AORN Journal
Volume 89, Issue 3 , Pages 538-552 , March 2009

Prevention of Pressure Ulcers in the Surgical Patient

  • Patina S. Walton-Geer, RN-BC, MSN, CWCN, CFCN

      Affiliations

    • Patina S. Walton-Geer, RN-BC, MSN, CWCN, CFCN, is a wound and foot care nurse clinician at AnMed Health Outpatient Wound and Foot Care Clinic, Anderson, SC. Ms Walton-Geer has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

References 

  1. Ayello EA , Baranoski S , Lyder CH , Cuddigan J . Pressure ulcers . In:  Baranoski S ,  Ayello EA editor. Wound Care Essentials: Practice Principles . 2nd ed.. Philadelphia, PA: Lippincott Williams & Wilkins; 2007;p. 254–286
  2. Pressure ulcer stages revised by NPUAP  . National Pressure Ulcer Advisory Panel . http://www.npuap.org/pr2.htm Accessed December 27, 2008.
  3. Pieper B . Mechanical forces: pressure, shear, and friction . In:  Bryant R ,  Nix D editor. Acute & Chronic Wounds: Current Management Concepts . 3rd ed.. St Louis, MO: Mosby; 2007;p. 205–234
  4. Position statement: Pressure ulcer staging. Wound Ostomy and Continence Nurses Society . http://www.wocn.org/pdfs/WOCN_Library/Position_Statements/PressureUlcerStaging.pdf Accessed December 27, 2008.
  5. Montalvo I . The National Database of Nursing Quality Indicators™ (NDNQI®) . The Online Journal of Issues in Nursing . 2007;12(3): http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.aspx Accessed January 30, 2009.
  6. Relieve the pressure and reduce harm. Institute for Healthcare Improvement . http://www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral/ImprovementStories/FSRelievethePressureandReduceHarm.htm Accessed January 28, 2009.
  7. Graves N , Birrell F , Whitby M . Effect of pressure ulcers on length of hospital stay . Infect Control Hosp Epidemiol . 2005;26(3):293–297
  8. Brown G . Long-term outcomes of full-thickness pressure ulcers: healing and mortality . Ostomy Wound Manage . 2003;49(10):42–50
  9. Reddy M , Gill SS , Rochon PA . Preventing pressure ulcers: a systematic review . JAMA . 2006;296(8):974–984
  10. Hospital-acquired conditions (present on admission indicator). The Centers for Medicare and Medicaid Services . http://www.cms.hhs.gov/HospitalAcqCond Accessed January 28, 2009.
  11. Baumgarten M , Margolis D , Localio AR , et al.   Extrinsic risk factors for pressure ulcers early in the hospital stay: a nested case-control study . J Gerontol A Biol Sci Med Sci . 2008;63(4):408–413
  12. Ayello EA , Lyder CH . Protecting patients from harm: preventing pressure ulcers in hospital patients . Nursing . 2007;37(10):36–40
  13. Padula CA , Osborne E , Williams J . Prevention and early detection of pressure ulcers in hospitalized patients . J Wound Ostomy Continence Nurs . 2008;35(1):65–75
  14. Dybec RB . Intraoperative positioning and care of the obese patient . Plast Surg Nurs . 2004;24(3):118–122
  15. Recommended practices for positioning the patient in the perioperative setting . In: Perioperative Standards and Recommended Practices . Denver, CO: AORN, Inc; 2008;p. 497–520
  16. Nix DP . Support surfaces . In:  Bryant R ,  Nix D editor. Acute & Chronic Wounds: Current Management Concepts . 3rd ed.. St Louis, MO: Mosby; 2007;p. 235–248
  17. Lee BY , Ostrander LE . Noninvasive evaluation of the cutaneous circulation . In:  Lee BY editors. The Wound Management Manual . New York, NY: McGraw-Hill; 2005;p. 131–140
  18. Price MC , Whitney JD , King CA , Doughty D . Development of a risk assessment tool for intraoperative pressure ulcers . J Wound Ostomy Continence Nurs . 2005;32(1):19–30
  19. Bates-Jensen BM . Pressure ulcers: pathophysiology and prevention . In:  Sussman C ,  Bates-Jensen BM editor. Wound Care: A Collaborative Practice Manual for Health Professionals . 3rd ed.. Philadelphia, PA: Lippincott Williams & Wilkins; 2007;p. 336–373
  20. Posthauer M . Introduction to wound diagnosis . In:  Sussman C ,  Bates-Jensen BM editor. Wound Care: A Collaborative Practice Manual for Health Professionals . 3rd ed.. Philadelphia, PA: Lippincott Williams & Wilkins; 2007;p. 52–71
  21. Sewchuk D , Padula C , Osborne E . Prevention and early detection of pressure ulcers in patients undergoing cardiac surgery . AORN J . 2006;84(1):75–96
  22. Nixon J , Cranny G , Iglesias E , et al.   Randomised controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial . BMJ . 2006;332(7555):1413
  23. Phillips NF . Positioning, prepping, and draping the patient . In:  Phillips NF editors. Berry and Kohn's Operating Room Technique . St Louis, MO: Mosby; 2004;p. 470–511
  24. O'Connell MP . Positioning impact on the surgical patient . Nurs Clin North Am . 2006;41(2):173–192
  25. Intraoperative nursing management . In:  Smeltzer SC ,  Bare BG ,  Hinkle JL ,  Cheever KH editor. Brunner & Suddarth's Textbook of Medical-Surgical Nursing . 11th ed.. Philadelphia, PA: Lippincott Williams & Wilkins; 2006;p. 417–435
  26. Lindgren M , Unosson M , Krantz AM , Ek AC . Pressure ulcer risk factors in patients undergoing surgery . J Adv Nurs . 2005;50(6):605–612
  27. Hoshowsky VM , Schramm CA . Intraoperative pressure sore prevention: an analysis of bedding materials . Res Nurs Health . 1994;17(5):333–339
  28. Mackey D . Support surfaces: beds, mattresses, overlays—oh my! . Nurs Clin North Am . 2005;40(2):251–265

  indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 549–550 and then completing the answer sheet and learner evaluation on pages 551–552. The contact hours for this article expire March 31, 2012.You also may access this article online at http://www.aornjournal.org.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN recognizes this activity as continuing education for registered nurses. This recognition does not imply that AORN or the American Nurses Credentialing Center approves or endorses products mentioned in the activity.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.

PII: S0001-2092(08)00898-3

doi: 10.1016/j.aorn.2008.12.022

AORN Journal
Volume 89, Issue 3 , Pages 538-552 , March 2009

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