Written by Rochelle Froloff, RN:
Recently, I had a discussion with a podiatrist who takes care of many patients in several nursing homes for wound care. We talked about the different devices that is available, viscoelastic/ gel mattress overlays, alternating air mattresses, etc. Some caregivers seem to think that if you utilize these wound prevention devices it will take the place of physically repositioning the patients. In my discussion with her, and with many nurses from around the world, I always stress the fact that you still have to reposition the patient at least every two hours. In doing so, you are getting the optimum effect of the mattress overlay pad. Additiionally, it has been demonstrated that if you use other Akton® viscoelastic polymer gel positioners, along with repositioning you are enhancing the performance of these pads.
As the pioneer of the polymer niche of pressure ulcer management products, Action Products, Inc. has been at the forefront of pressure sore prevention and pressure ulcer education. We wanted to contribute and realized the valuable input AORN and other professional organizations could provide in the dedication to our mutual goal of Patient Safety. One of the greatest benefits the membership offers is access to and consultation with organization that are formulating and discussing the programs, policies, standards and initiatives guiding the future of patient safety. I would like to include a list of just some of these organizations: The Joint Commission, AORN, ASHRM, ACS, CMS and AHRMM to name a few.
Pressure ulcer management has become a standard part of every modern hospital's protocol. The inclusion of HAPU's (hospital acquired pressure ulcers) as a Never Event by CMS in 2008 marked a turning point for most facilities. Action Products, Inc. will continue its dedication to the development of DME products, Surgical Table Pads and Gel Positioners which support Pressure Ulcer Management and will strive to ensure patient safety. We are honored to be a member of IPPS.
As many of you know- Action turned 40 years old this year. At a company party we showed a corporate timeline slide show to our founder, Dr. McElroy, who invented Akton(R) polymer in the basement of his New York home. He created a viscoelastic polymer with the sole purpose of decubitus ulcer prevention. The first products made were for the DME market. Since it had such a positive effect in preventing pressure sores, Action went on to combat hospital acquired pressure ulcers. Now, we export to over 58 countries across the globe. In fact, 40+ countries a week read this blog.In the medical marketplace, the polymer was lumped in with gel pads for wound prevention and surgical patient safety- which is why you will see Action(R) products in with gel wheelchair cushions and gel positioners. Please know that we view ourselves fondly as a viscoelastic polymer manufacturer.
Please enjoy this short slide show and take a trip down Action's "Memory Lane." The view is beautiful.
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"User insight into medical product engineering and design can be gotten by attending one of the Medical Design and Manufacturing shows held across the country throughout the year. My staff and I just returned from New York after attending the show held June 7-10. It is a great opportunity to view and discuss new materials, manufacturing methods and a vast variety of enhancements to bring to our pressure ulcer management products, to you. We in the Action Medical Products Engineering Group are continually looking for ways to grow the form, fit and function of those products to best address those requirements defined by our customers. Trade shows like this are only one of the many vehicles we utilize to stay fresh and progressive as we move forward in this dynamic field. My experience has shown that users are highly insightful and creative, thus, a strong asset for Action Products."
Thanks John! We look forward to more clinically engineered wound prevention products. Welcome back.
We all know what hospitals designed to care for children offer the parents who place their trust in the hands of the caring surgical teams. As I researched many hospitals across the US, I learned that there is a focus to create a deinstitutionalized environment in the pediatric departments.
You may be anxious like me when entering a Children's Hospital. While discussing pediatric positioning and our gel positioners, I am constantly mindful of the importance of my surroundings. While preparing to present decubitus ulcer prevention and surgical patient safety information, I am always impressed with the creativity of the architects who design the waiting room where I am sitting. Even the reading materials provided by volunteers are carefully selected. I learned lighting is able to play a role in calming the environment. Awards are proudly presented for such efforts. The Children's Hospital of Boston at Waltham won an award for their efforts to "de-stress" their waiting area.
This served as a lesson to me. When I am entering a hospital to relate the importance of wound prevention and the consequences of hospital acquired pressure ulcers, someone else is dedicated to providing a nurturing environment and I am grateful.
Can Action(R) positioning pads be used in areas other than the OR? YES!
Action(R) viscoelastic polymer has been successful in Level 1 Trauma Centers, in the ICU and Surgical ICU to position patients with very limited mobility and assist in wound prevention.
The Lateral Head Pad with Center Dish (40207) conforms to the occipital area of the head. It is a low cost solution for pressure redistribution and can be used throughout the hospital for decubitus ulcer prevention.
The Extra Long Patient Positioners (40615) and Small Chest Rolls (40616-8) alleviate pressure build up of the sacral and trochanters areas in the ICU. There is an increased chance of Hospital Acquired Pressure Ulcers (HAPU) when the patient is lying on their back for long periods of time. These polymer gel positioners will help to lift the patient on their side and get them off center.
If you have any additional ideas on ICU pressure sore prevention, please let us know.
I was researching articles that pertained to gel wheelchair cushions, mattress overlay pads and DME products requested by Veterans Affairs (VA) hospitals and found unrelated but encouraging information. It was nice to learn that an architectural firm, NBBJ, held workshops with veterans to learn what they appreciated when they enter a VA hospital. The veterans started by expressing their challenges such as, limited mobility and vision problems. (One major challenge that surprised me was colorblindness.) NBBJ listened and at each entrance of the VA hospital under construction in New Orleans, you will see an orientation person, wheelchairs, and mobility assistance. I learned the veterans humbly wanted to feel honored, so NBBJ is planning an art program to honor the veterans of different service branches. Memorial Day will soon be here and once again I am reminded of the sacrifices of the brave men and women who serve in our military.One way of saving your O.R. dollars while promoting decubitus ulcer prevention is to convert from disposable to reusable products. Surgical patient safety is always the first consideration when reviewing any wound prevention product. An unexpected benefit was revealed. One RN made the interesting point that when they switched from foam to gel positioners a great deal of warehouse space was made available. I read an article pointing out the fact that Washington County Healthcare System located in our town, Hagerstown, MD, moved to a new location and reused, recycled and donated items they had accumulated over the years. We relocated an office and did the same. Please share your solutions for reducing waste in your facility.
The second article was How Green Is Your OR? This article talked about using reusable products, like our viscoelastic polymer gel pads for surgery patient positioning. Environmentally preferred products (EPP) can be ones that are reusable to avoid all of the red bag waste accumulated in the hospital's operating rooms. If you are looking for new "green" positioning products, please review our website for suggestions.
The CE included in this issue was on Optimal Outcomes for the Obese Pediatric Patient. There aren't very many articles written on this subject, and pediatric positioning is so important. This article goes into the importance of the surgical table pad and pediatric positioning for patient safety and deubitus ulcer prevention.
All in all, this magazine continues to bring us current, relevant education. Thanks ORNURSE!
Pediatric Perioperative RNs must be knowledgeable in the area of surgical patient positioning, but must also be skillful in the area of pediatric positioning. They have many positioning products to choose from to ensure wound prevention. When they have a young child on a mattress overlay pad they must be confident the positioning products they choose deliver optimum surgical outcomes. We receive many comments expressing thanks for manufacturing polymer mattress overlays, positioning products and DME products to assist in decubitus ulcer prevention. We are committed to pressure ulcer education to ensure your patient's pressure redistribution to avoid hospital acquired pressure ulcers.
I would like to express my thanks to Sanford Children's Hospital in Sioux Falls, S.D. for providing a program, Zoo TV, to their pediatric patients. The children have an opportunity to view tigers, monkeys, giraffes and many other animals in their habitats. The program even provides a ticker at the bottom of the screen to enable the young patients to learn interesting facts about the animals they are watching. Perhaps you could start such a program at your hospital. Keep us posted! 
You may want to review our blog post illustrating our pediatric positioner set. It is truly a multi-purpose positioning unit designed for pediatric positioning. The kit includes a rectangular shaped pad with an indented channel in the the center to allow for chest expansion, a pediatric positioning horseshoe pad and two pediatric positioning chest rolls. I would value hearing from you and learning how this kit or any of our pediatric positioning products benefited your patient positioning efforts.
I am certain the pediatric patients and their families are smiling when they turn on the TV and see the playful penguins.
The National Pressure Ulcer Advisory Panel is an independent not-for-profit organization dedicated to the prevention and management of pressure ulcers and is dedicated to informing consumers on the importance of choosing the right wheelchair cushion to meet the needs of the user. The NPUAP has established nine wheelchair cushion surface characteristics that they feel determine the safety and efficacy of the wheelchair cushion selection process. Temperature control, moisture control, friction, maintenance requirements, life expectancy of the wheelchair cushion, flammability, fail safety, infection control and pressure redistribution.
I think we would all agree that one the most important features of a wheelchair cushion is pressure ulcer prevention. Be mindful, in order to maintain healthy skin the wheelchair cushion you purchase must support your body weight and distribute pressure evenly.
Just like all DME products, no single wheelchair cushion is right for everyone. I an certain you will find it valuable to consider the wheelchair cushion surface characteristics established by NPUAP. Please let us know what characteristics directly affect your wheelchair cushion selection.
I found a great CE on avoiding Hospital Acquired Pressure Ulcers in the March OR Nurse 2010. On page 27 there is a 1.9 hour CE called "Maintaining Skin Integrity in the OR" by Diana Wadlund, MSN, RN, CRNFA, CRNP. It gives risk factors, strategies for pressure ulcer prevention and pressure redistribution, patient positioning concerns, incidence of pressure ulcer formation by specialty, NPUAP pressure ulcer stages, and all over surgical patient safety.
If you have any questions about anything that you have read, remember, Action has a Nurse Advice Line at 1.800.290.8657.
This CE can also be found on www.nursingcenter.com/CE/ORNurse.
If you see a good CE on wound prevention, please let us know.
Our Customer Service Department gets asked this question all the time. So again, we have asked our Canadian expert, Alan Kline of HPU Rehab, for his advice:
This is a hard question to answer. Your personal situation should be evaluated by a clinical OT or PT, and not a vendor or manufacturer. These clinicians tend to review the possible diseases you may have- is it progressive, acute, etc. In addition, they can do a home assessment to determine what barriers may exist. For example, if your kitchen table is 33” high and your wheelchair/power chair won’t go under the table, then you won’t be able to eat your meals. The seat to floor height becomes an important issue when choosing the right size cushion and will determine if you can eat your meals and be independent.
I personally like the Action® Xact® Lite cushion because of the low profile. So, if you foot propel in a wheelchair this is a low height cushion which allows your feet to reach the ground. Using the above example with the kitchen table, the Action® Xact® Lite polymer gel wheelchair cushion might be appropriate.
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Happy Nursing!
Written by Alan Kline, HPU Rehab:
This is a common complaint. After sitting for several hours a day, foams tend to bottom out. Air products have to make sure the inflation is proper (to little air/to much air) or it can cause discomfort and even create a pressure sore.
You would be better off with a product made of Akton® viscoelastic polymer. Since it is a polymer and not a true gel pad, it gives constant pressure redistribution and is extremely difficult to bottom out. I believe the polymer offers you the best protection against pressure sores.
Tell us about your experiences.....
Many people have asked this question, so I asked our Canadian expert, Alan Kline of HPU Rehab to answer it for us.....
As human beings, we all slouch when we sit. However, when you get older it’s more pronounced and can cause greater discomfort. In addition, as you get older you don’t move around as much so the discomfort in seating increases, as well as the potential for pressure sores.
This is why it’s important to have a good wheelchair cushion that is not only comfortable, but offers good support and positioning. I highly recommend the Action® Xact® Soft because it offers so much comfort, support and positioning. I have found in some cases this product even outperforms other air cushions because of the positioning component. Gel wheelchair cushions provide stability and proper pressure ulcer management and the Xact® Soft gives that added comfort everyone needs.
During the recent 57th AORN Congress held in Denver, CO; Nurses visiting the Action Products, Inc. booth were given the opportunity to enter a drawing for a chance to win one of two AORN Membership Renewals for the upcoming year. And the winners are:
Jan Hay,RN, CNOR from Madison Surgery Center, Madison, Wisconsin and Frances Hikido,RN from Harbor-UCLA Medical Center, Torrance, California.
Congratulations ladies.
If your facility needs to lower the occurrence of Hospital Acquired Pressure Ulcers and is concerned with infection control in the surgical suite-- please go to www.4yourOR.com for more information.
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Thursday, April 1, 2010 by Marc Parent,RN,CNOR: