Outpatient Surgery Magazine

Special Edition: Staff & Patient Safety - October 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 31 of 43

protocols for treatment of Stage 1 and 2 pressure injuries, as well as a wound care consult service to respond in the event of a more severe injury. If none exist, document that their skin was normal. 6. Educate your staff Hard data for inpatient hospital stays shows that approximately 35% of hospital-acquired pressure injuries begin on the OR table. We know this because pressure injuries typically become visible about 72 hours after they're caused, and we can track where the hospitalized patients were three days before the wound became apparent. No such data exists for outpatient surgery because patients are home before a wound is noticeable. In both are- nas, however, many OR teams have very little idea that pressure injuries can start in the OR. If this is the case in your facility, have wound- care specialists show cases of pressure injuries — complete with medical records and photos — to the OR team. Highlight for staff how these injuries are linked directly to the OR. Consider developing OR- specific educational tools that include these case studies, as well as prevention strategies. Be sure to equip your surgical team with skin- safe equipment such as mattress pads for your OR tables and patient positioning devices. 7. Follow the standards There are national guidelines for pressure injury prevention — and these guidelines should be fol- lowed to the letter. A copy of these recently updat- ed evidence-based practices is available from the 3 2 • S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 2 0 National Pressure Injury Advisory Panel (npiap.com). Several years ago, the Wound, Ostomy and Continence Nurses Society (WOCN) began collaborating with the Association of periOperative Registered Nurses (AORN) to high- light and bring awareness of pressure injuries occurring in the OR. This collaboration resonated with AORN and, as a result, its published guidelines now include preventing pressure injuries as an addi- tional reason to position patients properly. All trust- ed, relevant organizations are now following suit because everyone recognizes that most pressure injuries are preventable and that many happen as a result of inappropriate practices. Following national guidelines is one sure way to prevent hospital- acquired pressure injuries. An unacceptable outcome Pressure injuries are a patient-safety issue, a quali- ty-of-care issue and a patient-satisfaction issue — and the majority of them are largely avoidable. We never want anyone who was under our care to leave in worse shape than when they came in. It took three months for the buttocks wound on the woman who underwent the jaw surgery to heal. As caregivers, it's simply unacceptable to prolong unnecessary pain and suffering like that. It's horren- dous for the patient and exposes the facility to a potentially costly legal entanglement. OSM Ms. Creehan (sue.creehan@live.com) is an independ- ent wound nurse consultant and the former program manager of the Virginia Commonwealth University Health Wound Care Team in Richmond, Va. DEVICE DAMAGE Poorly placed items can cause pressure injuries as easily as poor positioning. In this case, a blanket placed under a child in the prone position resulted in a chest injury.

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