Multidisciplinary initiative reduces nasal pressure injuries in prolonged head and neck surgery
A historical controlled study evaluated a multidisciplinary quality improvement initiative to prevent nasal pressure injuries in patients undergoing prolonged oral, head and neck surgery. The study included 515 patients: 221 in a historical control group (pre-intervention) and 294 in the intervention group. The intervention consisted of structured risk assessment, dynamic and graded nursing interventions, systematic postoperative follow-up, and use of a modified CORN scale, compared to standard care in the historical control period.
The primary outcome was the incidence of nasal pressure injuries. The incidence decreased from 7.24% in the historical control group to 2.38% in the intervention group, representing a relative risk (RR) of 0.33 and an absolute risk reduction (ARR) of 4.86% (p = 0.008; 95% CI for ARR: 1.19–9.23%; 95% CI for RR: 0.14–0.79). For secondary outcomes, stage 2 injuries were eliminated (3 cases in the control group vs. 0 in the intervention group), and no stage 3 or higher injuries were observed in either cohort.
Safety and tolerability data were not reported. Key limitations include the study's historical controlled design, which is subject to confounding and temporal bias, and the lack of reported follow-up duration. The absence of reported funding or conflicts of interest should be noted. The practice relevance is that the described bundle of interventions appears scalable for perioperative nursing management in this surgical context, but its effectiveness should be interpreted cautiously due to the study design.
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