Clinical
Educator
Evidence Based Practice
Novel Curriculum to Enhance Teamwork for Pressure Injury Prevention #1044 (0.50 CH)
Nancy Appling, MSN,APRN,ACNP-BC,CNOR, CRNFA
RNFA Lead Instructor
University of Tennessee Health Science Center, College of Nursing
Germantown, Tennessee
Susan Scott, MSN, RN, WOC Nurse
Scott Triggers PLLC
Despite years of research into the cause of perioperative pressure injuries (PPI), avoidable injuries persist leading to an increase in malpractice cases. AORN Guidelines state the goals of patient positioning include protecting muscles, nerves, bony prominences, joints, skin, and vital organs from injury. AORN Guidelines and educational programs such as Periop 101 provide evidence-based practices; however, barriers exist that allow integration into clinical settings. APRNFAs are in a unique position to champion patient safety in the OR related to the ABCs of positioning: A-Assessment of skin and risk, B-Better positioning and skin bundles, and C-Communication across the perioperative continuum of care. APRNFAs practice includes all areas of perioperative care. They conduct preoperative assessments, provide intraoperative care and follow-up in the postoperative phase. They support needed peer-to-peer education, promote awareness of risks of pressure and nerve injury in the surgical population, and ensure integration of prevention initiatives. A novel curriculum was developed by an APRN CRNFA and a Wound, Ostomy, Continence (WOC) Nurse subject matter expert (SME). Innovative strategies included use of the anatomage virtual dissection table to visualize common anatomy subjected to pressure in common surgical positions. Students participated in simulation of proper positioning, while didactic education focused on targeted skin assessments utilizing the Scott Triggers® screening tool for pressure ulcer prevention in the surgucak patient, case studies, real-time root-cause-analysis (RCA) findings, and integration of an OR Skin Bundle. The development of OR Skin Champions can enhance interprofessional collaboration, teamwork, and communication among surgeons, nurses, and anesthesia while improving patient safety.
Learn ideas to overcome the lack of recognition and how to reduce the potential of pressure injury acquired in the OR. Strategies will be defined and outlined including both preoperatively and postoperatively. Key stakeholders needed for prevention and reduction will be identified as well as suggestions to increase patient safety, communication, and improve outcomes.