Papers by Hester Fletcher
OR nurse, May 1, 2014
A Assessing patients before, during, and after surgery is an integral part of perioperative nursi... more A Assessing patients before, during, and after surgery is an integral part of perioperative nursing. This assessment and intervention can prevent skin injury and reduce hospital length of stay in addition to undue pain. Prolonged surgery can be an added risk factor for pressure ulcer development in surgical patients. According to the National Pressure Ulcer Advisory Panel (NPUAP), a pressure ulcer is defined as "localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with a shear." 1 With the prolonged pressures from surgery paired with immobility and tissue compression, pressure ulcers are a major risk factor. Pressure ulcers are caused by blood vessel occlusion from increased pressure and tissue compression as well as from reduced microcirculation. As a result, the tissue can't remove any excess fluids or toxic materials that develop in the area. The small changes in the tissue and pressure distort the affected areas, and necrosis can occur within a few hours. In 2007, the NPUAP updated the staging system for pressure ulcers. There are four stages of pressure ulcer development and two additional categories: unstageable pressure ulcers and suspected deep tissue injury. 1 (See NPUAP stages of pressure ulcers.) Due to the many changes in government intervention regarding healthcare reform, pressure ulcer prevention has received increased attention. The Centers for Medicare and Medicaid Services (CMS) includes stage III and IV pressure ulcers on their
OR Nurse, 2014
A Assessing patients before, during, and after surgery is an integral part of perioperative nursi... more A Assessing patients before, during, and after surgery is an integral part of perioperative nursing. This assessment and intervention can prevent skin injury and reduce hospital length of stay in addition to undue pain. Prolonged surgery can be an added risk factor for pressure ulcer development in surgical patients. According to the National Pressure Ulcer Advisory Panel (NPUAP), a pressure ulcer is defined as "localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with a shear." 1 With the prolonged pressures from surgery paired with immobility and tissue compression, pressure ulcers are a major risk factor. Pressure ulcers are caused by blood vessel occlusion from increased pressure and tissue compression as well as from reduced microcirculation. As a result, the tissue can't remove any excess fluids or toxic materials that develop in the area. The small changes in the tissue and pressure distort the affected areas, and necrosis can occur within a few hours. In 2007, the NPUAP updated the staging system for pressure ulcers. There are four stages of pressure ulcer development and two additional categories: unstageable pressure ulcers and suspected deep tissue injury. 1 (See NPUAP stages of pressure ulcers.) Due to the many changes in government intervention regarding healthcare reform, pressure ulcer prevention has received increased attention. The Centers for Medicare and Medicaid Services (CMS) includes stage III and IV pressure ulcers on their
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Papers by Hester Fletcher