Tissue Viability Nurse

Tissue Viability Nurses (TVNs) are specialist nurses who manage complex wounds and lead pressure ulcer prevention programmes across NHS trusts and community services. Your clinical work includes assessment and management of complex chronic wounds — pressure ulcers, leg ulcers (venous, arterial, mixed, and diabetic), surgical wounds with complications, fungating tumours, fistulae, and burns. You apply evidence-based wound management protocols, select appropriate dressings and wound care products, perform or supervise debridement, manage wound infection, and prescribe wound care treatments (with V300 prescribing qualification).

Beyond direct patient care, TVNs lead trust-wide pressure ulcer prevention programmes — conducting root cause analyses of hospital-acquired pressure ulcers, training nursing and healthcare assistant staff in pressure ulcer risk assessment (using tools such as Waterlow or SSKIN), and reporting on organisational pressure ulcer rates as a patient safety metric. You advise on pressure-relieving equipment, tissue viability care pathways, and interface with NHS procurement on wound care products. Community TVNs provide specialist wound clinics and home visit advice, supporting community and district nurses managing complex leg ulcer and wound patients. Senior TVNs hold strategic roles in patient safety and quality improvement.

Pressure ulcers are a key NHS patient safety indicator, and NHS trusts are subject to CQC inspection and NHS England reporting requirements on hospital-acquired pressure ulcer rates. The financial cost of pressure ulcers to the NHS — estimated at over £3 billion annually — ensures sustained institutional investment in TVN services. An ageing population with increasing rates of diabetes, vascular disease, obesity, and immobility creates a growing caseload of patients requiring specialist wound management.

NMC registration and the specialist clinical knowledge required to manage complex wounds — wound bed preparation science, compression bandaging, debridement techniques, microbiological assessment — create a protected professional expertise. NHS trusts cannot manage without TVN oversight of wound care quality and patient safety reporting. The role is predominantly NHS-employed but experienced TVNs also find roles in commercial wound care, medical device companies, and independent wound care clinics.

Morning: ward referral round on surgical and orthopaedic wards — assessing a grade 3 hospital-acquired pressure ulcer on a post-operative patient, photographing, staging, and documenting; recommending a dressing change protocol and reviewing the pressure-relieving mattress. Train a junior nurse on moisture-associated skin damage (MASD) recognition. Afternoon: community wound clinic — reviewing six patients with complex leg ulcers, performing Doppler ABPI assessment on a new patient to establish compression suitability, and adjusting compression regimes. Complete a root cause analysis report for a grade 4 pressure ulcer incident.