Miller Stephannie, Parker Michael, Blasiole Nicole, Beinlich Nancy, Fulton Judith
Akron General Medical Center, Akron, OH 44307, USA.
Ostomy Wound Manage. 2013 Feb;59(2):44-8.
Deep tissue injury (DTI) can rapidly evolve into a higher stage pressure ulcer. Use of pressure-redistribution surfaces is a widely accepted practice for the prevention of pressure ulcers in acute care patients, particularly in departments where care processes limit mobility. A 15-year-old patient developed a sacral DTI 24 hours after completion of a lengthy (12- hour) electrophysiology (EP) study and catheter ablation. A root cause analysis (RCA) conducted to investigate the origin of the hospital-acquired suspected DTI prompted a small investigation to evaluate the pressure-distribution properties of the EP lab surface and an OR table pad. Five healthy adult employee volunteers were evaluated in the supine position by placing a sensing mat between the volunteer and the test surface. Interface pressures (on a scale of 0 mm Hg to 100 mm Hg) were captured after a "settling in" time of 4 minutes, and the number of sensors registering very high pressures (above 90 mm Hg) across the surface were recorded. On the OR table pad, zero to six sensors registered >90 mm Hg compared to two to 20 sensors on the EP lab surface. These data, combined with the acquired DTI, initiated a change in EP lab surfaces. Although interface pressure measurements only provide information about one potential support surface characteristic, it can be helpful during an RCA. Studies to compare the effect of support surfaces in all hospital units on patient outcomes are needed.
深部组织损伤(DTI)可迅速发展为更高阶段的压疮。使用压力再分布表面是预防急性护理患者压疮的一种广泛接受的做法,特别是在护理过程限制活动能力的科室。一名15岁患者在完成长达12小时的电生理(EP)研究和导管消融术后24小时出现骶部DTI。为调查医院获得性疑似DTI的起源而进行的根本原因分析(RCA)促使开展了一项小型调查,以评估EP实验室表面和手术台垫的压力分布特性。通过在志愿者和测试表面之间放置传感垫,对五名健康的成年员工志愿者进行仰卧位评估。在4分钟的“适应”时间后记录界面压力(范围为0毫米汞柱至100毫米汞柱),并记录整个表面记录到非常高压力(高于90毫米汞柱)的传感器数量。在手术台垫上,有零至六个传感器记录到>90毫米汞柱,而在EP实验室表面则有两个至二十个传感器。这些数据,结合所获得的DTI,引发了EP实验室表面的改变。虽然界面压力测量仅提供有关一个潜在支撑表面特性的信息,但在RCA过程中可能会有所帮助。需要开展研究以比较所有医院科室的支撑表面对患者结局的影响。