Exploring the New Standards in Patient Positioning

October 19, 2017

For more than 50 years, AORN (Association of Perioperative Registered Nurses) has been recognised as the world leader in the development of standardised OR techniques. Their recommendations are roundly seen to represent what is believed to be the optimal level of practice, policies and procedures.

Earlier this year, AORN released their 2017 Guidelines for Perioperative Practice, offering evidence based guidelines for all invasive and perioperative procedures from Aseptic Practice to Patient Care and Sterilization, with many more topics in between. To this end, the area of focus that is most relevant to Trulife is the findings around Positioning the Patient, and the advancements in this area.

The use of Gel in the OR to prevent Pressure Injury

Studies have estimated that surgical patients account for 20-30% of all pressure injuries, an extremely high percentage. If the patient’s skin has broken down, there is immediately a higher risk of developing infection. In a number of cases patients have even been known to die from pressure ulcers. For this reason it is of extreme importance that the correct steps are taken to eliminate their development.

The use of support surfaces containing materials such as gel and foam in the positioning of patients has long been advised; however the most effective pressure distributing surface remains somewhat inconclusive. At Trulife we have always championed the use of gel based products in the support of patients undergoing surgery, and while the findings outlined in the 2017 AORN guidelines find that a multidisciplinary team should determine what support surfaces are used, gel compares exceptionally favourably against other support surfaces.

“The use of gel during procedures lasting 90 minutes or longer decreases the incidence of pressure injury by 0.51% resulting in an overall cost savings of $38 per patient.” Pham et al.

In a study conducted by King & Bridges, they found that a gel overlay proved significantly better in the prevention skin breakdown and pressure sore development when tested against an OR bed mattress and a polyurethane convoluted foam overlay.

The researchers concluded that in the supine and lateral positions respectively, “participants sacral and trochanter pressures were significantly higher on the OR bed mattress with the foam overlay than on the OR mattress with the Gel Overlay”.

This reflected the findings of Hoshowsky and Schramm who found that “foam-and-gel mattresses and viscoelastic gel overlays were significantly more effective than foam mattresses in preventing skin changes and pressure injury, but the gel overlay was the most effective surface for preventing pressure injury.”

While Wu et al concluded that “the average and peak pressures measured at the points padded with the gel were significantly lower than at the points padded with high-density foam”.

Pressurecare by Trulife

The findings contained in the guidelines support Trulife’s conclusions around pressurecare in proposing that gel based products are the most effective at combating the onset of pressure sores or pressure related injuries in the Operating Room.  Often it can take a few days for a pressure ulcer to develop post-surgery. Unfortunately hospital employees don’t always make this link between the development of a pressure ulcer and the patient’s time in surgery. By making this link however, and using preventative measures during surgery, the incidence of pressure ulcer formation can be significantly reduced and even potentially eliminated.

The author of ‘The Art and Science of Patient Positioning’ Clare Tager notes that, for the most part, all pressure injuries are preventable. She revealed in her findings that she has enough material to write numerous books on her own experiences in the OR about complications due to positioning. From a young mother going in for a routine gynaecology procedure and leaving ten days later on a walker, to a breast cancer patient undergoing double mastectomy who suffered a brachial plexus injury during surgery, losing the use of her arms and legs. Tager claims that with the right education, awareness and action these types of injuries can be prevented in the future.

The Trulife Pressurecare Ranges were developed to help prevent Decubitus injuries. Trulife is committed to providing innovative pressurecare products like the Oasis, Elite, Azure and now Oasis + ranges, so pressure injuries can be eliminated.

Huge amounts of in-depth research have gone into the development of each range. The Trulife Pressurecare range offers a simple and cost effective solution with a comprehensive offering to cover all surgical procedures.  All the Trulife products are reusable which has a positive environmental impact also.

A Successful week at EPUAP

At Trulife we are always looking to learn more about the current work being done in the area of pressure care. We recently attended the European Pressure Ulcer Advisory Panel annual conference held in Belfast, Northern Ireland. This year’s annual conference brought together clinical care practitioners, researchers and people from industry, to discuss the current status of pressure ulcer care in Europe and the world, and to discuss new developments in pressure ulcer prevention and treatment. We made a lot of new connections and caught up with some familiar faces. The meeting was very well attended and they gave our team a great opportunity to showcase our pressurecare products to delegates as well as attend some of the interesting lectures and workshops themselves.

The event was a reminder of the importance of further education and awareness around pressurecare, with the ultimate aim to reduce pressure injuries to zero.

Stop Pressure Ulcer Day 2017 – November 16th

This is now a global annual event supported by the NPUAP and the EPUAP; where the medical industry, healthcare professionals, public and media join forces to help raise awareness of pressure ulcers – something many people are touched by every year.

What will you do to raise awareness?

We have one goal worldwide:  STOP PRESSURE ULCERS

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