What a difference a degree makes

Healthcare Purchasing News, Dec, 2005 by Jeannie Akridge

Grisanti adds that ongoing evaluation is key to long-term reduction of pressure ulcers in the O.R. "You constantly have to reevaluate what you're doing to manage pressure in the O.R. If you're using foam, are you using it correctly? If you're using foam on a heel, you're not managing a potential pressure ulcer. It's not floating the heel. There's nothing there to protect/the heel], so any pressure you put on that heel is potential for a pressure ulcer."

Contributing to the problem, pressure ulcers may not present until after the surgery, and to further complicate the issue, they are sometimes mistaken for burns.

"There are a lot of horror stories that you hear where people say that they think that people are getting burned from blankets," said Grisanti. "Which is not necessarily tree. People are probably getting more pressure ulcers from lying in one spot for a prolonged period of time, than they are getting thermal injuries. They see a reddened area and they think it was because of the heat from the blanket. But in reality it is the beginning of a pressure ulcer."

She noted that the Association of periOperative Registered Nurses (AORN) along with other organizations, are increasing education efforts on pressure ulcers in the O.R.

Gaymar's line of PurGel positioning devices use a patented XCeIGel formula that conforms to the patients and helps to evenly distribute weight. Gaymar also offers an air-filled heel boot that can be used throughout the hospital or in the O.R.

Action Products (Hagerstown, MD) offers a broad line of over 150 reusable pads and positioners for pressure management and shear reduction in a multitude of size and configuration options, including custom requests. Made from a visco-elastic dry polymer, called Akton, the pads won't leak, flow, migrate or become misshapen. A durable but thin film covering moves with the patient to prevent shear. According to Mistie McElroy Witt, vice president corporate development, Action Products, the company was a pioneer in the development of gel and polymer based positioning products and pads and has substantial independent third-party clinical research to back up the claims made about their effectiveness. The company provides continuing education opportunities on pressure ulcer prevention.

"I do think, in general, the use of higher quality pads and positioners has evolved over the past fifteen years," said Witt. "With a lot of the patient safety initiatives currently going on throughout the hospital, they've really started to focus on where are injuries occurring, where are problems developing? talk about pressure ulcers, there's a lot of post-operative presentation of ulcers that occurred during surgery. And hospitals are starting to really look at: Do our nurses and anesthesiologists understand the proper protocol put out by AORN for positioning patients ? And then also what is the quality of the products we have in our hospital? And how does the cost of those products play into our overall hospital budget?"