patient's EMR, and
verbally communicate
and document skin
assessments at hand-
offs throughout the
surgical process, says
Ms. Kooiker. They can
send electronic Best
Practice Alerts to
inpatient nurses
regarding the patient's
PI risk. In addition,
they perform dual-
nurse skin assessments upon transfers of care, says Ms. Kooiker.
The hospital's outpatient surgical center also participates in the safe
skin initiative. "There's this idea out there that PIs aren't an issue in
the outpatient world, but knowing what we know, and knowing sur-
geries in outpatient centers can still be complex, lengthy and stressful
for the patient's body, we feel it's really important for our program to
be implemented both at our inpatient and outpatient ORs," says Ms.
Kooiker.
Focus on the prone position
In 2013, Vanderbilt University Medical Center in Nashville, Tenn.,
implemented a practice change to address PIs that developed in surgi-
cal patients who were in the prone position, particularly in specialties
that were high areas of prevalence for PIs: neurology, ortho, spine and
cardiac. Candi Haggard, RN, CWOCN, a wound, ostomy and conti-
nence nurse, explains why they focused on the prone position:
• nationally, PIs related to the prone position in surgery are at 36%;
A U G U S T 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 4 5
• DRESS UP Preventing pressure injuries during surgery requires a careful applica-
tion of protective materials, as well as precise patient positioning, by the OR team.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
