zero patient harm. Here's what you can do to help make that happen.
1. Identify opportunities for improvement
How do your positioning protocols compare with evidence-based
practices? Note your facility's pressure injury rate, the percentage of
patients who are considered high risk for pressure injuries and
observe your staff in action.
Develop an evidence-based checklist for patient positioning and
make sure all staff follow the steps consistently. Set aside time to edu-
cate your staff about preventing pressure injuries based on proven
standards of care that are comprehensive, current and clear — your
staff should have documented annual competencies for pressure
injury prevention.
Gather a team of representatives from each perioperative care area
to discuss how your team can collaborate to protect patients. Here's a
neat idea: Ask every person at the meeting to jot down her one great
idea for preventing pressure injuries on a sticky note. Stick the notes
on a whiteboard or wall, and then discuss the merits and practicality
of each one. You'll get some great ideas.
2. Perform skin assessments
Efforts to prevent pressure injuries in the OR begin in pre-op, where
nurses should perform skin assessments on every patient (see "Look
for These 3 Pressure Injury Risk Factors"). Some nurses wonder why
they have to examine patients who aren't high risk or who are sched-
uled for relatively brief procedures, but all anesthetized patients can
suffer skin injuries as they lie on the OR table. Keep in mind that
patients are lying down during pre-op assessments, anesthesia induc-
tion and recovery in the PACU, so the potential for harm is not limited
to the time it takes to perform the actual surgery.
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