than in other published work. Furthermore it illustrates that with research based equipmenmt choice it is possible to re­duce both costs and incidence of pressure sores.

References 1. Department of Health. Pressure sores, a key quality indica

tor: a guide for NHS purchasers and providers. London: The Department, 1993.

2. Malone C. Intensive pressures. Nursing Times 1992; 88(36): 57-64.

3. Diamond B. Pressure sores; a case to answer. British Jour­nal of Nursing 1994;3(4): 721-727.

4. West P, Priestly J. Money under the mattress. Health Serv­ice Joumal1994;14 April: 20-23.

5. Young J, Cotter D. Pressure sores; do mattresses work? Lancet 1990; 336:182-183.

6. James H. Evaluating the success of a pressure sore preven tion policy. In: Harding KG, Dealey C, Cherry G, Gottrup F, editors. London: Macmillan Magazines Ltd, 1994.

7. Bliss M, Thomas J. An investigative approach. An over­view of randomised trials of alternating pressure supports. Professional Nurse 1993; 8(7): 437-444.

Journal of Tissue Viability Vol6 No 2 45

8. Gebhardt K, Bliss M. A randomised controlled trial of al­ternating pressure mattresses and constant low pressure sup­ports in the intensive care unit. Clinical Science 1994;86 (Supp 30):39.

9. Barker D, Rose G. Epidemiology in medical practice, 2nd ed. Oxford: Churchill Livingstone, 1988,48.

10. City and Hackney Health Authority. Pressure sore preven tion policy. London: Royal Hospitals Trust, 1992.

11. David JA, Chapman RG, Chapman EJ, et al. An investiga­tion of current methods used in nursing for the care of patients with established sores. Harrow: Nursing Practice Research Unit, 1983.

12. Hunt J. Application of a pressure area risk calculator in an intensive care unit. Intensive and Critical Care Nursing 1993; 9: 226-231.

13. Clough N. The cost of pressure area care in an intensive care unit. In: Harding KG, Dealey C, Cherry G, Gottrup F, editors. London: Macmillan Magazines Ltd, 1994.

14. Hibbs P. The economics of pressure sore prevention. In: D Bader, editor. Pressure sores; clinical practice and scien­tific approach. London: Macmillan, 1990.

PROFESSIONAL ROLES

A PRESSURE RELIEVING EQUIPMENT MANAGER

The job of equipment and audit assistant combines two dis­tinct but connected roles - of pressure relieving equipment (PRE) manager and audit data collector. The primary role of the PRE manager is the delivery of pressure relieving mat­tresses from a central store to the patient's bedside on request of ward staff, who have the responsibility of assessing pres­sure sore risk. Depending on the weight of the patient, I either provide an alternating pressure overlay (under 17 stone) or a mattress replacement (17 stone and over). We aim to deliver equipment within two hours of request. When I leave at the end of the day, I hand over to the bed managers who subse­quently hand over these duties to the night practitioners. I work between 0800 and 2600 hours.

Currently I am assessing a number of different makes of PRE with the ultimate aim of selecting the most robust, easy to use, reliable and cost-effective models. Having made the selec­tion, we hope to standardise on it to simply administration, teaching and maintenance.

My other duties involve making a daily round of all equip­ment in use on the wards to ensure that it is functioning cor­rectly (often to ensure that it is plugged in and switched on!) I correct any faults that I can and replace the equipment if it needs repair. I liaise with the Department of Medical physics regarding maintenance and repair of the equipment and I am on call to the ward staff to assist with any problems they may be experiencing with PRE equipment. All the equipment is sterilised and maintained every three months, and it is my job to ensure that mattresses and overlays are taken out of service at the right time to make this possible.

To facilitate tracking, all equipment has a unique number and I keep a record of where each piece of equipment is at any moment. I also have a record of the last time each piece of equipment was sterilised and maintained. An ongoing record of all mechanical breakdowns and examples of poor equip­ment management is kept. This helps in assessing mechanical reliability of PRE equipment and suggests areas for staff edu­cation.

The other side of my job, that of audit collector, involves col­lating data supplied by wards on a weekly basis about the ex­istence, origin, anatomical location and grade of pressure sores. I then abstract this data for monthly and annual pressure sore incidence reports for the St George's NHS Trust, according to a method described previously!.

This is a very new post and the workload is expanding rapidly as staff are increasingly aware that pressure relieving equip­ment can be obtained readily and easily. Also, as awareness is increased, staff are beginning to notice malfunctions more of­ten and are increasingly calling me to deal out to deal with breakdowns. As my own knowledge in this field increases, so it becomes possible to increase patient comfort in imaginative ways and to help clinical staff prevent more pressure sores.

References 1. St Clair M, Cooper S, Gebhardt KS. Measuring pressure sore incidence: a study. Nursing Standard, 1995;95(19): 50-51.

Address for correspondence J Hookway, Equipment and Audit Assistant, Ground Floor, St Jame's wing, StGeorge's Hospital, Blackshaw Road, London SW17 OQT.