Authors (including presenting author) :
Li T(1), Ng TY(1), Li WT(1), Lau SF(1), Li MP(1)
Affiliation :
(1) Operation Theatre and Theatre Service Centre, PMH
Introduction :
Medical Adhesive-Related Skin Injury (MARSI) can occur when draping materials, among other adhesive products, are removed, leading to epidermal damage. This can cause erythema, laceration, or trauma that persists for 30 minutes or longer, negatively impacting patient outcomes and increasing healthcare costs. At Princess Margaret Hospital (PMH), incidents of MARSI rose from 4 in 2022 to 13 in the first 8 months of 2024, predominantly affecting gynaecological patients in the lithotomy position.
Objectives :
1. Raise staff awareness about MARSI. 2. Enhance knowledge and skills related to MARSI through an educational program. 3. Assess the effectiveness of skin barrier application in reducing MARSI incidence. 4. Decrease overall MARSI incidents in the operating theatre (OT). 5. Develop an in-house MARSI reporting document for better tracking of incidents.
Methodology :
The enhancement program was supported by the gynaecology department's Chief of Service (COS) and surgeons. Key components included: - Educational Sessions:** Focused on preventive measures for MARSI and perioperative nursing care, including: - Preoperative baseline skin assessments. - Safe draping and removal techniques. - Application of skin barriers. - Effective documentation practices. - Training Materials: Educational videos and demonstrations were utilized to enhance staff engagement and understanding. - Assessment Tools: Pre-tests and post-tests, along with evaluation forms, were deployed to analyze knowledge changes and program effectiveness. - Target Group: Nurses in the OT caring for patients undergoing elective gynaecological surgeries in the lithotomy position.
Result & Outcome :
- Attendance: 74 OT nursing staff participated in the educational sessions. - Knowledge Improvement: Over 60% of staff initially had limited knowledge of MARSI and its preventative measures. The mean test score improved from 5.4/14 pre-test to 10.64/14 post-test. - Program Satisfaction: Staff provided positive feedback on the program’s content and delivery. - MARSI Incidence: A total of 82 cases were evaluated from 21/10/2024 to 21/12/2024, with no reported MARSI incidents during this period. - Documentation Improvement: An in-house MARSI reporting document was successfully implemented for better record-keeping. The pilot enhancement program at PMH OT demonstrated an increased in nursing staff awareness and knowledge about MARSI, leading to a decrease in MARSI incidents among gynaecological patients. Continued education and effective documentation practices are essential for maintaining patient safety and improving health outcomes in the operating theatre.
