Guideline Implementation: Positioning the Patient

Burlingame, Byron

doi:10.1016/j.aorn.2017.07.010

Cited by 41 publications

(63 citation statements)

References 24 publications

(50 reference statements)

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“…Donut-shaped gel head supports are typically made of gel materials and are used to protect the head, neck, and ears during motionless treatments by off-loading the occiput, often in the OR during surgical procedures conducted in supine patients, as well as during recovery from operation or in the ICU. 8,9 In the present work, we compared the state of mechanical loads in scalp tissues of the occipital region while using a donut-shaped gel head support, a Z-Flo head positioner, or a standard medical foam support for the same virtual adult head using our FE modelling framework, which was validated against pressure mapping. Our results demonstrated that a standard, flat medical foam is more successful than a donut-shaped gel head support in dispersing scalp tissue loads, but the foam is still limited in conformability relative to the Z-Flo fluidised positioner.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] Head positioning, specifically, is required for maintaining midline and/or the chin upwards, for immediate access to the airways in an anaesthetised, ventilated patient, as well as for the distribution of head loads at the occipital region in the supine posture. 8,9 Common positioning techniques that nursing teams are employing often include the use of items that are not specifically designed for the purpose of therapeutic positioning, such as rolled towels and blankets that flatten and will not maintain a set position, and may also heat up. 8 Dedicated head supports also exist.…”

Section: Introductionmentioning

confidence: 99%

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Modelling an adult human head on a donut‐shaped gel head support for pressure ulcer prevention

Katzengold

Gefen

2019

International Wound Journal

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Patients who are stationary endure prolonged pressures and shear loads at contact areas between their body and the support surface, which over time may cause pressure ulcers (PUs). Donut‐shaped gel head supports are commonly used to protect the occiput, which is among the most common anatomical sites for PUs; however, the biomechanical efficacy of these devices is unclear. To investigate their effects on scalp tissues, we have used our three‐dimensional anatomically realistic finite element model of an adult head, to which we have added a donut‐shaped gel head support. We then compared the occipital scalp tissue loads' occurrence while the donut‐shaped gel head support is in use with those associated with a fluidised head positioner and a standard medical foam. The donut‐shaped gel head support inflicted the greatest exposure to tissue mechanical stresses, particularly to the high (and therefore dangerous) stress domain, when compared to the other positioners. We concluded that while the donut‐shaped gel head support is designed to avert tissue loads away from the occiput and disperse them to the surroundings, in practice, it fails to do so. In fact, the donut‐shaped gel head support imposes the head‐weight forces to transfer through a relatively narrow ring of scalp tissues, hence increasing the risk of developing occipital PUs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modelling an adult human head on a donut‐shaped gel head support for pressure ulcer prevention

Katzengold

Gefen

2019

International Wound Journal

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“…This could be possibly due to the unsuitability of operating table length for tall people, which causes their ankles to hang off the bed and puts excess pressure on their skin. Therefore, it is recommended to place a proper pad where the patient's ankles hang off the operating table (34).…”

Section: Discussionmentioning

confidence: 99%

Postoperative Skin Complications after Spine Surgery in the Prone Position

Bagheri

Sadati

Beyrami

et al. 2019

jcbr

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Background and objectives: One of the adverse effects of prone positioning in spine surgery is the occurrence of skin damage. Due to the high rate of spine surgeries and the frequent use of prone positioning during these procedures, we aimed to investigate postoperative skin complications after spine surgery in the prone position. Methods: This descriptive cross-sectional study was performed in 2016-2017 on 160 patients undergoing spine surgery in the prone position at a teaching hospital in Tehran, Iran. The patients' body parts were examined for presence any redness, ecchymosis and pressure ulcers before discharge from the hospital. Collected data were analyzed in SPSS software (version 19) using descriptive statistics, Chi-square test, Mann-Whitney U test and Kendall's correlation coefficient. Results: Almost all patients had skin damage, especially redness, in the postoperative stage. Age, gender, duration of surgery, height, weight and body mass index were significantly associated with incidence of skin damage (P<0.05). Conclusion: Our results indicated that the incidence of postoperative skin damage is relatively high in patients undergoing spine surgery in the prone position. Therefore, it is recommended to take appropriate precautions in order to prevent these complications.

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“…Surgery specific positioning protocols should be integrated into surgical checklist to decrease positioning injuries. 67…”

Section: Intraoperative Considerations Patient Positioningmentioning

confidence: 99%

Patient Safety in Microvascular Plastic Surgery

Colakoğlu

Tebockhorst

Chong

et al. 2019

J reconstr Microsurg

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Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to identify the characteristics of patients, practitioners, and microvascular surgical procedures that place patients at risk for preventable harm, and to discuss evidence-based prevention practices that can potentially help to generate a culture of patient safety.

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Guideline Implementation: Positioning the Patient

Cited by 41 publications

References 24 publications

Modelling an adult human head on a donut‐shaped gel head support for pressure ulcer prevention

Modelling an adult human head on a donut‐shaped gel head support for pressure ulcer prevention

Postoperative Skin Complications after Spine Surgery in the Prone Position

Patient Safety in Microvascular Plastic Surgery

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