NurseFrawg

Thank you all for your replies! So we are doing some stuff well. We do chart about skin pre and post in the chart. I think our manager wanted something else for us to fill out so that tracking of cases could be easier. Our PACU staff follows up on all of postop patients, issues or not. We use a lot of foam padding, gel padding, and padded covers that go on the hip pads for the Jackson table. We tried duoderm without much success and in a few cases caused more issues that it prevented. Maybe breakdown is a bit of an overstatement. Generally what we see is intact red to dark red blanchable intact skin. Very rarely we have blistering. Many of our kids are not great surgical candidates unfortunately either very underweight or obese with many contractures and other deformities that we must position and pad around. What I saw is that we under use our camera for documenting purposes and I will relay this information back. Thanks again for your responses.

I have been tasked to do some sluething about skin alteration caused by positioning in the OR. I work in a small children's hospital that specializes in ortho and plastic surgery. I work in presurgery admitting, OR and PACU. We currently have a form that is NOT part of the chart used to track any skin issues, but the form isn't always filled out or lost or incorrect verbage is used. We have seen some pretty significant skin breakdown on our kids, mostly over bony prominences after extended length spine surgeries. Most of us feel we are doing everything possible to avoid alterations, but we are seeing more obese children that do not fair well with being in one position for 9 plus hours. I would like to know Who and how do you chart this? How do you follow up with patients? Do you write an incident report for each case? What have you done to avoid breakdowns? Thanks for any help!

At the hospital I work at the circulator and anesthesiologist go to pick up the patient from the preop area. The scrub and an aide or a floating RN stay in the room to finish opening items and preparing for the surgery. The only issue is making sure the count is done. We always ask before just surprising staff in the OR. At the end of the sturgery PACU if able will come to the OR to get report and the patient. Granted I work in a small (3 OR peds facility), but it works for us. Very short turn over times. I wouldn't trust my anesthesiologist checking to make sure ALL of the paperwork was done. I love them, but seriously they are pretty clueless on the paperwork needed. Also if I spot that a procedure is changed or added or a supply is needed I can call in and let the room know.