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Challenges With The Development and Implementation of a Perioperative Pressure Ulcer Prevention Protocol in a Tertiary Care Hospital
Matthew S. Zell, MD; Jacqueline Sions, RN, MSN; Cristiane Ueno, MD
West Virginia University General Surgery Residency Program
2016-03-07
Presenter: Matthew S. Zell, MD
Affidavit:
I acknowledge that the resident made a substantial contribution to this project.
Director Name: Jon Cardinal, MD
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose: Perioperative acquired pressure ulcers represent a significant impact to healthcare expenses for the surgical patient. The incidence of these pressure ulcers varies depending on the type of surgical procedure and on intrinsic patient factors. It has been shown that the application of prophylactic dressings reduces the risk of ulcer development. The goal of this study is to address the implementation of a protocol for reducing perioperative pressure ulcers in a tertiary care setting.
Methods: A pressure ulcer prevention protocol was developed including perioperative nursing assessment, documentation, and intervention. Education was provided for participating staff in the form of lectures and demonstrations. Compliance was assessed by chart review after 2 weeks. An online survey was performed to assess barriers to compliance. Compliance was reassessed by chart review after another 2 week period.
Results: Compliance with the protocol on the initial chart review was low at 40%. This led to the creation of an online survey to assess barriers to compliance. The online survey demonstrated that the nurses were aware of the protocol. The feedback from the online survey was then discussed with the staff. Repeat chart review after 4 weeks demonstrated an improvement to 55% compliance.
Conclusion: The implementation of a practical protocol for the reduction of perioperative pressure ulcers is a complex issue that requires collaboration to be successful. One of the barriers to pressure ulcer prevention continues to be staff education. Regular assessment and ongoing multi-level communication appear to be effective at addressing this problem.
