241 - A Pressure Injury Risk Reduction Strategy for the Outpatient Surgery Center
Description: Outpatient surgery centers have not generally been concerned about the risk of development of perioperative pressure injuries. After all, our patients are healthy with normal body mass indexes BMIs, no comorbidities, and a low American Society of Anesthesiologist’s, ASA score and their procedure never exceeds 3 hours. Right? Wrong. A patient with a BMI exceeding 40 presented for a hand surgery in our outpatient surgery center. The procedure exceeded 3 hours and adding in the pre-Operative phase, this patient was on a stretcher in the supine position for over 5 hours. During the pre-Operative phase, the RN assessed the patient’s sacrum and found a deep tissue injury. Because we had no prevention bundle in place, no pre-Operative baseline skin assessment had been done. Because of this, we will never know if our patient presented with the injury or whether the injury was facility-acquired. Our organization has had over 5 years’ experience with a very successful perioperative pressure injury risk reduction bundle that brought our HAPI rate down from 8 to 0 annually and we have maintained a rate of zero for over 2 years. Our team reconvened to discuss and create a PPI strategy for the surgery center patient. This poster will illustrate the risk reduction algorithm including the pre-admission testing high risk factors, the pre-Operative assessment and high-risk indicators, the intra-Operative nursing interventions, the post-operative assessment, the follow-up components, as well as the education, communication, documentation and audit tool used in this bundle to.