PENCEGAHAN PRESSURE INJURY MELALUI PENGGUNAAN SILICONE FOAM DRESSING PADA PASIEN PERIOPERATIF DALAM POSISI PRONE : STUDI ACTION RESEARCH BERBASIS SKALA ELPO

Abstrak

Kejadian pressure injury pada pasien intraoperatif dengan posisi prone masih menjadi tantangan serius dalam praktik keperawatan perioperatif. Penelitian ini bertujuan untuk mengevaluasi efektivitas penggunaan silicone foam dressing dalam pencegahan pressure injury pada pasien perioperatif risiko tinggi berdasarkan Skala ELPO. Desain penelitian menggunakan action research dengan siklus plan–action– observe–reflect, melibatkan tiga pasien operasi posisi prone dan tiga perawat kamar operasi. Data dikumpulkan melalui observasi, wawancara, dan dokumentasi klinis, kemudian dianalisis secara deskriptif. Hasil penelitian menunjukkan seluruh responden memiliki skor ELPO ≥20 (kategori risiko tinggi), namun tidak ditemukan kejadian pressure injury pascaoperasi (0%). Mekanisme silicone foam dressing dalam mencegah PI terlihat melalui fungsinya sebagai bantalan yang mendistribusikan tekanan, mengurangi gesekan, dan menjaga kelembaban kulit. Observasi menunjukkan perawat melakukan asesmen risiko dengan Skala ELPO, mempersiapkan area rawan tekanan, mengaplikasikan silicone foam dressing, serta mengatur posisi pasien dengan benar hingga operasi selesai. Pascaoperasi, pasien menunjukkan integritas kulit yang terjaga tanpa tanda PI pada wajah, dada, maupun lutut. Dari sisi pasien, intervensi memberikan kenyamanan dan mengurangi keluhan nyeri tekan, sedangkan perawat menilai intervensi ini praktis, mudah diaplikasikan, dan meningkatkan rasa aman dalam praktik klinis.. Kesimpulan penelitian ini adalah penggunaan silicone foam dressing efektif mencegah pressure injury intraoperatif pada pasien dengan posisi prone, sekaligus meningkatkan keselamatan pasien dan mutu praktik keperawatan.

Intraoperative pressure injury in patients undergoing surgery in the prone position remains a significant challenge in perioperative nursing practice. This study aimed to evaluate the effectiveness of silicone foam dressing in preventing pressure injury among high-risk perioperative patients based on the ELPO scale. The research design employed action research with plan–action–observe–reflect cycles, involving three patients undergoing surgery in the prone position and three operating room nurses. Data were collected through observation, interviews, and clinical documentation, and analyzed descriptively. The results showed that all respondents had an ELPO score ≥20 (high-risk category), yet no cases of postoperative pressure injury were found (0%). The mechanism of silicone foam dressing in preventing pressure injury was evident through its function as a cushion that redistributes pressure, reduces friction, and maintains skin moisture. Observations revealed that nurses conducted risk assessments using the ELPO scale, prepared pressure-prone areas, applied silicone foam dressing, and ensured proper patient positioning throughout surgery. Postoperatively, patientsmaintained skin integrity without signs of pressure injury on the face, chest, or knees. From the patients’ perspective, the intervention provided comfort and reduced pressure-related discomfort, while nurses reported that it was practical, easy to apply, and enhanced their sense of safety in clinical practice. The study concludes that silicone foam dressing is effective in preventing intraoperative pressure injury in patients positioned prone, while simultaneously improving patient safety and the quality of nursing practice.