Nursing interventions for preventing pressure ulcers in the perioperative period

Authors

DOI:

https://doi.org/10.5327/Z1414-4425202428919

Keywords:

Pressure ulcer, Perioperative period, Nursing, Nursing care, Perioperative nursing

Abstract

Objective: To identify risk factors and nursing interventions for preventing pressure ulcers in perioperative patients. Method: This is an integrative literature review, for which data were collected in the following databases: Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and National Library of Medicine (Medline). Data collection took place between July and August 2022. Original articles, without language restrictions and related to the research topic, were included. Thematic analysis was used for data processing. Results: Based on the analysis of the 16 publications that composed the corpus of this study, two categories were listed: a) risk factors for developing pressure ulcers in patients in the perioperative period; b) nursing interventions to prevent pressure ulcers. Conclusion: Risk factors for developing pressure ulcers are: being an older adult, malnourished or overweight, and comorbidities such as diabetes mellitus, vasculopathy, neuropathy, among others. Nursing interventions include: assessing risks using scales, such as ELPO and Munro, performing appropriate surgical positioning, protecting bone spurs, and planning unique patient care.

References

Medeiros AC, Araújo-Filho I. Centro cirúrgico e cirurgia segura. J Surg Cl Res. 2017;8(1):77-105. https://doi.org/10.20398/jscr.v8i1.13037 DOI: https://doi.org/10.20398/jscr.v8i1.13037

Brasil. Ministério da Saúde. Protocolo para cirurgia segura [Internet]. Brasília: Ministério da Saúde; 2013 [acessado em 10 jul. 2022]. Disponível em: https://proqualis.net/sites/proqualis.net/files/0000024279j862R.pdf

Governo do Distrito Federal. Secretaria de Estado de Saúde. Subsecretaria de Atenção Integral à Saúde. Comissão Permanente de Protocolos de Atenção à Saúde. Segurança do paciente: cirurgia segura [Internet]. Brasília: Governo do Distrito Federal; 2019 [acessado em 10 jul. 2022]. Disponível em: https://www.saude.df.gov.br/documents/37101/51535/02.++Protocolo+de+Segurança+do+Paciente+-+Cirurgia+Segura.pdf

Neiva MJLM, Sousa MM, Silva MFN, Vieira JL, Melo MF, Reis EM, et al. Nursing care in prevention to pressure injuries in hospitalized patients. Braz J Hea Rev. 2019;2(5):4336-44. https://doi.org/10.34119/bjhrv2n5-036 DOI: https://doi.org/10.34119/bjhrv2n5-036

Angelo CS, Pachioni CFM, Joaquim EHG, Silva EAL, Santos GG, Bonfim IM, et al. Effectiveness of the protocol for the prevention of skin lesions in robotic urological surgeries. Rev SOBECC. 2017;22(3):152-60. https://doi.org/10.5327/Z1414-4425201700030006 DOI: https://doi.org/10.5327/Z1414-4425201700030006

Lopes CMM, Haas VJ, Dantas RAS, Oliveira CG, Galvão CM. Assessment scale of risk for surgical positioning injuries. Rev Lat Am Enfermagem. 2016;24:e2704. https://doi.org/10.1590/1518-8345-0644.2704 DOI: https://doi.org/10.1590/1518-8345.0644.2704

Mendes KDS, Silveira RCCP, Galvão CM. Integrative literature review: a research method to incorporate evidence in health care and nursing. Texto & Contexto Enferm. 2008;17(4):758-64. https://doi.org/10.1590/S0104-07072008000400018 DOI: https://doi.org/10.1590/S0104-07072008000400018

Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Gestão e Incorporação de Tecnologias em Saúde. Diretrizes metodológicas: elaboração de revisão sistemática e meta-análise de ensaios clínicos randomizados [Intertnet]. Brasília: Ministério da Saúde; 2012 [acessado em 10 jul. 2022]. Disponível em: https://rebrats.saude.gov.br/phocadownload/diretrizes/20210622_Diretriz_Revisao_Sistematica_2021.pdf

Melnyk BM, Fineout-Overholt E. Evidence based practice in nursing & healthcare: a guide to best practice. 3rd ed. Philadelphia: WoltersKluwer Health; 2015.

Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 12a ed. São Paulo: Hucitec; 2010.

Trevilato DD, Melo TC, Fagundes MABG, Caregnato RCA. Posicionamento cirúrgico: prevalência de risco de lesões em pacientes cirúrgicos. Rev SOBECC. 2018;23(3):124-9. https://doi.org/10.5327/Z1414-4425201800030003 DOI: https://doi.org/10.5327/Z1414-4425201800030003

Oliveira KF, Pires PS, De-Mattia AL, Barichello E, Galvão CM, Araújo CA, et al. Influence of support surfaces on the distribution of body interface pressure in surgical positioning. Rev Lat Am Enfermagem. 2018;26:e3083. https://doi.org/10.1590/1518-8345.2692.3083 DOI: https://doi.org/10.1590/1518-8345.2692.3083

Bjorklund-Lima L, Müller-Staub M, Cardozo MC, Bernardes DS, Rabelo-Silva ER. Clinical indicators of nursing outcomes classification for patient with risk for perioperative positioning injury: a cohort study. J Clin Nurs. 2019;28(23-24):4367-78. https://doi.org/10.1111/jocn.15019 DOI: https://doi.org/10.1111/jocn.15019

Xiong C, Gao X, Ma Q, Yang Y, Wang Z, Yu W, et al. Risk factors for intraoperative pressure injuries in patients undergoing digestive surgery: a retrospective study. J Clin Nurs. 2019;28(7-8):1148-55. https://doi.org/10.1111/jocn.14712 DOI: https://doi.org/10.1111/jocn.14712

Guo Y, Zhao K, Zhao T, Li Y, Yu Y, Kuang W. The effectiveness of curvilinear supine position on the incidence of pressure injuries and interface pressure among surgical patients. J Tissue Viability. 2019;28(2):81-6. https://doi.org/10.1016/j.jtv.2019.02.005 DOI: https://doi.org/10.1016/j.jtv.2019.02.005

Bezerra MBG, Galvão MCB, Vieira JCM, Lopes MGS, Cavalcanti ATA, Gomes ET. Factors associated with skin lesions resulting during the intraoperative period. Rev SOBECC. 2019;24(2):76-84. https://doi.org/10.5327/Z1414-4425201900020005 DOI: https://doi.org/10.5327/Z1414-4425201900020005

Peixoto CA, Ferreira MBG, Felix MMS, Pires PS, Barichello E, Barbosa MH. Risk assessment for perioperative pressure injuries. Rev Lat Am Enfermagem. 2019;27:e3117. https://doi.org/10.1590/1518-8345.2677-3117 DOI: https://doi.org/10.1590/1518-8345.2677-3117

Oliveira HMBS, Santos AMJF, Madeira MZA, Andrade EMLR, Silva GRF. Risk assessment for the development of perioperative lesions due to surgical positioning. Rev Gaúcha Enferm. 2019;40(spe):e20180114. https://doi.org/10.1590/1983-1447.2019.20180114 DOI: https://doi.org/10.1590/1983-1447.2019.20180114

Nascimento FCL, Rodrigues MCS. Risk for surgical positioning injuries: scale validation in a rehabilitation hospital. Rev Lat Am Enfermagem. 2020;28:e3261. https://doi.org/10.1590/1518-8345.2912.3261 DOI: https://doi.org/10.1590/1518-8345.2912.3261

Eberhardt TD, Lima SBS, Soares RSA, Silveira LBTD, Pozzebon BR, Reis CR, et al. Prevention of pressure injury in the operating room: Heels operating room pressure injury trial. Int Wound J. 2021;18(3):359-66. https://doi.org/10.1111/iwj.13538 DOI: https://doi.org/10.1111/iwj.13538

Sousa CS. Tradução, adaptação cultural e validação da Munro Scale para português do Brasil. REME Rev Min Enferm. 2021;25:e1404. http://dx.doi.org/10.5935/1415-2762-20210052 DOI: https://doi.org/10.5935/1415-2762-20210052

Gonzaga MJD, Gomes DF, Alves LC, Marques MF, Menezes RSP. Aplicação da escala em avaliação de risco para o desenvolvimento de lesões decorrentes do posicionamento cirúrgico do paciente. Rev SOBECC. 2021;26(2):99-106. https://doi.org/10.5327/Z1414-4425202100020006 DOI: https://doi.org/10.5327/Z1414-4425202100020006

Buso FDS, Ferreira MBG, Felix MMS, Galvão CM, Barichello E, Barbosa MH. Pressure injury related to surgical positioning and associated factors. Acta Paul Enferm. 2021;34:eAPE00642. https://doi.org/10.37689/acta-ape/2021AO00642 DOI: https://doi.org/10.37689/acta-ape/2021AO00642

Lei L, Zhou T, Xu X, Wang L. Munro pressure ulcer risk assessment scale in adult patients undergoing general anesthesia in the operating room. J Healthc Eng. 2022;2022:4157803. https://doi.org/10.1155/2022/4157803 DOI: https://doi.org/10.1155/2022/4157803

Santos LS, Silva MG, Souza DN, Tartaglia A. Risk evaluation for injuries due to surgical positioning in cardiac surgery. Rev SOBECC. 2022;27:E2227765. https://doi.org/10.5327/Z1414-4425202227765 DOI: https://doi.org/10.5327/Z1414-4425202227765

Associação Brasileira de Estomaterapia. Associação Brasileira de Enfermagem em Dermatologia. Consenso NPUAP 2016: classificação das lesões por pressão. Adaptada culturalmente para o Brasil [Internet]. 2016 [acessado em 18 jul. 2022]. Disponível em: https://sobest.com.br/wp-content/uploads/2020/10/CONSENSO-NPUAP-2016_traducao-SOBEST-SOBENDE.pdf

Burlingame BL Guideline implementation: positioning the patient. AORN J. 2017;106(3):227-37. https://doi.org/10.1016/j.aorn.2017.07.010 DOI: https://doi.org/10.1016/j.aorn.2017.07.010

Association of Perioperative Registered Nurses. Guidelines for perioperative practice. AORN: Canada; 2017.

Published

2024-02-07

How to Cite

Santana, L. O., Leal, S. M. C., Trevilato, D. D., Moraes, C. M. de, Silva Rodrigues Santos, G. N., & Treviso, P. (2024). Nursing interventions for preventing pressure ulcers in the perioperative period. Revista SOBECC, 29. https://doi.org/10.5327/Z1414-4425202428919

Issue

Section

REVIEW ARTICLES