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Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
07:15

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Reducing Pressure Injuries Due to Noninvasive Ventilation Masks in the Pediatric Intensive Care Unit: An

Brenna Saltzman1, Lindsay Fayram2, Mandi Houston3

  • 1Brenna Saltzman is a registered nurse and the unit skin representative in the pediatric intensive care unit (PICU), University of Iowa Health Care Stead Family Children's Hospital, Iowa City, Iowa.

Critical Care Nurse
|May 31, 2026
PubMed

Insights

Implementing an evidence-based bundle significantly reduced pressure injuries from noninvasive ventilation masks in a pediatric intensive care unit. Staff knowledge and preventive behaviors improved, eliminating injuries by 2022.

Area of Science:

  • Pediatric critical care medicine
  • Patient safety research
  • Evidence-based practice implementation

Background:

  • Medical devices, particularly noninvasive ventilation masks, are a leading cause of health care-associated pressure injuries in pediatric patients.
  • Pediatric facial anatomy, mask sizing, and lack of specific guidelines contribute to these injuries.
  • In 2021, 66% of severe pressure injuries in the pediatric intensive care unit were mask-related.

Purpose of the Study:

  • To prevent noninvasive ventilation mask-related pressure injuries in a pediatric intensive care unit.
  • To implement an evidence-based practice bundle tailored to the unit.

Main Methods:

  • Developed a localized, evidence-based bundle using the Iowa Model-Revised and interprofessional collaboration.
  • Collected process data on staff knowledge, attitude, and behavior.
  • Tracked health care-associated pressure injury outcomes.

Main Results:

  • Health care-associated pressure injuries related to noninvasive ventilation masks decreased from 6 in 2021 to 0 in 2022.
  • Postimplementation surveys indicated improved staff knowledge and increased preventive behaviors.
  • Successful implementation of the practice change was demonstrated.

Conclusions:

  • An evidence-based practice approach facilitated a successful localized practice change.
  • Bundle implementation and interprofessional collaboration effectively reduced pressure injuries.
  • The study highlights the importance of tailored interventions for patient safety.
Abstract

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