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Twilight (The Flamingo Hotel)
Monday, 29 January 2007
6:30 PM - 8:00 PM
Twilight (The Flamingo Hotel)
Tuesday, 30 January 2007
4:30 PM - 6:00 PM
Heel Pressure Blister Prevention in Orthopedic Surgery Patients
Nancy L. Grandovic, RN, BSN, MEd, Kathleen J. Valenty, RN, BSN, MSN, Judy Reiner, RN, BSN, MSN, Beth Jones, RN, Vanessa Santucci, RN, BSN, Shelley Wrotney, RN, Ken McHattie, BSHA, Diane Heasley, RN, BSN, MSN, ME, and Tibor Ketzan, MD. Heritage Valley Health System - Sewickley Valley Hospital, 720 Blackburn Rd, Sewickley, PA 15143
Behavioral objectives
Prevention of heel pressure blisters and sores is challenging for immobile orthopedic patients. An increase of skin breakdown in joint replacement patients prompted registered nurses to conduct a study to determine the efficacy of heel pillows (HP) versus a durable, cyanoacrylate liquid barrier film (LS) (LiquiShieldTM MedLogic UK).
Methods
Patients (n=146) admitted for primary hip (n=55) or knee replacement (n=91) surgery (DRG 209) over a 3 month period. Heel pillows or LiquiShieldTM used exclusively for alternating one-week periods. HP applied in the post anesthesia care unit. LS applied once,post-op day one. Daily Skin assessment, Braden Scale, ASA score, heel elevation were recorded by trained RN staff.
Results
HP = 85 patients, LS = 61 patients. Eighteen patients had some signs of skin breakdown (10 HP, 8LS). Erythema of the heels occurred on post-operative day one in 6 HP patients and in 5 patients prior to the application of LS. By post-operative day four there was a 90% decrease of heel erythema for LS treated patients compared to 42% decrease for HP (p=0.027). No correlation was found between elevated heels or ASA scores and signs of skin breakdown. Costs of using LS were also significantly lower than the use of HP ($1.68 v $14.50).
Conclusions
LiquiShieldTM is a simple and cost-effective technique to prevent skin breakdown related to friction and shear in the orthopedic patients.
- Determine effective nursing interventions for the prevention of skin breakdown related to friction and shear in the post operative orthopedic patient
- Identify and implement best practice standards ensuring optimal quality patient outcomes
Prevention of heel pressure blisters and sores is challenging for immobile orthopedic patients. An increase of skin breakdown in joint replacement patients prompted registered nurses to conduct a study to determine the efficacy of heel pillows (HP) versus a durable, cyanoacrylate liquid barrier film (LS) (LiquiShieldTM MedLogic UK).
Methods
Patients (n=146) admitted for primary hip (n=55) or knee replacement (n=91) surgery (DRG 209) over a 3 month period. Heel pillows or LiquiShieldTM used exclusively for alternating one-week periods. HP applied in the post anesthesia care unit. LS applied once,post-op day one. Daily Skin assessment, Braden Scale, ASA score, heel elevation were recorded by trained RN staff.
Results
HP = 85 patients, LS = 61 patients. Eighteen patients had some signs of skin breakdown (10 HP, 8LS). Erythema of the heels occurred on post-operative day one in 6 HP patients and in 5 patients prior to the application of LS. By post-operative day four there was a 90% decrease of heel erythema for LS treated patients compared to 42% decrease for HP (p=0.027). No correlation was found between elevated heels or ASA scores and signs of skin breakdown. Costs of using LS were also significantly lower than the use of HP ($1.68 v $14.50).
Conclusions
LiquiShieldTM is a simple and cost-effective technique to prevent skin breakdown related to friction and shear in the orthopedic patients.
See more of Evidence Based Practices
See more of The NDNQI Data Use Conference (January 29-31, 2007)