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Munro’s Mission

Perioperative nurse develops risk assessment scale to prevent pressure injuries in surgical patients

July 1, 2021

A question posed by a Mount professor put Cassendra Munro '08 on the path to developing a risk assessment scale that now bears her name
A question posed by a Mount professor put Cassendra Munro '08 on the path to developing a risk assessment scale that now bears her name

Cassendra Munro ’08 had no aspiration to become a nurse. But she knew from a young age that she had a purpose — and every step since has confirmed her calling.

“Nursing was suggested to me by a friend, so I consulted with nurses I knew to learn more about the profession before pursuing a degree,” she says.

Munro graduated from Quinnipiac College with an associate degree in nursing, but her first three years on the job had her second-guessing her career choice.

“Working on a medical-surgical unit didn’t appeal to me, and I didn’t feel like I was making a difference,” she recalls. “I almost left nursing when someone else suggested that I try the operating room.”

There, Munro found her niche and seized every opportunity for advancement. She became a registered nurse first assistant, took on leadership roles, and obtained a bachelor’s degree in business and management from Redlands University.

“Caring for perioperative patients is my priority, yet I only spend a few minutes with them in their wake state to gain their confidence and trust,” says Munro. “No other nursing opportunity puts the patient in such a vulnerable state to rely on me as their protector and advocate.”

Then, during one of her shifts, the power of suggestion moved her once more: A surgeon spoke of the lack of educators and recommended that she pursue a degree in nursing education. Munro enrolled in the master’s degree in nursing education program at the Mount, where a chance decision and a thought-provoking question planted her firmly on the path of her divine destiny.

“For my first assignment in my first class, I randomly selected a topic by flipping open a perioperative nursing book,” she says. “I landed in the middle and came upon patient positioning in the operating room.”

During Munro’s PowerPoint presentation, her professor, Rebecca Otten, interrupted her.

“She said, ‘Cassendra, did you hear what you just said?’” Munro recalls. “‘Do you mean to tell me that almost half of your patients who go into surgery can come out with a pressure injury?’”

Per her findings, Munro’s answer was yes. But she wasn’t prepared for Otten’s next question: What are you going to do about it? 

The chart depiction of the Munro Scale guides nurses in their evaluation of a patient's risk of a postoperative pressure injury
The chart depiction of the Munro Scale guides nurses in their evaluation of a patient's risk of a postoperative pressure injury

As it turned out, Munro did plenty. Her master’s thesis led to the development of the Munro pressure injury risk assessment scale for perioperative patients, a standard guide that has been translated into six languages and is used currently in 5% of countries. It is the first tool of its kind to meet the needs of this patient population.

Thus began Munro’s research career, leading to a PhD in nursing from Azusa Pacific University in February 2021. She plans to continue her scientific studies involving validity and reliability evidence for the Munro Scale and expand its global reach.

Munro is currently an independent consultant and interim perioperative executive leader for B.E. Smith, AMN Healthcare Company. She frequently encourages nurses who are interested in pursuing a master’s degree to consider nursing education.