Welcome to the latest edition of the superb resource informing your clinical practice: the JWOCN. The wound section focuses on acute care and skin damage. Kim and Lee conducted a case-control epidemiological study on over 6,000 Korean adult surgical patients. Their retrospective study identified that the coccyx and the trunk were the most common sites for pressure injuries (PIs). Notable risk factors for PI development were patient position, ICU admission after surgery, requiring a blood transfusion during OR care, and surgery duration.
Lauderbaugh, Popein, Lesser and colleagues focused on pediatric patient care during noninvasive ventilation via masks and facial skin breakdown. By implementing a bundled approach including keeping mask leak parameter pressure between 25 and 55 lpm, the researchers' quality improvement (QI) project decreased high stage PI injury rate from 6 (5.2%) to 1 (1.1%). By monitoring both mask pressure and compliance rates of clinicians' care, pediatric PI risk decreased markedly.
In a novel study, Berke used the QI approach to identify the actual prevalence rate of friction skin injury (FcI) on patients' buttocks in an academic medical center. The identified rate was 2.3% with a strong overlap between FcI and fecal/urinary incontinence. A need for further studies is documented to establish FcI's true epidemiology across care settings.
A major study anchors the ostomy section. Schott, Eaves, Inglese, and Sinha reported the results of a major retrospective cohort study on individuals undergoing abdominal ostomy surgery using a United States database that stores information from 25% of all inpatient hospital discharges. The sample comprised 27,658 adults (15,512 colostomy, 10,207 ileostomy, and 1,930 urostomy patients). The study provides a needed “big picture" in a critical area: ostomy surgery. The results provide information like median length of stay (9 days), most common underlying diagnoses, and rates of hospital readmission per type of ostomy. Expect this article to be cited frequently in future, and it can inform your practice by providing benchmarks.
Check out this issue; what you can learn is well worth your time.
Janice Beitz, Deputy Editor