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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

Authors :
Guido Ciprandi
Serena Crucianelli
Mario Zama
Giancarlo Antonielli
Riccarda Armani
Stefano Aureli
Gianmarco Barra
Charlie Joseph Charles Beetham
Giulio Bernardini
Federica Cancani
Andrea Carai
Marta Cajozzo
Laura Carlesi
Alessandra Cialdella
Italo Ciaralli
Gaetano Ciliento
Tiziana Corsetti
Benedetta De Chirico
Paolo Di Corato
Andrea Dotta
Sergio Filippelli
Marina Franci
Jacopo Frattaroli
Francesca Grussu
Silvia Lico
Patrizia Losani
Marjola Giergji
Simonetta Magli
Simone Faustino Marino
Antonella Mongelli
Martina Nazzarri
Mauro Pace
Giancarlo Palmieri
Ilaria Pannacci
Franca Paparozzi
Manuel Pomponi
Anna Portanova
Alessandra Preziosi
Angela Ragni
Massimiliano Raponi
Tommaso Renzetti
Mirialda Rizzo
Marco Roberti
Eleonora Sasso
Immacolata Savarese
Simone Secci
Daniele Selvaggio
Laura Serafini
Giorgio Spuntarelli
Urbano Urbani
Valentina Vanzi
Roshani Permatunga
Nick Santamaria
Source :
International Wound Journal. 19:1887-1900
Publication Year :
2022
Publisher :
Wiley, 2022.

Abstract

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.

Details

ISSN :
1742481X and 17424801
Volume :
19
Database :
OpenAIRE
Journal :
International Wound Journal
Accession number :
edsair.doi.dedup.....0cc1ec3483d76492ef16420acf71510d
Full Text :
https://doi.org/10.1111/iwj.13967