Members of the perioperative team at The Johns Hopkins Hospital in Baltimore work many challenging surgeries on very sick patients, yet can count the number of pressure injuries their patients have suffered on two hands. That’s no accident, as pressure injury prevention is a key initiative at the hospital.
About five years ago, a multidisciplinary team investigated how to better assess pressure injury risks and prevent injuries from occurring. They focused on cases involving the prone position such as craniotomies and particularly spine. “We were seeing redness when we turned the patient back to the supine position,” explains Kendra B.J. Myers, BSN, RN, CNOR, lead clinical nurse of neuro-surgery/ortho/spine/otology. In addition, the team noted a general increase in pressure injuries and skin integrity issues on the Hopkins Event Reporting Online (HERO) system, which logs safety concerns.
The team trained its spotlight on the quality of its skin assessments and intervention strategies throughout the perioperative episode, with the goal of creating a pressure injury prevention bundle for high-risk patients. Its key elements offer useful guidance on how to protect patients’ skin during the course of their care.