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Learning Objective 1: Understand the effectiveness of using a predictive tool to identify perioperative patients at risk for pressure ulcers.
Learning Objective 2: Compare the benefits of using the Braden and PUREŠ Scales to evaluate patients for risk of pressure ulcer development.
The objective was to create a tool that will predict pressure ulcers in the perioperative population. The tool, Pressure Ulcer Risk Evaluation (PURE©), was developed with a multidisciplinary team including a wound care specialist and dietician.
The scale incorporates two elements from the Braden scale: activity and nutrition. The PURE© scale mirrors the scoring of the Braden scale: the lower the score, the higher the risk. The PURE© scale is used preoperatively and intraoperatively to assess a patient’s risk for developing pressure ulcers during surgery. Preoperatively the scale evaluates age, activity, malnutrition risk, skin assessment, previous history of ulcers, diabetes, hematocrit, cardiovascular surgery. Intraoperatively the scale evaluates anesthesia risk score (ASA), use of a warming blanket under the patient, use of extracorporeal circulation, hypotensive episodes (diastolic less than 60mm Hg), operating room time, surgical position and hypothermic episodes (less than 36°C) during surgery.
PURE© scale was validated by comparing results of both the Braden and the PURE © scales using 40 surgical patients. Results of the comparison indicated that the PURE© tool predicted surgical patients at risk for pressure ulcer development.
Using the PURE© scale, The Methodist Hospital in Houston, Texas will conduct a research study of 100 cardiovascular patients to predict pressure ulcer risk and methods of reducing the development of pressure ulcers.