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Perioperative Pressure Ulcer Prevention (PPUP) Team: A Strategy for Success

Abstract:

The purpose of this evidence-based practice project was to identify perioperative practices that can reduce occurrence of perioperative pressure ulcers (PPUs). At Huntington Hospital, the rate of PPUs was comparable to the national average. The desired outcome was reduction of PPUs. A perioperative pressure ulcer prevention (PPUP), team was formed, including preoperative, OR, post anesthesia care unit, and wound ostomy continence nurses. Evidence-based practices were identified from peer-reviewed journal articles and AORN Standards and Recommended Practices. Literature described intrinsic and extrinsic factors that contribute to PPU occurrence and methods to reduce extrinsic risks. The PPUP Team recommended using Braden Risk Assessment Scale for identification of high-risk intrinsic factors of all surgical patients. Inservices began immediately for each department, including preoperative skin assessments, control of extrinsic factors through use of pressure redistribution, positioning, moisture management in the OR, and patient-turning schedules in PACU. A tool was developed to improve PPUP communication and track PPUP techniques. Resulting changes in practice have lead to decreased incidence of PPUs, as measured by our Nursing Quality Council. The PPUP team approach is a successful method to achieve desired outcome of PPU reduction. Perioperative nurses who share the goal of PPU reduction can benefit by starting a team like ours. Resulting changes in practice have lead to decreased incidence of PPUs, as measured by our Nursing Quality Council. The PPUP team approach is a successful method to achieve desired outcome of PPU reduction. Perioperative nurses who share the goal of PPU reduction can benefit by starting a team like ours.


Primary Author:

Anne Nowlin, RN, CNOR
OR Staff Nurse, Chairperson Evidence-Based Practice, Nursing Research Council, Huntington Hospital, Pasadena, CA
annenowlin.rn@gmail.com

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