Open AccessThe 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
Author(s) -
Ciprandi Guido,
Crucianelli Serena,
Zama Mario,
Antonielli Giancarlo,
Armani Riccarda,
Aureli Stefano,
Barra Gianmarco,
Beetham Charlie Joseph Charles,
Bernardini Giulio,
Cancani Federica,
Carai Andrea,
Cajozzo Marta,
Carlesi Laura,
Cialdella Alessandra,
Ciaralli Italo,
Ciliento Gaetano,
Corsetti Tiziana,
De Chirico Benedetta,
Di Corato Paolo,
Dotta Andrea,
Filippelli Sergio,
Franci Marina,
Frattaroli Jacopo,
Grussu Francesca,
Lico Silvia,
Losani Patrizia,
Giergji Marjola,
Magli Simonetta,
Marino Simone Faustino,
Mongelli Antonella,
Nazzarri Martina,
Pace Mauro,
Palmieri Giancarlo,
Pannacci Ilaria,
Paparozzi Franca,
Pomponi Manuel,
Portanova Anna,
Preziosi Alessandra,
Ragni Angela,
Raponi Massimiliano,
Renzetti Tommaso,
Rizzo Mirialda,
Roberti Marco,
Sasso Eleonora,
Savarese Immacolata,
Secci Simone,
Selvaggio Daniele,
Serafini Laura,
Spuntarelli Giorgio,
Urbani Urbano,
Vanzi Valentina,
Permatunga Roshani,
Santamaria Nick
Publication year - 2022
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.13967
Subject(s) - medicine , multidisciplinary approach , duration (music) , quality management , surgery , anesthesia , operations management , art , social science , literature , sociology , management system , economics
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.