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

Crit Care Nurse. 2022 Oct 1;42(5):14-21. doi: 10.4037/ccn2022783.

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Results: 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.

Discussion: 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.

Conclusion: Following institutional approval, all noninvasive ventilation masks and nasal cannulas were transitioned to the trial devices at the study institution.

MeSH terms

  • Adult
  • Cannula / adverse effects
  • Humans
  • Masks / adverse effects
  • Noninvasive Ventilation* / adverse effects
  • Noninvasive Ventilation* / methods
  • Oxygen
  • Polyvinyl Chloride
  • Pressure Ulcer* / prevention & control

Substances

  • Oxygen
  • Polyvinyl Chloride