A Change in Focus: Shifting From Treatment to Prevention of Perioperative Pressure Injuries

AORN J. 2019 Oct;110(4):379-393. doi: 10.1002/aorn.12806.

Abstract

Hospital-acquired pressure injuries are a patient safety concern and can be costly for health care organizations. A multidisciplinary team of senior leaders, managers, nurses, and educators from departments that care for perioperative patients created an evidence-based perioperative pressure injury prevention bundle that includes skin and risk assessments, visual and electronic health record cues, prophylactic protection of at-risk skin, communication among providers and leaders regarding patient risk and injury throughout hospitalization, staff member education, compliance audits, root cause analyses, and wound care team follow-up. The prevention bundle resulted in a 50% reduction in perioperative pressure injuries the first calendar year after implementation and a zero-incidence rate for perioperative pressure injuries for at least a two-year period. This article discusses hospital-acquired pressure injuries related to the perioperative setting and outlines the full perioperative pressure injury prevention bundle.

Keywords: fluidized positioner; hospital-acquired pressure injury (HAPI); perioperative pressure injury; prevention bundle; prophylactic dressing.

MeSH terms

  • Humans
  • Iatrogenic Disease / epidemiology
  • Iatrogenic Disease / prevention & control
  • Patient Care Bundles
  • Perioperative Period / methods
  • Perioperative Period / standards*
  • Perioperative Period / trends
  • Pressure Ulcer / etiology
  • Pressure Ulcer / prevention & control
  • Pressure Ulcer / therapy*
  • Risk Assessment / methods
  • Risk Factors