A Nurse‐Initiated Perioperative Pressure Injury Risk Assessment and Prevention Protocol

Meehan, Anita; Beinlich, Nancy; Hammonds, Tracy

doi:10.1016/j.aorn.2016.10.004

Cited by 29 publications

(17 citation statements)

References 21 publications

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“…The findings of our study show that intraoperative risk factors play a role in the development of pressure injuries in surgical patients. Various studies have reported the incidence of perioperative pressure injuries in a wide range of ratios, from 0.3% to 69% . The incidence in our study was 40.4%, which is within the range reported in the literature.…”

Section: Discussionsupporting

confidence: 80%

“…Various studies have reported the incidence of perioperative pressure injuries in a wide range of ratios, from 0.3% to 69%. 12,14,[28][29][30][31] The incidence in our study was 40.4%, which is within the range reported in the literature. The number of pressure injuries that occurred in our study may be in the higher half of the previously reported range because the support surfaces used in our ORs did not have any features to prevent pressure on the patient and positioning devices were not used in most of the procedures.…”

Section: Discussionsupporting

confidence: 75%

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The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

Çelik¹,

Öğce²

2019

AORN Journal

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Patients undergoing operative and other invasive procedures are at high risk for developing pressure injuries. This study aimed to determine the incidence of perioperative pressure injuries in patients who underwent procedures lasting two hours or more in Turkey and the risk factors that affect the development of pressure injuries. Data were collected during the perioperative period. The incidence of perioperative pressure injuries was 40.4%. The results of univariate logistic regression analysis showed that intraoperative vasopressor use, skin turgor, and diastolic blood pressure less than or equal to 60 mm Hg were significantly related to the development of pressure injuries. There was no significant difference between patients who developed pressure injuries and patients who did not when comparing their preoperative Braden Scale scores. Perioperative nurses should assess each patient for pressure injury risk and perform interventions to prevent pressure injuries during each stage of the patient's perioperative course.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 75%

The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

Çelik¹,

Öğce²

2019

AORN Journal

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“…Prevention of pressure ulcer/injury is a surrogate marker for quality of nursing care www.ahrq.gov/professionals/systems/hospital/pressureulcertoolkit/index.html and scroll down to Tool 3D and 3E. (Meehan, et al, 2016).…”

Section: Risk Factorsmentioning

confidence: 99%

The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

Meehan

Maher²,

Brent

et al. 2019

International Journal of Orthopaedic and Trauma Nursing

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Sarcopenia is age-related loss of muscle mass and strength with resulting decrease in function that affects balance, gait, and overall ability to perform tasks of daily living. Decline in skeletal muscle mass begins around age 30 with a significant acceleration after age 65, accompanied by a concomitant reduction in muscle strength (Curcio, et al., 2016). Muscle strength is a critical component of walking and its decrease in the older adult contributes to a high prevalence of falls (Dhillon & Hasni, 2017). Early recognition and intervention can modify some of these detrimental outcomes. Some major risk factors for sarcopenia include; lack of exercise, age-related decreases in hormone concentrations and a decrease in the body's ability to synthesize protein, combined with inadequate caloric and/or protein intake (Dhillon & Hasni, 2017). Acute and chronic illnesses raise the risk level. Screening for sarcopenia may not be routine in many clinical practices. However, screening for impairment in physical function and activities of daily living (ADL's) should be routine for all older adults. Individuals with impaired ADLs and those who describe a noticeable decline in function, strength, or overall health status should have more specific testing for sarcopenia (Brown & McCarthy, 2015). The European Working Group on Sarcopenia in Older people (EWGSOP), in their consensus document, outlined an algorithm to aid the screening and diagnosis of sarcopenia (Cruz-Jentoft, et al., 2010).

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“…7 Furthermore, studies show that positive outcomes (reduced costs, mortality, length of hospital stay, and complications such as PI) have been found when malnutrition was identified promptly (within 24 h) and nutrition intervention (using ONS) was initiated early and in a standardized manner. 4,10,25,47 For example, the Cleveland Clinic in Akron, Ohio conducted a QI project to assess the impact of prompt nutrition care on health care outcomes. 47 This retrospective study reviewed 20,000 hospitalized records and found decreased HAPI prevalence by 50% (from 40 PIs to 20 PIs) from quarter to quarter after implementing automated screening and intervention protocol (ONS) for at-risk patients.…”

Section: Coppermentioning

confidence: 99%

Optimizing Nutrition Care for Pressure Injuries in Hospitalized Patients

Citty

Cowan

Wingfield

et al. 2019

Advances in Wound Care

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It is estimated that up to 50% of hospitalized patients are malnourished. Malnutrition can lead to longer hospital stays, altered immune function, and impaired skin integrity and wound healing. Malnutrition has been found to be a significant factor influencing pressure injury (PI) risk and wound healing. While PI prevention requires multidimensional complex care using a variety of evidence-based strategies, hospitalized patients benefit from interventions that focus on improving oral nutrition to reduce PI risk and enhance wound healing. Unfortunately, malnutrition is often underrecognized and inadequately managed in hospitalized patients and this can lead to higher rates of complications such as PI. Recent Advances: Recent studies suggest that nutritional care has a major impact in PI prevention and management. Strategies, including early identification and management of malnutrition and provision of specially-formulated oral nutritional interventions to at-risk patients, optimization of electronic health record systems to allow for enhanced administration, monitoring, and evaluation of nutritional therapies, and implementation of protocol-based computerized decision support systems, have been reported to improve outcomes. Critical Issues: Unfortunately, there are gaps in the implementation of nutritional care in hospitals. Timely identification and management of malnutrition is needed to advance quality care for hospitalized patients and reduce malnutrition and associated PI. Future Directions: Further research on effective, evidence-based strategies for implementation of all stages of the nutrition care process is needed to reduce pressure injuries and malnutrition in hospitalized patients.

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A Nurse‐Initiated Perioperative Pressure Injury Risk Assessment and Prevention Protocol

Cited by 29 publications

References 21 publications

The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

Optimizing Nutrition Care for Pressure Injuries in Hospitalized Patients

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