[A project to reduce the incidence of facial pressure ulcers caused by prolonged surgery with prone positioning].
OBJECTIVE
We observed in our institute a 13.6% incidence of prolonged surgery (>4 hours) induced facial pressure ulcers that required prone positioning. Causes identified included: (1) customized silicon face pillows used were not suited for every patient; (2) our institute lacked a standard operating procedure for prone positioning; (3) our institute lacked a postoperative evaluation and audit procedure for facial pressure ulcers.


OBJECTIVE
We designed a strategy to reduce post-prolonged surgery facial pressure ulcer incidence requiring prone positioning by 50% (i.e., from 13.6% to 6.8%).


METHODS
We implemented the following: (1) Created a new water pillow to relieve facial pressure; (2) Implemented continuing education pressure ulcer prevention and evaluation; (3) Established protocols on standard care for prone-position patients and proper facial pressure ulcer identification; (4) Established a face pressure ulcers accident reporting mechanism; and (5) Established an audit mechanism facial pressure ulcer cases.


RESULTS
After implementing the resolution measures, 116 patients underwent prolonged surgery in a prone position (mean operating time: 298 mins). None suffered from facial pressure ulcers. The measures effectively reduced the incidence of facial pressure ulcers from 13.6% to 0.0%.


CONCLUSIONS
The project used a water pillow to relieve facial pressure and educated staff to recognize and evaluate pressure ulcers. These measures were demonstrated effective in reducing the incidence of facial pressure ulcers caused by prolonged prone positioning.
Department of Nursing, National Taiwan University Hospital, Republic of China.
Wen-Yi
WY
Lee
Pao-Chen
PC
Lin
Chia-Hsing
CH
Weng
Yi-Lin
YL
Lin
Wen-Lin
WL
Tsai
D001512:Bedding and Linens; D005151:Facial Injuries / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D011312:Pressure; D003668:Pressure Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D016684:Prone Position