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Pressure Ulcer Prevention in High-Risk Post-Operative Cardiovascular Surgery Patients
J Drumm, B Merrick, M Jackson, T Lemaster... - 2011 - Pressure Ulcer Prevention in High-Risk Post-Operative Cardiovascular Surgery Patients Conference Sponsor: American Association of Critical-Care Nurses Conference Year: 2009 Author: Drumm, Jennifer PI Institution Name: St. Joseph Hospital Contact Address:, ...
PURPOSE: There is a lack of evidence in the literature as to how to prevent pressure ulcers in the severely debilitated, immobile ICU patient. This study presents a possible prevention strategy for these very sick patients. The post-operative cardiovascular surgery patient is at high risk for developing pressure ulcers as they have decreased tissue perfusion resulting from hypotension, shock, or dehydration. Also they are immobile due to sedatives or paralytics, have poor nutrition, and incontinence. Description: In the St. Joseph's CTVU, a retrospective analysis of patients who developed pressure ulcers revealed that these patients had high doses, and a variety of vasopressor orders; they received multiple blood products in the operating room prior to skin breakdown, and they were mechanically ventilated post-operatively. The skin breakdown rate was approximately 10% in this unit, and patients commonly developed quite severe pressure ulcers. In an effort to prevent pressure ulcer development the CTVU staff chose to implement air fluidized therapy (AFT) beds which provide maximal emersion and envelopment as a pressure ulcer prevention measure for patients who: 1) Required vasopressors for at least 24 hours, and 2) Required mechanical ventilation for at least 24 hours post operatively. Evaluation and Outcomes: The results of this implementation have been extremely positive during the last 7 months that the program has been in place (February 2008 through August 2008). Only 1 patient out of 27 patients developing a pressure ulcer while on the AFT bed, and this ulcer was only a Stage I. Patients spent an average of 7.9 days on the mattress and the cost of bed rental was approximately $18,000, which compared to the costs of treatment of even one Stage III or IV pressure ulcer (estimated ~ $40,000 in the literature) was considered cost effective. We are currently developing further efforts to expand this high risk pressure ulcer prevention program. 2009 National Teaching Institute Creative Solutions Abstracts. Crit Care Nurse. 2009;29(2):e1-e28. Available at: http://ccn.aacnjournals.org/cgi/reprint/29/2/e1
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Pressure Ulcer Prevention in High-Risk Post-Operative Cardiovascular Surgery Patients |
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