Investigation of the effect of a pressure sore care bundle in reducing the development of operating room pressure injury in patients undergoing orthopedic surgery: a non-randomized controlled study

BACKGROUND: Orthopedic surgical procedures pose a significant risk for operating room-acquired pressure injuries development in patients due to the long operating times, immobilization, and special positioning requirements. The primary aim of this study was to evaluate the effectiveness of a pressure injury care bundle in preventing operating room-acquired pressure injuries in patients undergoing orthopedic surgery. The secondary aim was to assess its impact on pain, fear of falling, and patient comfort. METHODS: This non-randomized controlled study was conducted between July 2021 and April 2022 in the orthopedics and traumatology clinic of a public hospital. A total of 190 patients (control group: 122, study group: 68) were included in the study. Data were collected using the Patient Identification Form, the 3 S Intraoperative Risk Assessment Scale of Pressure Sore (3 S Intraoperative RAS of Pressure Sore), the National Pressure Ulcer Advisory Panel (NPUAP, 2016) Pressure Injury Staging System, the Visual Analog Scale (VAS), the Fear of Falling Scale (FFS), and the Shortened General Comfort Questionnaire (SGCQ). Statistical analyses were performed using the Independent Samples t-test, the Mann-Whitney U test, and Chi-square test. The level of significance was set at p < 0.05. RESULTS: The mean age of the patients included in the study was 72.01 ± 11.58. The majority were female and had at least one chronic disease. At baseline, the control and study groups were similar and homogeneous in terms of demographic and clinical characteristics (p > 0.05). Still, the 3 S Intraoperative RAS of Pressure Sore risk score was significantly higher in the study group (p < 0.05). The incidence of pressure injuries in the study group (5.7%) was lower than in the control group (18.4%), and the difference was statistically significant (p < 0.05). Additionally, on postoperative day 3, the study group had lower pain scores, significantly reduced fear of falling, and higher comfort levels (p < 0.05). CONCLUSION: This study demonstrated that the pressure sore care bundle was effective in reducing operating room-acquired pressure injuries. Additionally, this intervention had positive effects on patients' pain, fear of falling, and comfort levels.