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Development of an evidence-based protocol for the prevention of perioperative pressure injuries in pediatric cardiac
Xiangai Ma1, Jialu Fan2, Jiehui Wang2
1Health Management Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China.
Insights
This study developed a scientific and feasible protocol to prevent pressure injuries (PPIs) in pediatric cardiac surgery patients. The evidence-based guidelines offer standardized care for nurses, improving patient outcomes.
Area of Science:
- Pediatric Cardiac Surgery
- Patient Safety
- Evidence-Based Practice
Background:
- Pediatric patients undergoing cardiac surgery face significant risks of perioperative pressure injuries (PPIs).
- Standardized prevention strategies are crucial for this vulnerable population.
Purpose of the Study:
- To develop an evidence-based protocol for the prevention of PPIs in pediatric cardiac surgery.
- To create a standardized approach for perioperative nurses.
Main Methods:
- A comprehensive literature review identified existing PPI prevention evidence.
- Two rounds of Delphi surveys with 20 multidisciplinary experts refined the protocol.
- Statistical analysis assessed the reliability and consensus of expert opinions.
Main Results:
- Consensus was achieved on a 4-level, 15-s-level, and 27-third-level PPI prevention protocol.
- High Delphi survey response rates (83.3% and 100%) and reliability coefficients (Cr=0.905, CV<0.25, Kendall' W=0.172) confirmed expert agreement.
- The protocol is deemed scientific and feasible.
Conclusions:
- A robust, evidence-based protocol for PPI prevention in pediatric cardiac surgery was successfully developed.
- This protocol provides a standardized framework for perioperative nurses.
- Implementation of this protocol aims to reduce PPI incidence in pediatric cardiac surgery patients.
Aim:
Pediatric patients undergoing cardiac surgery are at high risk for perioperative pressure injuries (PPIs). This study aimed to develop an evidence-based protocol for the prevention of PPIs in pediatric cardiac surgery.
Methods:
A literature review was conducted to identify and summarize the existing evidence on PPI prevention in pediatric cardiac surgery to construct an initial protocol. Two rounds of Delphi surveys were then performed to refine the protocol. The expert panel consisted of 20 multidisciplinary professionals from five tertiary hospitals, including nurses, surgeons, and anesthesiologists, 85 % of whom possess more than 20 years of clinical experience. The mean values of importance and feasibility of each indicator were calculated. Reliability of the Delphi method assessed by valid response rate, authority coefficient (Cr), coefficient of variation (CV) and Kendall' W coefficient (Kendall' W).
Results:
Consensus was reached on 4 first-level items, 15 s-level items, and 27 third-level items for the PPI prevention protocol. The valid response rates for the two Delphi rounds were 83.3 % and 100 %, respectively, with Cr of 0.905 and 0.901, CV of less than 0.25, and Kendall' W of 0.172 and 0.142 (P < 0.001).
Conclusion:
The developed PPI prevention protocol for pediatric cardiac surgery is both scientific and feasible, providing a reference for perioperative nurses to implement systematic and standardized PPI prevention care.
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