92 - Pressure Injuries Triggered by Patient Positioning: Incidence and Risk Factors
Clinical Issue: Health organizations have monitored the occurrence of adverse events, through indicators, to promote the quality of care provided and ensure patient safety. Among the various types of care indicators, the incidence of Pressure Injury (PI) is an important indicator of quality. PI is part of a worldwide scenario, affecting surgical patients due to tissue ischemia, prolonged immobility and pressure, and decreased sensory perception during surgery. Justification: Many PI may start during surgery and continue to worsen postoperatively. In seeking to explain the occurrence of PI originated during surgery, became interested in the present study.
Objective: To analyze the incidence and risk factors associated with PI development in surgical patients.
Method: Study is clinical, field, prospective cohort and quantitative. The collect occurred in a private hospital, general, extra size, of São Paulo, in two phases: intraoperative, assessing the patient's risk of developing PI, through the application of a Risk Assessment Scale of Injuries related to Patient Positioning (ELPO); postoperative period, in the unit that the patient remained hospitalized, through the inspection of the skin. The sample consisted of 128 adult patients, who underwent surgical procedures, accepted to participate in the study. The categorical variables are described by absolute and relative frequencies, the numerical by median, first and third quartiles. A significance level of 5% was adopted. The project was approved by the Research Ethics Committee of the study host institution, by the norms and ethical precepts of Resolution 466/2012. Outcomes: The presence of PI was observed in seven patients of 128 patients accompanied after the surgical procedure, with an incidence of 5.47%. It was verified a total of 10 PI among these patients, two of them with more than one lesion. The PI development among the studied patients was related to ELPO scale score (median of 19 points), with odds ratio of 1.54, in each unit increased in the total value of the score; time of surgery, because every hour added, the odds ratio increases by 85.7%; surgical position in prone, among the seven affected patients, five remained this position, representing a odds ratio of 13.42 in relation to the other positions; high body mass index, the patients with overweight and obese corresponded to 71.5% patients with PI and 63.9% patients without PI, with odds ratio of 1.43. Implications for Perioperative Nursing: It was verified that surgical patients presented presents characteristics that put them at risk of developing PI, some related to the intrinsic factors (patient) and others to the extrinsic (surgery). The use of ELPO assists in the identification process of patients at risk. It is necessary, therefore, special attention to the surgical patient. We hope that this research will contribute to better perioperative nursing care, as well as serve as subsidies for future research.