Investigation of the effect of care bundle for pressure injuries on reducing the development of operating room pressure injuries in patients undergoing orthopedic surgery

This non-randomized controlled, quasi-experimental clinical study aimed to determine the effect of the care bundle for pressure injuries applied in the early postoperative period in patients undergoing orthopedic surgery on the development of operating room pressure injuries, pain, fear of falling, and comfort. In the study, the care bundle for pressure injuries was prepared in accordance with the clinical guidelines and was applied to the patients in the study group. The care bundle consisted of "skin care, positioning, early mobilization, nutrition, and fluid intake" interventions. In the study, first, the data of the control group and then the data of the study group were collected. For data collection, a Patient Descriptive Data Form, the 3S Operating Room Pressure Injury Risk Assessment Scale, the Visual Comparison Scale, the Fear of Falling Scale, the General Comfort Questionnaire-Short Form, a Data Collection Form of Care Bundle for Pressure Injuries, National Pressure Ulcer Advisory Panel -NPUAP (2016) Pressure Injury Staging System, and a Follow-up Registration Form of Pressure Injury Areas and Stages were used. The patients in the control group underwent routine clinical application and the care bundle for pressure injuries, which was developed within the scope of the research, was not applied. In addition to routine clinical application, the care bundle for pressure injuries developed for this study was applied to the patients in the study group for 105 days. The data were evaluated using number, mean±standard deviation, percentage, and minimum-maximum values. In the study, the Independent Samples t-test was used to compare paired groups with normal distribution and the Mann-Whitney U test was used for the comparison of paired groups without normal distribution. The Chi-square test was used to compare categorical variables. Statistical calculations and interpretations were evaluated at a level of p<0.05. The research sample consisted of a total of 190 patients: 122 in the control group and 68 in the study group. The incidence of operating room pressure injuries was 18.4% in the control group and 5.7% in the study group. Age, presence of at least one chronic disease, especially hypertension, medical diagnosis, especially hip fracture, emergency surgical intervention, a preoperative ASA class ≥3, time spent in the clinic preoperatively, mean length of hospital stay (days), 3S Operating Room Pressure Injury Risk Assessment Scale score of ≥19, preoperative low albumin and hemoglobin values were determined to be effective in patients who developed pressure injuries (p<0.05). The care bundle for preventing operating room pressure injuries, which includes evidence-based interventions, was found to be effective in preventing the development of operating room-induced pressure injuries. Furthermore, it was determined that the care bundle had positive results in reducing the perception of pain and fear of falling and increasing the comfort level in patients. It is recommended to use the care bundle for pressure injuries to prevent the development of operating room pressure injuries.