Initiative reduces pressure injuries from noninvasive oxygen delivery devices

Medical Xpress / American Association of Critical-Care Nurses / Critical Care Nurse ^ | Oct. 3, 2022 | Kaitlyn Jenae Duerst et al

[ConservativeMind]

A short-term effort to prevent facial pressure injuries quickly demonstrated the potential impact of the initiative and led to institution-wide adoption of different types of noninvasive oxygen delivery devices.

The study's primary intervention was to transition from using a single over-the-nose oral-nasal noninvasive ventilation mask to a single-headset, interchangeable under-the-nose and over-the-nose oral-nasal noninvasive ventilation mask. Polyvinyl chloride nasal cannulas were also replaced with soft cannulas.

In addition, the initiative introduced a mask rotation schedule to the units, specifying that noninvasive ventilation masks be alternated every four hours. Hydrocolloid dressings to be used under the masks were stocked in easily accessible locations.

During the 60-day study, the units reported no medical device-related pressure injuries in patients who were using the trial devices, compared with five during the 60-day pre-intervention period and two in patients who were not switched to the trial devices during the study period.

Co-author Kaitlyn Duerst, DNP, APRN, AGACNP-BC, CCRN: "Patients told the nurses that the softer nasal cannula put less pressure on their ears and that they preferred the new under-the-nose noninvasive ventilation masks versus the over-the-nose types that are the standard at most institutions."

The initiative used several evidence-based interventions simultaneously, including providing collaborative education to nurses and respiratory therapists, establishing a schedule to alternate noninvasive ventilation masks every four hours, and applying preventive dressings proactively.

The study authors, with assistance from the academic medical center, developed an online education module within the hospital's existing education platform. The module included information on how to properly use and care for the trial devices, associated medical record requirements, and information on preventing pressure injuries in patients who were using these devices. The nurses and respiratory therapists working on the study units were assigned to complete the educational module prior to implementation.

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Who wants an uncomfortable mask?

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