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Burn Center Barrier Protocols During Dressing Change: A National Survey
Joseph Meyerson MD, Rebecca Coffey CNP, MSN, Larry Jones MD, Sidney Miller MD
Wexner Medical Center at Ohio State University
2014-03-11
Presenter: Joseph Meyerson
Affidavit:
Resident formulated project, organized and analyzed data.
Director Name: Gregory Pearson
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Infection control is a critical component of post-burn care with prevention of infection serving as a major cause of decreasing morbidity and mortality. One potential deterrent for infection is barrier protection during dressing changes. However, no evidence-based standard has been established among burn centers. A 24 question survey was sent to 121 burn center nurse managers within the United States comprised of yes or no questions with comment sections available for further detail. Questions were constructed to gain insight into the variation and commonality that may exist between burn center barrier protocols. Forty-one out of 121 (34%) centers responded. Data was compiled from the survey and averaged. Centers reported the use of head covers, masks, gowns and gloves during admission of a new burn (71%, 82%, 95% and 100% respectively); daily dressing changes (64%, 80%, 97%, and 100% respectively); post-operative dressing changes (64%, masks 80%, 97%, and 100% respectively); and dressing changes of a non-burn (66%, 82%, 97%, and 100% respectively). Burn centers reported their use of sterile gloves and gowns during typical burn dressing changes as occurring 20% and 10% of the time, respectively. Estimates for costs of these garments annually ranged from $0 to $250,000 within an institution. A calculation performed for this study demonstrated that barrier garments used exclusively for dressing changes nationwide is approximately $2.43 million. We demonstrated trends in barrier protocols, as well as the immense cost to an institution and nationwide, of barrier garments used solely for burn dressing changes.
