 2014 20:58		RT @nicolacullum: @Bartontd @WeNurses Completely agree #WeNurses
@WeNurses 11 November 2014 20:59		@mccarthy_ph eek yes ... and enjoy :D #wenurses
@WeNurses 11 November 2014 20:59		DON'T FORGET - U can now add your own summary,reflection with more than 140 characters in #wenurses Postchat comments http://t.co/gZ42Ky9ARs
@nursingSUni 11 November 2014 20:59		RT @McIntyreLyn: @MandyHollis3 excellent discussion - the hour goes so quick. Thank you Sarah and We Nurses #WeNurses #stopthepressure
@traceyhardy789 11 November 2014 20:59		RT @Bartontd: @traceyhardy789 Well said - tasks, skill, knowledge, experience #wenurses
@PSMJW 11 November 2014 20:59		RT @McIntyreLyn: @MandyHollis3 excellent discussion - the hour goes so quick. Thank you Sarah and We Nurses #WeNurses #stopthepressure
@claracluck 11 November 2014 20:59		@SarahChapman30 @WeNurses will def challenge more,esp younger one off visits,utter madness being exp'td to complete MUST,Waterlow!#wenurses
@WeNurses 11 November 2014 20:59		DONT FORGET We are continuing the pressure ulcer theme for Thursdays #WeNurses http://t.co/l4xhwrZqrt http://t.co/ALczzlYEx6
@SarahChapman30 11 November 2014 20:59		@clarahopscotch @SarahChapman30 That's great - let us know what response you get #wenurses
@SarahChapman30 11 November 2014 20:59		RT @WeNurses: DONT FORGET We are continuing the pressure ulcer theme for Thursdays #WeNurses http://t.co/l4xhwrZqrt http://t.co/ALczzlYE…
@AgencyNurse 11 November 2014 20:59		RT @TeamClaytonULHT: @WeNurses Nationwide standardised risk assessment + clinical judgement #WeNurses
@McIntyreLyn 11 November 2014 20:59		RT @sarah_searz: @AgencyNurse yes but that why you do it right and assess properly with clinical judgement too #WeNurses
@WeNurses 11 November 2014 20:59		RT @TeamClaytonULHT: @WeNurses Nationwide standardised risk assessment + clinical judgement #WeNurses
@TeamClaytonULHT 11 November 2014 20:59		@stpnottingham @CJohnston1903 @Bartontd Good point - #PUPCAs for all clincial staff? #WeNurses
@nursingSUni 11 November 2014 20:59		RT @Bartontd: @traceyhardy789 Well said - tasks, skill, knowledge, experience #wenurses
@sarah_searz 11 November 2014 20:59		Share your knowledge, don't be the tick box person that copies yesterday's, use your clinical judgement and tool #wenurses
@AgencyNurse 11 November 2014 20:59		RT @WeNurses: DON'T FORGET - U can now add your own summary,reflection with more than 140 characters in #wenurses Postchat comments http://…
@createyourself9 11 November 2014 20:59		#wenurses WE are still developing, we need to push for CJ with prof status and urge Trusts to evaluate the evidence behind their RA in use
@nursingSUni 11 November 2014 20:59		RT @WeNurses: well, we all got there, tricky we know when your fingers just want to fit it all in! #WeNurses http://t.co/MgpDC9EKaL
@nicolacullum 11 November 2014 20:59		@LizAllibone @SarahChapman30 @WeNurses @NurseEdUK loved it thanks everyone! xx #WeNurses
@SarahChapman30 11 November 2014 20:59		I'll be blogging more #CochraneEvidence on pressure ulcer management this Thursday on http://t.co/Bwyi6wKM1k #wenurses
@caej90 11 November 2014 20:59		@TeamClaytonULHT @Bartontd altho I was asked about mattress choice recently by Cons (had already seen to it!) was nice to hear! #wenurses

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