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P A T I E N T
P O S I T I O N I N G
stay and needlessly drive up healthcare costs. They're painful, can be
disfiguring and lower patient satisfaction scores, which could lead to
increased litigation and a negative impact on your facility's reputation.
Help protect patients — and your rep — from skin-related harm with
these important tenets of patient positioning.
Richard Berger, MD
1. Grasp the significance
Stakes are high when it comes to positioning patients properly.
Surgical departments account for 42% of all hospital-acquired pressure
ulcers, which are becoming more of an issue in the operative setting
because we're treating a greater percentage of older patients, people
are living longer with chronic illnesses, and more data and regulatory
changes are making us more aware of skin-related issues and injuries.
Treatment of a single pressure ulcer can cost $3,000 to $30,000, so pay
close attention to risk factors and educate staff on ways to position
patients properly to lower your pressure ulcer rate. (My hospital did,
and dropped our incidence per 100 procedures from 1.51 in 2009 to
0.22 in 2012.) Also keep in mind that pressure ulcers are key clinical
indicators of the standard and effectiveness of care. In fact, CMS considers stage III and IV ulcers "never events."
2. Define the problems
A pressure ulcer is a localized injury to the skin or underlying tissue,
usually occurring over a bony prominence as a result of pressure and
often in combination with shear force and friction, according to the
National Pressure Ulcer Advisory Panel (NPUAP).
Pressure injuries often develop when soft tissue is compressed
more than 32mmHg between a bony prominence and an external surface such as a surgical table mattress, medical device or piece of
equipment, all of which can interfere with capillary blood pressure in
J U N E 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
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