Pressure injuries resulting from surgical positions: occurrence and risk factors

Authors

DOI:

https://doi.org/10.5327/Z1414-4425202429943

Keywords:

Pressure ulcer, Patient positioning, Perioperative nursing

Abstract

Objective: To verify the occurrence of pressure injuries resulting from surgical positioning and analyze associated risk factors. Method: Observational, cross-sectional, prospective study with a quantitative design conducted at a large hospital in São Paulo, with 128 patients. Results: The occurrence of pressure injuries was observed in 5.47% of the study participants, which was related to: the score of the Surgical Positioning-Related Pressure Injury Risk Assessment Scale, with an odds ratio of 1.54 for each unit increase; surgery time, with an odds ratio of 85.7% for each additional hour; prone surgical position, with an odds ratio of 13.42 compared to other positions; and neurosurgery specialty, with an odds ratio of 10.65 compared to other specialties. Conclusion: Surgical patients exhibit characteristics that put them at risk of developing pressure injuries, and the instrument used in the risk assessment proved to be relevant.

Author Biographies

Wanessa Alves Federico, Faculdade Israelita de Ciências da Saúde Albert Einstein – São Paulo (SP), Brazil.

Enfermeira. Mestre pelo Programa de Mestrado Profissional em Enfermagem da Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE)

Camila Mendonça de Moraes, Universidade Federal do Rio de Janeiro – Rio de Janeiro (RJ), Brazil.

Enfermeira. Pós-doutorado pela Escola de Enfermagem da Universidade de São Paulo (EEUSP). Professora Adjunta da Universidade Federal do Rio de Janeiro (UFRJ).

Rachel de Carvalho, Faculdade Israelita de Ciências da Saúde Albert Einstein – São Paulo (SP), Brazil.

Enfermeira. Doutora em Enfermagem pela Escola de Enfermagem da Universidade de São Paulo (EEUSP). Professora dos Cursos de Graduação e Pós-Graduação da FICSAE.

References

Báo ACP, Amestoy SC, Moura GMSS, Trindade LL. Quality indicators: tools for the management of best practices in Health. Rev Bras Enferm. 2019;72(2):360-6. https://doi.org/10.1590/0034-7167-2018-0479 DOI: https://doi.org/10.1590/0034-7167-2018-0479

Brasil. Agência Nacional de Vigilância Sanitária. Plano Integrado para a Gestão Sanitária da Segurança do Paciente em Serviços de Saúde 2021-2025 [Internet]. 2021 [acessado em 14 fev. 2023]. Disponível em: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/plano-integrado-2021-2025-final-para-publicacao-05-03-2021.pdf.

Nazário SS, Cruz EDA, Batista J, Silva DP, Pedro RL, Laynes RL. Caracterização de eventos adversos hospitalares: busca ativa versus notificação espontânea. Cogitare Enferm. 2022;27:e82040. https://doi.org/10.5380/ce.v27i0.82040 DOI: https://doi.org/10.5380/ce.v27i0.82040

Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult pacientes: a systematic review and meta-analysis. Int J Nurs Stud. 2020;105:103546. https://doi.org/10.1016/j.ijnurstu.2020.103546 DOI: https://doi.org/10.1016/j.ijnurstu.2020.103546

Caliri MHL, Santos VRCG, Mandelbaum MHS, Costa IG. Consenso NPUAP 2016 – classificação das lesões por pressão adaptado culturalmente para o Brasil [Internet] 2016 [acessado em 24 fev. 2023]. Disponível em: https://sobest.com.br/wp-content/uploads/2020/10/CONSENSO-NPUAP-2016_traducao-SOBEST-SOBENDE.pdf

Buso FDS, Ferreira MBG, Felix MMS, Galvão CM, Barichello E, Barbosa MH. Lesão por pressão decorrente do posicionamento cirúrgico e fatores associados. Acta Paul Enferm. 2021;34:eAPEOO642. https://doi.org/10.37689/acta-ape/2021AO00642 DOI: https://doi.org/10.37689/acta-ape/2021AO00642

Bezerra MBG, Galvão MCB, Vieira JCM, Lopes MGS, Cavalcanti ATA, Gomes ET. Fatores associados a lesões de pele intraoperatórias. Rev SOBECC. 2019;24(2):76-84. https://doi.org/10.5327/Z1414-4425201900020005 DOI: https://doi.org/10.5327/Z1414-4425201900020005

European Pressure Ulcer Advisory Panel. National Pressure Injury Advisory Panel and Pan Pacic Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries: clinical practice guideline. The International Guideline 2019. [Internet]. 2019 [acessado em 24 fev. 2023]. Disponível em: https://www.epuap.org/wp-content/uploads/2020/11/qrg-2020-brazilian-portuguese.pdf

Associação Brasileira de Enfermeiros de Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização. Diretrizes de práticas em enfermagem perioperatória e processamento de produtos para a saúde. 8a ed. São Paulo: SOBECC; 2021.

Sandes MS, Costa MF, Santos GV, Freitas LP, Vasconcelos ACP, Silva LSL. Lesões provenientes de procedimento cirúrgico: fatores relacionados. Rev SOBECC. 2019;24(3):161-7. https://doi.org/10.5327/Z1414-4425201900030008 DOI: https://doi.org/10.5327/Z1414-4425201900030008

Lopes CMM, Haas VJ, Dantas RAS, Oliveira CC, Galvão CM. Escala de avaliação de risco para lesões decorrentes do posicionamento cirúrgico. Rev Latino-Am Enfermagem. 2016;24:e2704. https://doi.org/10.1590/1518-8345.0644.2704 DOI: https://doi.org/10.1590/1518-8345.0644.2704

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9. https://doi.org/10.1016/j.jclinepi.2007.11.008 DOI: https://doi.org/10.1016/j.jclinepi.2007.11.008

Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução no 466, de 12 de dezembro de 2012. Diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos [Internet]. 2012 [acessado em 24 fev. 2023]. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html

Brasil. Agência Nacional de Vigilância Sanitária. Implantação do núcleo de segurança do paciente em serviços de saúde [Internet]. 2016 [acessado em 24 fev. 2023]. Disponível em: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/caderno-6-implantacao-do-nucleo-de-seguranca-do-paciente-em-servicos-de-saude.pdf

Brasil. Ministério da Saúde. Portaria no 529, de 1 de abril de 2013. Institui o Programa Nacional de Segurança do Paciente (PNSP) [Internet]. 2016 [acessado em 24 fev. 2023]. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html

Aloweni FBAB, Lim SH, Agus NLB, Ang SY, Goh MM, Yong P, et al. Evaluation of an evidence-based care bundle for preventing hospital-acquired pressure injuries in high-risk surgical patients. AORN J. 2023;118(5):306-20. https://doi.org/10.1002/aorn.14021 DOI: https://doi.org/10.1002/aorn.14021

Lima DCJ, Di Piero KC, Pinto CMI, Moraes CM. Incidência de lesão por pressão e avaliação do risco pela escala ELPO: estudo observacional. Res Soc Dev. 2021;10(5):e403101522704. https://doi.org/10.33448/rsd-v10i15.22704 DOI: https://doi.org/10.33448/rsd-v10i15.22704

Peixoto CA, Ferreira MBG, Félix MMS, Pires PS, Barichello E, Barbosa MH. Classificação de risco de desenvolvimento de lesões decorrentes do posicionamento cirúrgico. Rev Latino-Am Enferm. 2019;27:e3117. https://doi.org/10.1590/1518-8345.2677-3117 DOI: https://doi.org/10.1590/1518-8345.2677-3117

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

Lumbley JL, Ali SA, Tchokouani LS. Retrospective review of predisposing factors for intraoperative pressure ulcer development. J Clin Anesth. 2014;26(5):368-74. https://doi.org/10.1016/j.jclinane.2014.01.012 DOI: https://doi.org/10.1016/j.jclinane.2014.01.012

Shaw LF, Chang PC, Lee JF, Kung HY, Tung TH. Incidence and predicted risk factors of pressure ulcers in surgical patients: experience at a Medical Center in Taipei, Taiwan. Biomed Res Int. 2014;e16896. https://doi.org/10.1155/2014/416896 DOI: https://doi.org/10.1155/2014/416896

Scarlatti KC, Michel JLM, Gamba MA, Gutierrez MGR. Úlcera por pressão em pacientes submetidos à cirurgia: incidência e fatores associados. Rev Esc Enferm USP. 2011;45(6):1372-9. https://doi.org/10.1590/S0080-62342011000600014 DOI: https://doi.org/10.1590/S0080-62342011000600014

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Published

2024-06-20

How to Cite

Federico, W. A., de Moraes, C. M., & de Carvalho, R. (2024). Pressure injuries resulting from surgical positions: occurrence and risk factors. Revista SOBECC, 29. https://doi.org/10.5327/Z1414-4425202429943

Issue

Vol. 29 (2024)

Section

ORIGINAL ARTICLES

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Copyright (c) 2024 Wanessa Alves Federico, Camila Mendonça de Moraes, Rachel de Carvalho

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