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N O V E M B E R 2 0 1 4 | O U T P AT 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
new tools he had worked with before.
5
Standardize skin assessments
While some of our surgical staff proactively checked before
and after surgery for any signs of a pressure ulcer, others did
so inconsistently. We set out to standardize assessment and documen-
tation of skin issues in preadmission testing and intraoperatively.
We've set up a process that ensures that skin is assessed before, dur-
ing and after surgery. Once we position a patient for surgery, staff
checks the patient's skin again to see if there is anything unusual
(they document any sign of a possible skin injury). During surgery,
especially longer procedures, nurses will periodically check the most
well-known spots for pressure injuries, like the heels. Anesthesia
repositions the head when possible. Finally, after surgery is complet-
ed, but before the patient is sent to recovery, we do another check for
any signs of skin injury. This thorough skin assessment protocol
makes sure that we can catch and document any skin injuries that
happen before the patient comes into the facility.
P R E S S U R E U L C E R S
BEFORE AND AFTER OR tables at Yale-New Haven Hospital used to be equipped with 2-inch
hard foam mattresses that were covered with a plastic water-circulating warming blanket
and gel overlays (left). The skin wellness committee at the hospital changed the OR tables to
3-inch memory foam mattresses and used forced air warming blankets on patients.
Melanie
Pipping,
BGS,
RN,
CNIII
