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The purpose of this project is to decrease Hospital-acquired pressure ulcers (HAPU) rates in prone surgical cases greater than 4 hours by using 5-layer soft silicone foam dressing.
Objective/Relevance/Significance
HAPU are a patient safety issue.1 In the US, national estimates of the incidence of HAPU in surgical patients is reported as high as 66%.2,3 Prone surgical cases completed in a mid-west tertiary academic medical center main OR between 11/09-02/10 showed an incidence of 28% . The sites of injuries were on the chin, chest, breast, iliac crest and/or thighs. Injuries ranged from blanchable erythema to deep tissue injury.
Strategy and Implementation
There is a lack of evidence-based practices available to prevent HAPU in OR patients so an interdisciplinary OR HAPU prevention workgroup was formed. Recommendations and funding were made for the following interventions to prevent OR related injuries:
- Application of five-layer soft silicone foam dressing to the iliac crests, chest, chin, and forehead for prone surgical cases.
- Acquisition of additional positioning devices to provide for improved weight/pressure distribution.
- Standardized educational content required for all OR staff involved in implementing prevention interventions for patients.
- Consultation of the Wound/Ostomy service for all skin injuries.
Evaluation
Plan is to continue to monitor for the reduction of HAPU in the prone cases at UIHC. Data will be obtained via chart abstraction, incident reports of HAPU and Wound/Ostomy consultation review.