The Braden Q+P: A Pediatric Perioperative Pressure Ulcer Risk Assessment and Intervention Tool

Pressure ulcers continue to be a personally and financially expensive complication of surgery and hospitalization. The effects of anesthesia, immobilization during surgery, and use of multiple medical devices all place the surgical patient at high risk for pressure-related skin injury. As part of a comprehensive pressure ulcer prevention initiative, nurses in the cardiac and main ORs at Children's Hospital Boston, Massachusetts, became concerned that current pressure ulcer risk assessment tools did not adequately capture the intense but short-term risk posed in the operating and procedural suites. A team, formed to investigate this matter, developed a tool to guide nursing assessment of patient risk and to plan nursing interventions to prevent pressure ulcers. Results after implementation of the Braden Q+P tool appear to show improvement in preventing pressure ulcers. Increased awareness of pressure ulcer prevention, a hospital focus on skin care, and nursing education about pressure ulcers supported this improvement.