2.50
Hdl Handle:
http://hdl.handle.net/10755/182736
Category:
Abstract
Type:
Presentation
Title:
Reducing the Incidence of Heel Pressure Ulcers on a Joint Replacement Unit
Author(s):
Evans, Amy; Bonfe, Michelle
Author Details:
Amy Evans, ARNP, CWOCN, Tampa General Hospital, Tampa, Florida, USA, email: mbonfe1@tampabay.rr.com; Michelle Bonfe, APRN, BC, ONC, MSN
Abstract:
Poster Presentation: Purpose: The development of pressure ulcers following surgical procedures may cause patients pain, delay their recovery, decrease patient satisfaction and increase length of stay. The Joint Replacement unit observed an increase in the prevalence of heel pressure ulcers in patients that underwent hip and knee replacements. The purpose of this quality improvement initiative was to identify causes of increase prevalence in this patient population. Method: An interdisciplinary team the included physicians, WOC nurses, ARNP's PA's and staff nurses were formed. Medical records were reviewed and home care nurses were contacted in order to identify any new skin care issues following discharge. Findings: It was determined that increased prevalence of heel ulcers was related to the following: 1) a change in the post operative protocol that discontinued the use of Continuous Passive Motion (CPM)machine, 2) increased use of femoral/sciatic blocks for pain management for surgical pain control, 3) decreased mobility related to surgical block and motor sensory deprivation, and 4) intermittent removal of anti-embolic stockings. Discussion: As a result of our findings, several changes were made of patients postoperatively: 1) Bilateral SCD's were initiated, and patients' heels were floated in the PACU if CPM was not ordered, 2) Ted hose were discontinued because of the potential increase in heel pressure, 3) Upon transfer to the acute care unit, an air boot was placed to the affected extremity, 4) An ARNP measures the limb for proper fit of bilateral Ted hose for home use after discharge ,5) Obese patients were measured for Jobst stockings, and 6) Extensive education to all disciplines including Case Management. Results: This initiative has been very successful as evidenced by : 1) Zero incidence of skin breakdown over the heel areas, 2) Increased staff awareness of skin management and preventive measures, 3) Improvement in patient care outcomes, 4) Increased...[Please contact the primary investigator for more information about this poster presentation.] REFERENCES: Allen, Liu, Ware, Nairn and Owens. Peripheral nerve blocks improve analgesia after total knee replacement surgery. Anesthesia Analog 1998: 87: 93-97. 2. Capdevilla, Barthelet, Biboulet, et al. Effects of preoperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. 3. Ginsberg, B. 92001). Pain Management in Knee Surgery. Orthopaedic Nursing, March/April 20 (2), 37-41. 4. Wang, Boctor and Verner, The effect of single injection femoral nerve block on rehabilitation and length of hospital stay after total knee replacement. Regional Anesthesia and Pain Medicine. Vol. 27, No.2. 2002 pp 139-144. 5. Geerts, W. H., Pineo, G.F., Heit, J. A., Bergqusit, D., Lassen, M. R., Colwell, C.W., & ray, J.G. (2004). Prevention of Venous Thromboembolism: The Seventh Accp Conference on Antithrombotic and Thrombolytic Therapy, Chest, 126, 338S-400S. 6. Byrne, B. (2001). Deep vein thrombosis prophylaxis: The effectiveness and implications of using below knee of thigh -length graduated compression stockings. Journal of Vascular Nursing, XX (2), 53-59.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2008
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Salt Lake City, Utah, USA
Description:
The 12th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 15-17 October, 2008 in Salt Lake City, Utah, 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_US
dc.typePresentationen_GB
dc.titleReducing the Incidence of Heel Pressure Ulcers on a Joint Replacement Uniten_GB
dc.contributor.authorEvans, Amyen_US
dc.contributor.authorBonfe, Michelleen_US
dc.author.detailsAmy Evans, ARNP, CWOCN, Tampa General Hospital, Tampa, Florida, USA, email: mbonfe1@tampabay.rr.com; Michelle Bonfe, APRN, BC, ONC, MSNen_US
dc.identifier.urihttp://hdl.handle.net/10755/182736-
dc.description.abstractPoster Presentation: Purpose: The development of pressure ulcers following surgical procedures may cause patients pain, delay their recovery, decrease patient satisfaction and increase length of stay. The Joint Replacement unit observed an increase in the prevalence of heel pressure ulcers in patients that underwent hip and knee replacements. The purpose of this quality improvement initiative was to identify causes of increase prevalence in this patient population. Method: An interdisciplinary team the included physicians, WOC nurses, ARNP's PA's and staff nurses were formed. Medical records were reviewed and home care nurses were contacted in order to identify any new skin care issues following discharge. Findings: It was determined that increased prevalence of heel ulcers was related to the following: 1) a change in the post operative protocol that discontinued the use of Continuous Passive Motion (CPM)machine, 2) increased use of femoral/sciatic blocks for pain management for surgical pain control, 3) decreased mobility related to surgical block and motor sensory deprivation, and 4) intermittent removal of anti-embolic stockings. Discussion: As a result of our findings, several changes were made of patients postoperatively: 1) Bilateral SCD's were initiated, and patients' heels were floated in the PACU if CPM was not ordered, 2) Ted hose were discontinued because of the potential increase in heel pressure, 3) Upon transfer to the acute care unit, an air boot was placed to the affected extremity, 4) An ARNP measures the limb for proper fit of bilateral Ted hose for home use after discharge ,5) Obese patients were measured for Jobst stockings, and 6) Extensive education to all disciplines including Case Management. Results: This initiative has been very successful as evidenced by : 1) Zero incidence of skin breakdown over the heel areas, 2) Increased staff awareness of skin management and preventive measures, 3) Improvement in patient care outcomes, 4) Increased...[Please contact the primary investigator for more information about this poster presentation.] REFERENCES: Allen, Liu, Ware, Nairn and Owens. Peripheral nerve blocks improve analgesia after total knee replacement surgery. Anesthesia Analog 1998: 87: 93-97. 2. Capdevilla, Barthelet, Biboulet, et al. Effects of preoperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. 3. Ginsberg, B. 92001). Pain Management in Knee Surgery. Orthopaedic Nursing, March/April 20 (2), 37-41. 4. Wang, Boctor and Verner, The effect of single injection femoral nerve block on rehabilitation and length of hospital stay after total knee replacement. Regional Anesthesia and Pain Medicine. Vol. 27, No.2. 2002 pp 139-144. 5. Geerts, W. H., Pineo, G.F., Heit, J. A., Bergqusit, D., Lassen, M. R., Colwell, C.W., & ray, J.G. (2004). Prevention of Venous Thromboembolism: The Seventh Accp Conference on Antithrombotic and Thrombolytic Therapy, Chest, 126, 338S-400S. 6. Byrne, B. (2001). Deep vein thrombosis prophylaxis: The effectiveness and implications of using below knee of thigh -length graduated compression stockings. Journal of Vascular Nursing, XX (2), 53-59.en_GB
dc.date.available2011-10-28T15:37:50Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:37:50Z-
dc.conference.date2008en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationSalt Lake City, Utah, USAen_US
dc.descriptionThe 12th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 15-17 October, 2008 in Salt Lake City, Utah, USA.en_US
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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