A Nurse-Initiated Perioperative Pressure Injury Risk Assessment and Prevention Protocol

AORN J. 2016 Dec;104(6):554-565. doi: 10.1016/j.aorn.2016.10.004.

Abstract

Pressure injuries negatively affect patients physically, emotionally, and economically. Studies report that pressure injuries occur in 69% of inpatients who have undergone a surgical procedure while hospitalized. In 2012, we created a nurse-initiated, perioperative pressure injury risk assessment measure for our midwestern, urban, adult teaching hospital. We retrospectively applied the risk assessment to a random sample of 350 surgical patients which validated the measure. The prospective use of the risk assessment and prevention measures in 350 surgical patients resulted in a 60% reduction in pressure injuries compared with the retrospective group. Our findings support the use of a multipronged approach for the prevention of health care-associated pressure injuries in the surgical population, which includes assessment of risk, implementation of evidence-based prevention interventions for at-risk patients, and continuation of prevention beyond the perioperative setting to the nursing care unit.

Keywords: health care–associated pressure injury (HAPI); pressure injury; risk assessment; risk indicators.

Publication types

  • Validation Study

MeSH terms

  • Aged
  • Evidence-Based Nursing
  • Hospitals, Teaching
  • Humans
  • Middle Aged
  • Postoperative Complications / etiology*
  • Postoperative Complications / nursing
  • Postoperative Complications / prevention & control*
  • Practice Patterns, Nurses'*
  • Pressure Ulcer / etiology*
  • Pressure Ulcer / nursing
  • Pressure Ulcer / prevention & control*
  • Prospective Studies
  • Retrospective Studies
  • Risk Assessment*