2.50
Hdl Handle:
http://hdl.handle.net/10755/156983
Category:
Abstract
Type:
Presentation
Title:
Reducing Pulmonary Complications and Hospital Acquired Pressure Ulcers in Quadriplegics
Author(s):
Gates, Gary; White, Cheri
Author Details:
Gary Gates, RN,MS,TNCC, Sutter Health, Roseville, California, USA, email: gary_gates@hotmail.com; Cheri White
Abstract:
PURPOSE: Cervical spinal cord injury (SCI) patients are at high risk to develop pulmonary complications and pressure ulcers that lead to increased morbidity and length of stay. In 2008, we admitted 6 SCI patients. All these patients developed some form of pressure ulcer (PU) despite aggressive prevention measures. A process improvement (PI) initiative was developed to reduce hospital-acquired PU while maximizing mobility and supporting pulmonary function and pulmonary toilet in SCI patients. DESCRIPTION: To optimize pulmonary excursion and toilet, SCI patients are positioned sitting fully upright in a chair sitting position as soon as their condition allows. Existing unit beds could not achieve a full upright position, so patients were placed in a cardiac chair, which led to skin shearing from the transfer and pressure from chair sides and cushions. Considerable staff time was also needed to reposition the patient frequently in the chair to eliminate pressure. Use of specialty mattresses was frequently discontinued by the physicians because the patient could not be placed in a full upright position. To achieve the goals of optimizing pulmonary function and toilet and zero skin breakdown, we collaborated with a specialty mattress vendor who developed a prototype pressure-relieving (PR) surface replacement for use with facility-owned critical care frames for the SCI population. The PR surface was placed on a specialty bed frame that can assume a chair position. A nurse-driven protocol was developed for ordering the bed and PR surface. Staff was trained on the protocol and PU prevention measures. EVALUATION/OUTCOMES:Since implementation in December 2008, we have used the PR bed system 16 times, including in 6 SCI patients with zero incidence of PU. Incidence of pulmonary complications in the SCI population has declined from 66% to 16%. Staff and physician awareness and ownership of PU prevention has increased greatly as a result of this initiative. This PR system allows us to fully treat the patient, and its use has been incorporated into the hospital-wide process for ordering specialty beds. In our unit, the use of the PR bed system has expanded beyond the SCI population to other critically injured patients who cannot be mobilized out of bed.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleReducing Pulmonary Complications and Hospital Acquired Pressure Ulcers in Quadriplegicsen_GB
dc.contributor.authorGates, Garyen_GB
dc.contributor.authorWhite, Cherien_GB
dc.author.detailsGary Gates, RN,MS,TNCC, Sutter Health, Roseville, California, USA, email: gary_gates@hotmail.com; Cheri Whiteen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156983-
dc.description.abstractPURPOSE: Cervical spinal cord injury (SCI) patients are at high risk to develop pulmonary complications and pressure ulcers that lead to increased morbidity and length of stay. In 2008, we admitted 6 SCI patients. All these patients developed some form of pressure ulcer (PU) despite aggressive prevention measures. A process improvement (PI) initiative was developed to reduce hospital-acquired PU while maximizing mobility and supporting pulmonary function and pulmonary toilet in SCI patients. DESCRIPTION: To optimize pulmonary excursion and toilet, SCI patients are positioned sitting fully upright in a chair sitting position as soon as their condition allows. Existing unit beds could not achieve a full upright position, so patients were placed in a cardiac chair, which led to skin shearing from the transfer and pressure from chair sides and cushions. Considerable staff time was also needed to reposition the patient frequently in the chair to eliminate pressure. Use of specialty mattresses was frequently discontinued by the physicians because the patient could not be placed in a full upright position. To achieve the goals of optimizing pulmonary function and toilet and zero skin breakdown, we collaborated with a specialty mattress vendor who developed a prototype pressure-relieving (PR) surface replacement for use with facility-owned critical care frames for the SCI population. The PR surface was placed on a specialty bed frame that can assume a chair position. A nurse-driven protocol was developed for ordering the bed and PR surface. Staff was trained on the protocol and PU prevention measures. EVALUATION/OUTCOMES:Since implementation in December 2008, we have used the PR bed system 16 times, including in 6 SCI patients with zero incidence of PU. Incidence of pulmonary complications in the SCI population has declined from 66% to 16%. Staff and physician awareness and ownership of PU prevention has increased greatly as a result of this initiative. This PR system allows us to fully treat the patient, and its use has been incorporated into the hospital-wide process for ordering specialty beds. In our unit, the use of the PR bed system has expanded beyond the SCI population to other critically injured patients who cannot be mobilized out of bed.en_GB
dc.date.available2011-10-26T19:19:02Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:19:02Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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