patients simply by not properly
assessing them for pressure
injury risks and intervening
when necessary.
I'm very passionate about
pressure injury prevention, and
I truly believe we can create a
culture that sees PIs — occur-
rences that in extreme cases
lead to infection, sepsis and even death — as "never events." But
getting there depends on breaking down the silos that exist in the
care continuum and following a critical three-step PI process for
every single patient who comes through our doors: Identify, inter-
vene and prevent. At my previous facility, I combined a thorough,
standardized risk assessment with a PI prevention bundle to reduce
what we were seeing in far too many patients. Here's how you can
do the same at your HOPD or ASC.
Identify at-risk patients
PI prevention all starts with identifying those patients who are
most at risk for a pressure injury by using an appropriate risk-
assessment tool. The key word here is appropriate. There's a com-
mon misconception that the Braden scale, which is still generally
the gold standard across this country, is the only way to identify
any patients who are at-risk for PIs — even those undergoing
shorter outpatient procedures. With this population, you want a
tool that will quickly allow you to determine if a patient is at-risk
for an injury, as opposed one that measures the patient's specific
risk level, which is what the Braden scale gauges). That's why we
used the CMUNRO SCALE (osmag.net/RjwK4V). In the critical
4 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 2 0
Pressure injuries
occur when staff fail to
take specific measures
to protect patients'
vulnerable areas.
