The clinical effectiveness of an integrated multidisciplinary evidence-based program to prevent intraoperative pressure injuries in high-risk children undergoing long-duration surgical procedures: A quality improvement study

被引：7

作者：

Ciprandi, Guido ^{[1
]}

Crucianelli, Serena ^{[1
]}

Zama, Mario ^{[1
]}

Antonielli, Giancarlo ^{[2
]}

Armani, Riccarda ^{[3
]}

Aureli, Stefano ^{[4
]}

Barra, Gianmarco ^{[3
]}

Beetham, Charlie Joseph Charles ^{[5
]}

Bernardini, Giulio ^{[6
]}

Cancani, Federica ^{[5
]}

Carai, Andrea ^{[7
]}

Cajozzo, Marta ^{[1
]}

Carlesi, Laura ^{[8
]}

Cialdella, Alessandra ^{[6
]}

Ciaralli, Italo ^{[9
]}

Ciliento, Gaetano ^{[10
]}

Corsetti, Tiziana ^{[11
]}

De Chirico, Benedetta ^{[6
]}

Di Corato, Paolo ^{[1
]}

Dotta, Andrea ^{[12
]}

Filippelli, Sergio ^{[6
]}

Franci, Marina ^{[13
]}

Frattaroli, Jacopo ^{[1
]}

Grussu, Francesca ^{[1
]}

Lico, Silvia ^{[8
]}

Losani, Patrizia ^{[14
]}

Giergji, Marjola ^{[9
]}

Magli, Simonetta ^{[8
]}

Marino, Simone Faustino ^{[1
]}

Mongelli, Antonella ^{[11
]}

Nazzarri, Martina ^{[4
]}

Pace, Mauro ^{[13
]}

Palmieri, Giancarlo ^{[1
]}

Pannacci, Ilaria ^{[8
]}

Paparozzi, Franca ^{[9
]}

Pomponi, Manuel ^{[1
]}

Portanova, Anna ^{[14
]}

Preziosi, Alessandra ^{[13
]}

Ragni, Angela ^{[12
]}

Raponi, Massimiliano ^{[10
]}

Renzetti, Tommaso ^{[7
]}

Rizzo, Mirialda ^{[1
]}

Roberti, Marco ^{[6
]}

Sasso, Eleonora ^{[14
]}

Savarese, Immacolata ^{[12
]}

Secci, Simone ^{[3
]}

Selvaggio, Daniele ^{[6
]}

Serafini, Laura ^{[3
]}

Spuntarelli, Giorgio ^{[1
]}

Urbani, Urbano ^{[1
]}

机构：

[1] Bambino Gesu Pediat Hosp, Res Inst, Div Plast & Maxillofacial Surg, Piazza S Onofrio 4, I-00165 Rome, Italy

[2] Bambino Gesu Pediat Hosp, Res Inst, Operat Unit Odontostomatol, Rome, Italy

[3] Bambino Gesu Pediat Hosp, Res Inst, PIO XII Operating Room, Rome, Italy

[4] Bambino Gesu Pediat Hosp, Res Inst, Cardiol ICU, Rome, Italy

[5] Bambino Gesu Pediat Hosp, Res Inst, Emergency Care Unit, Rome, Italy

[6] Bambino Gesu Pediat Hosp, Res Inst, Div Cardiol Cardiothorac Surg, Rome, Italy

[7] Bambino Gesu Pediat Hosp, Res Inst, Div Neurol Neurosurg, Rome, Italy

[8] Bambino Gesu Pediat Hosp, Res Inst, S Onofrio Operating Room, Rome, Italy

[9] Bambino Gesu Pediat Hosp, Res Inst, Dept Pediat Oncohematol & Transfus Med, Rome, Italy

[10] Bambino Gesu Pediat Hosp, Res Inst, Hlth Management, Rome, Italy

[11] Bambino Gesu Pediat Hosp, Res Inst, Clin Pharmacol Unit, Rome, Italy

[12] Bambino Gesu Pediat Hosp, Res Inst, Neonatal Intens Care Unit, Rome, Italy

[13] Bambino Gesu Pediat Hosp, Res Inst, Pediat Intens Care Unit, Rome, Italy

[14] Bambino Gesu Pediat Hosp, Res Inst, Neonatal Surg, Rome, Italy

[15] Bambino Gesu Pediat Hosp, Res Inst, Div Gen & Specialized Pediat, Rome, Italy

[16] Univ Melbourne, Dept Nursing, Melbourne, Vic, Australia

[17] Royal Melbourne Hosp, Melbourne, Vic, Australia

来源：

INTERNATIONAL WOUND JOURNAL | 2022年 / 19卷 / 07期

关键词：

double protection strategy (DPS); paediatric pressure ulcers; prevention; prophylactic dressings; INTENSIVE-CARE-UNIT; OPERATING-ROOM; INTERFACE PRESSURE; ULCERS; SURGERY; DRESSINGS; TEAM;

D O I：

10.1111/iwj.13967

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

The prevention of hospital-acquired pressure injuries (HAPIs) in children undergoing long-duration surgical procedures is of critical importance due to the potential for catastrophic sequelae of these generally preventable injuries for the child and their family. Long-duration surgical procedures in children have the potential to result in high rates of HAPI due to physiological factors and the difficulty or impossibility of repositioning these patients intraoperatively. We developed and implemented a multi-modal, multi-disciplinary translational HAPI prevention quality improvement program at a large European Paediatric University Teaching Hospital. The intervention comprised the establishment of wound prevention teams, modified HAPI risk assessment tools, specific education, and the use of prophylactic dressings and fluidized positioners during long-duration surgical procedures. As part of the evaluation of the effectiveness of the program in reducing intraoperative HAPI, we conducted a prospective cohort study of 200 children undergoing long-duration surgical procedures and compared their outcomes with a matched historical cohort of 200 children who had undergone similar surgery the previous year. The findings demonstrated a reduction in HAPI in the intervention cohort of 80% (p < 0.01) compared to the comparator group when controlling for age, pathology, comorbidity, and surgical duration. We believe that the findings demonstrate that it is possible to significantly decrease HAPI incidence in these highly vulnerable children by using an evidence-based, multi-modal, multidisciplinary HAPI prevention strategy.

引用

页码：1887 / 1900

页数：14

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