Using pressure mapping intraoperatively to prevent pressure ulcers-A quasi-experimental study.

Background and Aim: Patients undergoing surgery are at high risk of developing pressure ulcers. However, pressure ulcer prevention in the operating room department is demanding and restricted. New techniques, such as continuous pressure mapping that visualizes interface pressure, are now available. The aim of the study was to determine whether pressure mapping information of interface pressure intraoperatively leads to (1) more frequent intraoperative micro repositioning and a reduced amount of pressure on the sacrum area and (2) a lower frequency of pressure ulcer development. Methods: A quasi-experimental ABA design was used. A total of 116 patients undergoing surgery were included. During the B phase, the need to consider repositioning the patient according to interface pressure readings was initiated. Results: The result showed that there was significantly higher interface pressure in the A2 phase than in the B phase. Micro repositioning of the patient during surgery was performed in the B phase, but not in the A phase. The regression model showed that a higher BMI was associated with higher interface pressure. None of the patients developed hospital-acquired pressure ulcers up to Day 1 postoperatively. Conclusion: Pressure mapping involves moving away from expert opinion and tradition towards objective assessment and flexibility and we see the benefits of using pressure-mapping equipment in operating room contexts. However, more research is needed in this area.

Different patient groups request different emergency care - a survey in a Swedish emergency department.

AIM: This study investigates possible differences in the perception of quality of care at an emergency department, as related to patient background and visit characteristics. METHODS: The study uses a prospective, descriptive survey design with data collected in May 2002 from the emergency department of a Swedish university hospital. It included 200 patients with an average age of 51 yr (range 18-91 yr). The research-based Quality from the Patient's Perspective (QPP) questionnaire, emergency department version, was used for data collection. RESULTS: Several factors, for example, information after procedures, respect and empathy, nutrition, general atmosphere and routines, were rated significantly lower by patients with gastrointestinal symptoms, general surgery patients and patients admitted to a hospital ward, than by patients with other background or visit characteristics. CONCLUSIONS: There are differences in the perception of quality of care related to patient background and visit characteristics at the emergency department. Clinical guidelines for different patient groups could facilitate the quality improvement work. However, to improve the quality of care at the emergency department there should be a balance between standardized care and individualized patient care. In addition, there has to be a changed attitude and behaviour towards the ED patients to improve their perception of the emergency care.