Preventing Medical Device-Related Pressure Injuries Due to Noninvasive Ventilation Masks and Nasal Cannulas.

Abstract

Medical device-related pressure injuries attributed to oxygen delivery devices are common yet preventable. Pressure injuries increase hospital costs, patients' length of stay, and mortality rates. To decrease medical device-related pressure injuries by transitioning patients from an over-the-nose noninvasive ventilation mask to a single-headset, interchangeable under-the-nose and over-the-nose noninvasive ventilation mask; replacing polyvinyl chloride nasal cannulas with a softer nasal cannula; and providing staff education on preventing pressure injuries related to oxygen delivery devices. The project was implemented on 4 adult inpatient units with a total of 75 inpatient beds at an academic medical center. Interventions included implementing the trial noninvasive ventilation masks and nasal cannulas, alternating masks every 4 hours, relocating protective dressings, promoting the use of protective dressings for over-the-nose oral-nasal masks, and educating health care staff. In the 2 months before implementation (September and October 2020), 1 medical device-related pressure injury was caused by a noninvasive ventilation mask and 4 injuries were caused by nasal cannulas. During the 2 months of trial implementation (November and December 2020), no pressure injuries developed in patients using the trial devices. The interventions implemented had clinically relevant results. A larger sample size would be necessary to determine statistical significance. Postintervention data indicated a need for further education on evidence-based practice guidelines on mask alternation and use of preventive dressings to bolster compliance. Following institutional approval, all noninvasive ventilation masks and nasal cannulas were transitioned to the trial devices at the study institution.