The early returns are promising. Vanderbilt has lowered its 7% inci-
dence of OR-acquired PIs for the prone position in 2015 to less than
1%, says Ms. Haggard.
"If I had to pick one PI prevention area that's often overlooked, it's
the moisture component," she says. "We know moisture makes skin
less tolerant and can increase PI risk. In the OR, perspiration,
drainage or saliva in the prone patient are often overlooked as con-
tributing factors."
A good streak
The perioperative areas at Dartmouth Hitchcock Medical Center in
Lebanon, N.H., recently went 10 months with no PIs. Megan Miller,
MSN, APRN, AGACNP-BC, CWON, of the department of wound care
services, outlines the keys to their success.
It started with a renewed focused on pre-op skin assessments, with
preventative dressings applied based on surgery type. In the OR, they
standardized support surfaces and replaced them at regular intervals.
They equipped tables with a better offloading surface while not inter-
fering with operations. They charged anesthesia with adjusting the
position of the patient's head. And in PACU, the focus
There's this idea that PIs aren't an issue in the
outpatient world. I think that's because the
patient is in and out in under a day, and the
center often never sees that patient again.
They largely aren't aware of subsequent PIs.
— Heather Kooiker, MSN, RN, CNL, CRNFA
