EWMA 2013 - Ep534 - Prevention of pressure ulcers in cardiac surgery patients

PREVENTION OF PRESSURE ULCERS (PU) IN CARDIAC SURGERY PATIENTS

Anaelí Brandelli Peruzzo RN, Manager of ulcer pressure prevention group of Hospital Nossa senhora da Conceição – Brazil

Sandra Simon

RN, Member of ulcer pressure prevention group of Hospital Nossa senhora da Conceição - Brazil

Silvana Prazeres

RN, ET, ET NEP Coordenation Unisinos - Brazil

INTRODUCTION The unsettling concern of the care team with the formation of pressure ulcers (PU) in patients admitted to the cardiac surgery unit, especially in the postoperative period, generated several discussions on methods for prevention and treatment. With the intention of assisting on improving the process, the risk management committee members, working in patient safety, have proposed to perform a brief situational diagnosis with the nurse in charge of the sector.

PREVENTION

Preventing pressure ulcers is indispensable for

patient care. This care needs to include Identifying

individuals at risk for developing pressure ulcers,

preserving skin integrity, relieving pressure,

correcting any deficiencies, and educating the

patient and his family about the topic.

Baranoski, Ayello, 2008

OBJECTIVE This study aims to preserve the skin integrity using

general care and introducing a new technology, with

soft silicone, to preserve the integrity of the skin in

cardiac surgery patients. The patients use the new

technology in pre, trans and post operatory.

METHODOLOGY Cross-sectional, exploratory, observational survey

by worksheet designed to investigate the

occurrence of PU on the return of patients from

the cardiac surgery unit, in the period of June-

August 2012. The research led to an electronic

medical record.

RESULTS 26 patients were monitored for two months. 9 of these had a higher risk of developing PU. It was noted that on the 1st post-operatory it was impossible to move 6 out of the 9 patients because of oxygenation instability. The use of sacred region protection adherent dressings with soft silicone foam was initiated. They were placed in the pre-operatory period, before the patients were directed to the operating room. In the period of use of these dressings, the patients did not develop PU and expressed comfort in using the product.

CONCLUSIONS

It was observed that in the First post-operatory, 70% of the 9 high-risk patients presented impossibility of

passive motion and 100% of these had hemoglobin

decrease, showing that extrinsic and intrinsic factors predispose to PU occurrences.

Prevention Measures: o  Increase the usage of pyramid mattresses; o  Use of adherent dressings with silicone foam

(level of evidence B) placed in the sacral region pre-operatory.

o  Patients did not develop UP and expressed comfort using the product.

CONCLUSIONS

The patients not developed PU, and they said that

the technology was confortable

CONCLUSIONS

It’s necessary to increase the care involving prevention measures. We are trying. This is only the beginning.

silprazeres@hotmail.com