Compliance. Ensure your facility is following the Association of periOperative Registered Nurses’ (AORN) Recommended Practices for positioning the patient in the perioperative practice setting. As hospitals look at their statistics of hospital acquired pressure ulcers (HAPU), a new focus is turning toward looking at the surgical patient population and the realization that a certain percentage of these patients may have OR acquired pressure ulcers (ORAPUs). ORAPUs are the result of what perioperative staff is doing or, in some cases, not doing to properly position and pad patients undergoing a surgical procedure. Each year, the Centers for Medicare and Medicaid Services (CMS) report close over 250,000 cases of preventable pressure ulcers. The average cost per case of a pressure ulcer is estimated to be over $40,000 per hospital stay.
Medicare changes and industry standards demand that your surgical team proactively seeks solutions to pressure injury challenges within the OR by implementing quality protocol and using proper positioning devices. You want to avoid the cost of caring for the complication that can occur from a pressure ulcer. Hospitals are going to have to take a harder, closer and more clinical look at what their staff members are using to ensure patient safety. The product you use should be clinically proven to be effective and supported by documentation and research from the manufacturer.
Patient Safety. Positioning products should be designed to help reduce pressure and shear. They need to combat tissue trauma and nerve damage, and always maintain support for all surgical procedures. You want adequate support for whatever desired position the patient needs to be in to guarantee patient safety, which is the primary goal. Pads and positioners should avoid excess pressure buildup and capillary closure. The devices need to maintain a normal capillary interface pressure of 32 mm Hg or less. The products should evenly distribute weight and provide constant support beneath the patient by not bottoming out. The pads must reduce shear by moving the skin, not against the skin.
Material. Positioners should be latex- and silicone-free, plasticizer-free and radiolucent. Pads should be tissue-friendly and comfortable. Heat and humidity can be controlled by the material’s ability to evenly radiate heat throughout the product. This reduces the risk of potential dangerous “hot spot” development and provides a uniform temperature environment for the patient. They should also be reusable and easily cleaned and disinfected with standard hospital disinfectants. Finally, products should be procedure-specific, include multiple designs and sizes, and provide pressure redistribution.