Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Robert McWhirt

Abstract

The purpose of this project was to develop clinical practice guidelines for intraoperative positioning that will help prevent deep tissue injury and skin breakdown. Maintaining skin integrity in the surgical patient by preventing deep tissue injuries and skin breakdown is an identified gap in practice for surgical patients in the Operating Room environment that a clinical practice guideline could positively impact. To assist in achieving the development of a clinical practice guideline to maintain skin integrity, Benner's novice to expert theory addressing the educational needs for novice operating room nurses was applied. The clinical practice guideline, based on evidence, should be made available to the peri-operative nurses that would include evidence-based guidance on positioning devices. A comprehensive literature search was performed, and the evidence obtained was synthesized based on the hierarchy of evidence table. The guideline was evaluated by a multidisciplinary expert panel using the Agree II tool. The multidisciplinary team consisted of an Operating Room Registered Nurse, a Certified Registered Nurse Anesthetist, and an Anesthesiologist. Each of the panel members is currently working in the operating room and has had at least 12 years of recent experience in that service line. The expert panel had additional recommendations that were included with the final guideline. A final clinical practice guideline was established for the project. Establishing a clinical practice guideline to prevent skin breakdown and deep tissue injuries will demonstrate a social change by assisting the nurses to adequately manage the surgical patient's needs, improve quality outcomes for the patients, and increase reimbursements for the facilities.

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