Plus a Pause Practice

With pressure injury on the rise, it’s going to take collaboration among leadership, the front line, and industry to tackle the problem on several fronts, Cassendra Munro, PhDc, MSN, RN, RNFA, CNOR asserts.

Preoperative risk assessment

Pressure injury prevention begins with a focus on preoperative risk assessment, Munro points out, with the results of this assessment documented and clearly communicated throughout the continuum of care. Munro, care experience manager at the Saint John’s Health Center in Santa Monica, California, is the creator of the Munro Pressure Ulcer Risk Assessment Scale for Perioperative Patients©.   Preoperative risk factors measured by Munro include mobility, nutritional state, Body Mass Index, weight loss, and age. Some of the warning signs include smoking, hypertension, renal failure, cardiovascular disease, pulmonary /respiratory disease, diabetes, and prior history of pressure ulcers.

The one-minute perioperative pause

“These (pressure) injuries are occurring even with evidence-based positioning practices and device placement”, Munro observes, convinced that there exists a mindset against even simple changes in practice such as adding a one-minute pause during lengthy surgery to reposition the patient. New OR technologies and procedures are increasing the length of surgery in many cases, she says, and, for patients already at risk for co-morbidities, the combination is leading to alopecia and deep tissue sacral injury. “Why can’t there be intraoperative process in place to pause and reposition the patient to relieve pressure?” she asks.

Data-driven continuity of care

The link between the different stages on the continuum of care, including the time after the patient leaves the perioperative setting, is better data management, Munro asserts.  Feedback among providers needs to be standardized, she adds.  

Emerging positioning technology

According to Munro, “The expense of maintaining the best positioning technologies available must be discussed as part of a value analysis.” Capital expenditures must be balanced with the costs to a facility when patients sustain pressure injuries.

Action Products and pressure injury prevention

Given today’s zero tolerance hospital policies (due to Medicare laws and rising costs), Action Products is proud to offer optimum pressure relief and shear reduction in the operating room and beyond. The company’s proprietary Akton® viscoelastic polymer has revolutionized the positioning market because the products redistribute weight and heat, and will not leak, flow, or absorb fluids. 

With collaboration among leadership, efficient data management, and prior assessment-plus a pause practices, pressure injury prevention can be tackled on all fronts!