The purpose of this presentation is to demonstrate the implementation of a series of preventative measures to reduce pressure ulcer (PU) prevalence in the cardio-thoracic surgical patient population. As a first measure to reduce the rate of PUs, standard OR (OR) bed surfaces were replaced with non-memory fluid pressure redistribution mattresses in the cardio-thoracic OR suites. This proved to be ineffective. The second measure replaced water-filled warming blankets to reduce negativity between the patient and the therapeutic mattress surface with forced-air. Underbody warming blankets did not reduce the rate of PU. The third measure implemented a therapeutic mattress surface for the immediate postoperative phase, the patient intensive care unit (ICU) experience. The research question: Should the ICU experience be considered an extension of the intraoperative phase of the cardio-thoracic surgical intervention in an effort to reduce the rate of PU in the cardio-thoracic surgical patient population? An ongoing retrospective chart review is performed to collect data on cardio-thoracic patients with PUs reported postoperatively. Data collected two months postimplementation of the therapeutic mattress surface for the patient postoperative/ICU experience demonstrated a dramatic reduction in the incidents of PUs. Preliminary findings revealed a 7.1% reduction in the rate of occurrence of PUs in the cardio-thoracic surgical patient population when compared to the same time period in 2009. Results of this ongoing study continue to demonstrate a decrease in the rate of PU occurrence in the cardio-thoracic surgical patient population.
Andrea M. Hagstrom, RN BSN MSN CNOR CNL
Nurse Educator, Hartford Hospital