Increasing the Safety of Patients Undergoing Breast Implant Surgery Using an Electronic Health Record Enhancement.

Breast implant surgery is a popular plastic surgery procedure performed worldwide. Despite its global popularity, patients undergoing breast implant surgery are at risk for systemic illness and more than one form of cancer. We conducted a nursing workflow analysis at our facility and determined that it is not standard practice to screen patients for the presence or absence of breast implant devices at every health care encounter. This lack of screening for breast implant devices may adversely affect patient safety by hindering the rapid identification of systemic illness or cancer related to breast implant devices and delaying effective medical intervention. Based on the results of the workflow analysis, we initiated a formal call for nursing action. We identified a nursing workflow process to increase patient safety and developed a universal screening tool for implantable devices. We defined universal screening for implantable devices as assessing all patients for the presence or absence of an implantable device, specifically breast implant devices, at every health care encounter. Implementing a universal process for screening patients for implantable devices at every health care encounter can be easily formulated into a policy and procedure and/or an electronic health record (EHR) update or enhancement. This article discusses how we utilized a workflow process map to translate universal screening for implantable devices into an EHR enhancement.

Breast Implant Surgery: An Overview of the Risks and Health Complications.

We present an overview of the risks and health complications associated with breast implant surgery with a focus on breast implant illness (BII), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), and breast implant-associated squamous cell carcinoma (BIA-SCC). BII is a constellation of systemic symptoms that can occur after breast implant devices are surgically implanted into the human body. BIA-ALCL is a T-cell lymphoma associated with the implantation of textured breast implant devices. BIA-SCC is a potentially aggressive epithelial-based tumor that can occur following implantation with smooth or textured breast implant devices. Nurses may lack awareness and knowledge regarding BII, BIA-ALCL, and BIA-SCC, and this can negatively affect patient safety. Therefore, it is essential that all nurses, especially members of the plastic and aesthetic nursing community, understand these disease processes. Currently, it is not standard practice to screen every patient for the presence of an implantable device at every health care encounter. However, by not doing so, health care professionals may miss the opportunity to identify illness, disease, or cancer that could be related to an implanted device; therefore, practice changes to increase patient safety are both necessary and warranted. To identify those individuals at greatest risk for implant-related illness, disease, or cancer, we propose implementing universal screening of all individuals for implantable devices. We define universal screening for implantable devices as assessing all patients for the presence or absence of an implantable device at every health care encounter. We recommend using the IOWA model to guide our proposed evidence-based practice update.