151 - Collaboration Between Wound Care and OR Nurses: A Quality Improvement Project to Decrease the Incidence of Pressure Injuries in Surgical Patients
Description: Description of the Team: A taskforce consisting of perioperative nurse educators, clinical OR nurses, and wound care nurses at a 620-bed Level I university hospital. Preparation and Planning: The OR nurse educators and wound care nurses recognized that joining forces to discuss postoperative pressure injuries could lead to strategies to prevent future injuries. The taskforce examined retrospective documentation data of every hospital-acquired pressure injury (HAPI) from the last seven years. The hospital performs roughly 25,000 surgeries per year. The most common HAPIs were on the sacrum.
Assessment: The taskforce examined intraoperative documentation from every HAPI determined to have originated in the operating room from the last seven years. The most common types of injuries were deep tissue injuries (DTI) on the sacrum. It was determined that education about the types of pressure injuries coming from the OR would be beneficial education for the OR nurses. Implementation: The OR nurse educators developed educational curriculum to be presented to each OR staff member. For the content of the curriculum, the taskforce referred to evidence-based guidelines from Association of Perioperative Nurses (AORN) as well as Wound Ostomy and Incontinence Nurses Society (WOCN). Additionally, using a pressure mapping device, the taskforce tested different types of surfaces and pressure-relieving devices currently in use in the OR to determine best strategies for patient positioning. To ensure compliance of the teaching, the taskforce will conduct audits of intraoperative documentation. The taskforce will continue to conduct root cause analyses of pressure injuries originating from the operating room. The OR nurse educators will work directly with the OR RNs involved to re-teach positioning practices. Implications for Perioperative Nursing: Safe intraoperative positioning of the patient is the hoped-for outcome for every surgical patient. Operating room nurses understand the significance of this responsibility. However, postoperative follow-up of surgical patients can be difficult for the OR nurse, therefore making it difficult to determine if positioning interventions were successful in keeping the patient injury-free. The goal of this collaborative project is to decrease pressure injuries by providing postoperative skin injury outcome data directly to the OR nurses. By opening the lines of communication between the wound care team and the operating room, pressure injuries originating in the OR will continue to decrease.