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.

Autor: Ciprandi G; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Crucianelli S; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Zama M; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Antonielli G; Operative Unit of Odontostomatology, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Armani R; PIO XII Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Aureli S; Cardiology ICU, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Barra G; PIO XII Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Beetham CJC; Emergency Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Bernardini G; Division of Cardiology-Cardiothoracic Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Cancani F; Emergency Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Carai A; Division of Neurology-Neurosurgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Cajozzo M; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Carlesi L; S.Onofrio Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Cialdella A; Division of Cardiology-Cardiothoracic Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Ciaralli I; Dpt of Pediatric Oncohematology and Transfusion Medicine, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Ciliento G; Health Management, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Corsetti T; Clinical Pharmacology Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., De Chirico B; Division of Cardiology-Cardiothoracic Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Di Corato P; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Dotta A; Neonatal Intensive Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Filippelli S; Division of Cardiology-Cardiothoracic Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Franci M; Pediatric Intensive Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Frattaroli J; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Grussu F; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Lico S; S.Onofrio Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Losani P; Neonatal Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Giergji M; Dpt of Pediatric Oncohematology and Transfusion Medicine, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Magli S; S.Onofrio Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Marino SF; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Mongelli A; Clinical Pharmacology Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Nazzarri M; Cardiology ICU, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Pace M; Pediatric Intensive Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Palmieri G; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Pannacci I; S.Onofrio Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Paparozzi F; Dpt of Pediatric Oncohematology and Transfusion Medicine, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Pomponi M; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Portanova A; Neonatal Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Preziosi A; Pediatric Intensive Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Ragni A; Neonatal Intensive Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Raponi M; Health Management, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Renzetti T; Division of Neurology-Neurosurgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Rizzo M; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Roberti M; Division of Cardiology-Cardiothoracic Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Sasso E; Neonatal Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Savarese I; Neonatal Intensive Care Unit, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Secci S; PIO XII Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Selvaggio D; Division of Cardiology-Cardiothoracic Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Serafini L; PIO XII Operating Room, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Spuntarelli G; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Urbani U; Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Vanzi V; Division of General and Specialized Pediatrics, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy., Permatunga R; Department of Nursing, University of Melbourne & Royal Melbourne Hospital, Melbourne, Australia., Santamaria N; Department of Nursing, University of Melbourne & Royal Melbourne Hospital, Melbourne, Australia.
Jazyk: angličtina
Zdroj: International wound journal [Int Wound J] 2022 Nov; Vol. 19 (7), pp. 1887-1900. Date of Electronic Publication: 2022 Oct 17.
DOI: 10.1111/iwj.13967
Abstrakt: 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.
(© 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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