118 - Prevention in Action: A Revolutionizing Strategy for Preventing Pressure Injuries

Description: Proper patient positioning is of paramount importance in ensuring the safety and success of surgical procedures. The healthcare team must have a clear understanding of the risks associated with positioning anesthetized patients and implement effective strategies to mitigate these risks and prevent injuries. In a significant 2023 study, a public orthopedic hospital in São Paulo reported that 60% of patients undergoing surgery experienced injuries as a direct result of improper positioning. This alarming statistic prompted the healthcare team to develop and launch an innovative program aimed at reducing surgical complications and shortening hospital stays, which concurrently led to an increase in the number of surgeries performed.
The program, aptly titled "Prevention in Action," was meticulously designed and comprised five comprehensive steps intended to enhance patient safety during surgical positioning:
1. Diagnosis: The initial step involved a thorough evaluation of the existing injury prevention measures within the operating room. 2. Training: The second step emphasized extensive education for the operating room staff, focusing on the potential complications related to surgical positioning. This included training sessions utilizing the Evidence-based Low-Positioning (ELPO) scale for risk assessment, as well as the development of a specific care protocol that outlined best practices for maintaining patient safety during procedures. Guided technical-scientific discussion to conclude the modifications to be made, and Guidance on the need to combine new technologies. 3. Simulations: The third step introduced realistic training simulations that provided staff the opportunity to practice handling relevant clinical cases and integrating advanced technologies commonly used in the operating room. These simulations included guided technical-scientific discussions that allowed for real-time feedback and collaborative decision-making regarding necessary procedural adjustments and the incorporation of innovative protective technologies. 4. Consultation: The fourth step focused on the integration of new protective technologies, such as specialized positioning devices and pressure-relief systems, while also developing a comprehensive care protocol that incorporated guidelines for their practical use.
5. Monitoring: The final step entailed ongoing monitoring of critical quality indicators to ensure that the objective of eliminating positioning-related injuries was met. A systematic follow-up approach was established to assess compliance with the new protocols and to evaluate patient outcomes.
As a result, the program was fully implemented over six months. By the conclusion, 100% (84 employees) of the surgical staff had completed the training, and new protective products were successfully integrated into practice. Follow-up assessments indicated a remarkable decrease in positioning-related injuries to 0% in the next 3 months following training, thereby allowing patients to be discharged more swiftly. Consequently, the average number of surgeries performed increased to nearly 700 per month, demonstrating enhanced efficiency within the hospital.
Implications for Practice: The robust framework established by the five steps of the Prevention in Action program can be replicated in any surgical center, effectively preventing injuries associated with patient positioning during surgery.