Pressure Injury Prevention Protocols Essential in all Care Settings for all Populations

Join us and your colleagues in healthcare settings across the country and globe in observing World Wide Pressure Injury Prevention Day, November 15, 2018. Help us to increase healthcare professional and public awareness about the very real risk of pressure injuries and take action in your care setting to prevent the damaging impact of pressure injuries for the patients you serve.

For World Wide Pressure Injury Prevention Day, we are focusing on two key areas that deserve attention: pressure injuries in outpatient settings and pressure injuries in the pediatric population.

Pressure Injuries in Outpatient Settings

Prevalence of pressure injuries tend to be associated with inpatient settings (e.g., hospitals and long-term care facilities). This is reflected in the available clinical practice guidelines on pressure injury prevention which are primarily for inpatient settings. However, patients in outpatient settings are also susceptible to pressure injury.

In the Emergency Department (ED)

Pressure injuries are common in the ED, even for a short stay. Factors such as a patient’s age, presence of a serious medical illness, and limited mobility can contribute to a patient’s risk. Additionally, the length of stay for most ED patients (99.2%) in the United States is over two hours.¹ Much of the time a patient is in the ED is spent on a gurney, which may not be recommended for extended use.

What you can do:

  • An Oregon solution: Replace all gurney mattresses with new ones designed for extended use.

  • An Oregon solution: Have a specialty pressure relieving mattress on-site for use with high-risk patients, as the wait time for the delivery of a specialty mattress may put the patient at increased risk of pressure injury.

In Outpatient Surgery

While surgery is scheduled for an expected length of time, and pressure injury precautions are taken accordingly, things don’t always go as planned. A surgery that takes more time than expected can increase a patient’s risk for pressure injury. 

What you can do:

  • An Oregon solution: Treat every surgical patient as though they are at risk for pressure ulcers and take appropriate precautions.

Pressure Injuries in Pediatric Patients

The available clinical practice guidelines for pressure injury prevention are specific to the adult populations, as are many of the products and devices used to treat patient’s, regardless of age. According to a white paper written by the National Pressure Ulcer Advisory Panel (NPUAP), “Given the anatomic and physiologic differences between adults and children, serious concerns arise about the safety, clinical efficacy, and cost-effectiveness of using adult protocols and products for neonates and children.”

What you can do:

  • Implement a pressure injury prevention bundle. The Children’s Hospitals’ Solutions for Patient Safety (SPS)—a network of more than 80 hospitals nationwide that examines several hospital-acquired conditions—developed the SPS Prevention Bundles for Pediatrics, which include a bundle on Pressure Ulcers that can be adapted for your organization.

Pressure Injury Prevention Resources

To celebrate World Wide Pressure Injury Prevention Day, NPUAP has a collection of best-practice pressure injury prevention resources freely-available on their website.
NPAUP’s Educational and Clinical Resources

What have you done to address this or similar safety risks? Share what you’ve learned in your organization and contribute to the ongoing learning about adverse events in Oregon through the Patient Safety Reporting Program.

Reference

¹ Liu, Peng, Wang-Qin Shen, and Hong-Lin Chen. “The Incidence of Pressure Ulcers in the Emergency Department: A Meta-analysis.” (2017): 14-19.

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