Worldwide Injury Prevention Day Declared

Published in Wound Care on November 05, 2019

Thursday, November 21 has been declared Worldwide Pressure Injury Prevention Day by the National Pressure Ulcer Advisory Panel (NPUAP). Healthcare professionals from around the world are raising awareness of the pressure injuries that are caused by medical devices.

An interdisciplinary team of nurses, respiratory staff, and physicians who have witnessed the rise in the incidence of medical device related pressure injuries have been taking the lead in preventing Medical Device Related Pressure Injuries (MDRPIs) by understanding risk factors, tailoring prevention to the device type, educating staff about the correct use of devices, and assessing skin breakdown early on.

In addition to the NPUAP, the joint commission points out that nearly all hospital patients require at least one medical device for care and treatment, putting them at risk for skin injury. One large, pediatric hospital found in 2012 that there was an increase in the incidence of PAP-related pressure injuries. With non-invasive ventilation (NIV) as a common first-line therapy for many pediatric respiratory conditions, PAP therapy is also used. It was noted at the time that mask discomfort and skin breakdown were the most common causes for NIV failure.

Bi-PAP-related pressure injuries can occur on areas where the mask contacts the skin on the face, including the nasal bridge, cheeks, chin, above the ears, and forehead. In addition to the pediatric population, other studies have identified that the most common devices associated with MDRPIs include continuous positive airway pressure devices.

Some risk factors identified include:

1. Tight device securement resulting in poor circulation, friction, or shearing
2. Moisture under the device
3. Lack of awareness by the patient, care giver, or family to be on the alert for skin changes assessments and early prevention

Because MDRPIs form faster than non-MDRPIs, being proactive is crucial. Patient education cannot be stressed enough. It is also crucial that the interface chosen for the PAP user is skin friendly as well as providing the appropriate PAP therapy.

There is more emphasis on the skin from all levels of healthcare professionals due to the high cost of wound care and healing. Some estimates are that wound care costs between $5000.00 per patient and can go as high as $70.000.00 per patient. It is recommended that skin-friendly options are seriously considered.

In addition, the two other important factors that will help prevent skin related injuries are:

1. The correct size of the mask interface MUST be chosen, as the success of PAP therapy dependent on the patient’s ability to tolerate the mask interface.
2. Patient education on mask fitting and skin assessments is crucial.

One product line to consider is the SleepWeaver® skin-friendly line of all-cloth masks. Understanding the ease and comfort of cloth as well as the mask interface’s ability to provide compliance to PAP therapy, leave no marks on the skin, wick away moisture, and its durability, it seems to provide both comfort and compliance.