Monitoring and alleviating the effects of pressure related injuries for spinal surgery–a need for improvement?

Abstract

The development of pressure injuries (PIs) is a common complication arising during surgery. Monitoring and alleviating PIs is currently not possible during lengthy spinal and orthopaedic surgeries, especially if a patient requires x-rays. We interviewed surgical staff to gain an understanding of attitudes regarding current methods and approaches for the management of PIs to allow the development of new devices based on staff feedback. Interviewees provided insights regarding the possible design of a new device used to monitor and alleviate pressure injuries in a surgical environment. From the interviews we derived key themes, including current devices/systems, current risk assessment/scales, and design considerations. As a result, we identified critical design requirements and an appropriate product design specification. Background: Complications can arise when perioperative staff are monitoring a patient’s health status during surgery, including the development of pressure injuries (PIs). It is important to reduce the incidence rates of developing PIs intraoperatively, and thereby mitigate both increased costs and negative impacts to patients and care providers. Current pressure relief supports offer limited monitoring abilities throughout the perioperative environment. Aim: The aim of this study is to establish clear design requirements and a product design specification that enables a new closed-loop product solution to be developed with real-time pressure monitoring during surgery. Method: We conducted semi-structured interviews with nine different clinical staff members involved in the perioperative environment. We conducted the interviews over a two-week period with two major teaching hospitals within the East Midlands, UK. Questions focused on healthcare professionals’ perceptions of current methods and their approaches to managing PIs. We recorded and transcribed participants’ data using NVivo software. Conclusion: The interview data identified a need for an improved method to manage and monitor PIs. We established that the incorporation of live feedback to reduce the prevalence of PIs is a critical design priority. Based on the interviews, we developed design criteria and a product design specification (PDS). Interview transcripts suggest a new device design should focus on a novel radiolucent pressure redistribution solution capable of reducing PIs intraoperatively while incorporating live feedback.