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Determination of medical device-related pressure injury in COVID-19 patients: A prospective descriptive study
Eylem Togluk Yiğitoğlu1, Semine Aydoğan2
1Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty Hospital, Ostomy and Wound Care Unit, Istanbul, Turkey.
Insights
Medical device-related pressure injuries (MDRPI) are common in COVID-19 patients, particularly those on ventilators. Early skin evaluation and intervention are crucial for prevention.
Area of Science:
- Critical Care Medicine
- Patient Safety
- Wound Care
Background:
- COVID-19 patients face a high risk of developing pressure injuries (PI).
- Medical devices used in intensive care increase the likelihood of PI development.
Purpose of the Study:
- To determine the incidence of medical device-related pressure injury (MDRPI) in COVID-19 patients.
- To identify common devices, sites, and injury grades associated with MDRPI in this population.
Main Methods:
- A prospective study involving 132 COVID-19 patients in an Intensive Care Unit (ICU).
- Data collected over a 7-day follow-up using standardized forms and the Braden Scale for risk assessment.
Main Results:
- The incidence of MDRPI was 59.1%, with ventilators being the most common cause.
- Common sites included the nose and mouth, particularly in patients in the prone position.
- Stage 2 injuries and suspected deep tissue injuries were frequent.
Conclusions:
- MDRPI is a significant issue in COVID-19 ICU patients.
- Ventilator-associated injuries are prevalent, often affecting the mouth and lips.
- Proactive skin assessment and preventive measures are essential for managing MDRPI risk.
Background:
COVID-19 patients are at risk for the development of pressure injuries (PI).
Aim:
The aim of this study was to determine the incidence of medical device-related pressure injury (MDRPI) in patients treated in the COVID-19 Intensive Care Unit (ICU)s.
Methods:
The sample of the study consisted of 132 patients, and each with a maximum follow-up of 7 days. Data were collected in the COVID-19 ICU of a university hospital between January and May 2021 by using a Patient Characteristics Form, the MDRPI Follow-up Form, the Braden Pressure Ulcer Risk Assessment Scale, and the Pressure Ulcer Staging Form.
Results:
Of the patients, 59.1% (n = 78) developed at least one MDRPI. MRDPI was observed in those with a mean age of 65.45 ± 2.462 years who were invasively ventilated (51.3%), enterally fed (46.2%), placed in the prone position (78.2%), and had a Braden score ≤12 (50%). The most common medical devices that caused MDRPIs included endotracheal tube (ET) (31.2% n = 44), non-invasive mechanical ventilation (NIVM) (23.4% n = 33), nasal high-flow (11.3% n = 16), nasogastric tube (10.6% n = 15), the ET connection (8.5% n = 12), respectively. The most common sites for pressure injuries were the nose (28.8% n = 34), mouth (25.8% n = 34), ear (12.9% n = 17), lip (9.1% n = 12), and cheek (8.3% n = 11). The most common gradings of MDRPIs were stage 2 (28.8% n = 38), stage 1 (19.7% n = 26), stage 3 (9.1% n = 12) mucous membrane injuries (12.9% n = 17) and suspected deep tissue injuries (9.1% n = 12), respectively. The time to PI was 3 days (25.7% n = 36).
Conclusions:
MDRPI was common among COVID-19 patients. It was found that the most common cause of pressure injury was ventilators, and PI developed in the mouth and lip sites most frequently in patients in prone position, stage 2 and suspected deep tissue damage was the most common grade. It is important to evaluate the skin in contact with medical devices in COVID-19 patients and to take the necessary interventions to prevent PI.
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