Perioperative Educator Overlook Medical Center Mountainside, New Jersey, United States
Description:
Description: Current practice includes use of foam egg-crate mattresses for intraoperative positioning and padding. Gel pads were proposed as an option for a therapeutic, cost-effective support surface to prevent a Hospital Acquired Pressure Injury (HAPI) during the intraoperative phase of care.
Presentation and Preparation: A recommendation to substitute standard foam positioners with gel pads was presented to the surgical services director, administrators, material managers, and focused team members. Utilizing a viscoelastic product (gel pad) provides many advantages including optimal protection for dependent body surfaces, financial savings from the reduction of a single-use product that generates nonrecyclable bulk waste and, decreased monopolization of manpower needed to cut foam material. A power point presentation on gel positioners highlighting their benefits to the patient, environment, workforce, and departmental budget was provided. A pilot unit was selected and through the performance improvement process, data was collected, compiled and analyzed.
Assessment: The pilot was conducted over nine weeks, data was collected from 151 cases. These cases were audited for compliance, patient outcome and financial savings. All 151 cases used gel pads for positioning. Of these 151 cases, 36 required supplemental foam padding due to case positioning needs or provider requests.
Implementation: Six operating rooms were supplied with gel pads for the arm boards and, calf and foot portion of the bed. Team members received instruction on positioning and disinfection of the gel pads. Support staff previously assigned to cutting and stocking foam were reassigned to other tasks.
Outcome: Preventative positioning was provided with a quality gel pad surface. Review of materials and labor costs show a saving of up to $60,000/year. The decreased volume of purchased foam saves the department $14,937/year. During the nine-week pilot period, reduction in foam use freed up valuable space. Staff no longer assigned to cutting foam material, saves the department approximately $44,109.00/year in hourly wages dedicated to this task.
Implication for Perioperative Nursing: AORN positioning guidelines emphasize the vulnerability of the anesthetized patient, rendering them immobile increases their risk of developing a HAPI. Viscoelastic products, such as gel pads, are acknowledged in the AORN guideline as an effective pressure redistribution surface. Preventative HAPI positioning, environmental prudence, and cost savings are benefits gained with the use of gel pad positioners.