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American Family Children’s Hospital Pressure Ulcer Prevention for High Risk Pediatric Perioperative Patients

American Family Children’s Hospital Pressure Ulcer Prevention for High Risk Pediatric Perioperative Patients - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Nursing Practice Guidelines, Related


Pressure Ulcer Prevention for High Risk Pediatric Perioperative Patients


Created: March, 2016
Review with: Pressure Ulcer Prevention and Treatment Nursing Practice Guidelines
Contact: Katharine Holley, MSN, RN, CNOR

PREOP:
YES



INTRAOP:


YES













POSTOP:






ξ Braden Q Score Less than or equal to 16
ξ NICU Patient: corrected age < 2months Consider the following actions
(Relieve, Reduce, Redistribute
Pressure, and Prevent shear):
ξ Elevate areas of concern every 2
hours
ξ Use of Silicone dressing
ξ Float heels
ξ Use of silicon dressing on heel
ξ Use of foam or gel cushions for
high-risk areas
ξ Use of appropriate padding
between the patient and
surgical devices
ξ Limit the amount of pads,
sheets, and blankets placed
between the patient and the
procedure bed mattress
ξ Avoid: towels, sheet rolls, IV
fluid bags, and blankets for
padding

ξ Is the surgery scheduled for > 4 hours
ξ Is the Patient and ASA Class of > 3
ξ Does the patient have Preexisting skin
breakdown
ξ Does the patient have a history of skin
breakdown
ξ Is the patient having surgery in any of the
following services?
 Trauma
 Cardiac
 Neuro
 Ortho
 Plastics
ξ Perform postoperative skin assessment
ξ Communicate what was done for the patient during
the SBAR to the PACU staff
ξ Try to place the patient in a different posture
postoperatively
ξ Leave all silicone dressing in place

Pressure Ulcer Prevention for High Risk Pediatric Perioperative Patients


Created: March, 2016
Review with: Pressure Ulcer Prevention and Treatment Nursing Practice Guidelines
Contact: Katharine Holley, MSN, RN, CNOR




Decision Guide
(Consider prevention if you check Yes to one or more questions)

Yes
ξ Does the patient have limited mobility pre-procedure?
ξ Will the patient have reduced mobility the first postoperative day?
ξ Will the patient be intubated postoperatively?
ξ Will the patient be place on purposeful Hypothermia during the procedure?
ξ Will the patient be in the prone position?
ξ Will there be an increase in moisture exposure to the patient? (incontinence, febrile, use of fluids during the procedure,
edema)
ξ Will the Patient leave the OR with medical devices?
ξ Is the Patient on Vasopressors greater than 24 hours?
ξ Is your patient immunocompromised?
ξ Is the patient on Immunosuppressant medications?
ξ Skin prematurity
ξ 2 or more of the following: (smoker, HTN, DM, Vascular/Renal/PVD/CVD)


References:
National Pressure Ulcer Advisory Panel (NPUAP), European Pressure Ulcer Advisory Panel (EPUAP), Pan Pacific Pressure Injury Alliance, 2014. In:
Haesler, E. (Ed.), Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Cambridge Media, Perth.