Medical Device Related Pressure Injury

Roseline. S

Deputy Nursing Superintendent, Kauvery Hospital, Alwarpet, Chennai, Tamil Nadu

Introduction

Medical device related pressure injuries result from the use of devices designed and applied for diagnostic or therapeutic purposes.

Devices which contribute to pressure ulcers/injuries

  • Percutaneous endothelial gastrostomy tubes
  • Endotracheal tubes
  • Nasogastric tubes
  • Nasal cannulas
  • Cervical collars
  • CPAP/BiPAP
  • Urinary catheters
  • Tracheostomy tubes
  • Intravenous catheters/tubing
  • Negative pressure wound therapy pump/tubing

Most common locations

  • Head and face    51%
  • Ears 29%
  • Nose 10%
  • Neck 1%
  • Pelvic area 5%
  • Upper extremities   3%
  • Lower extremities    27%
  • Feet 12%
  • Legs 10%
  • Heels 5%

Pressure Ulcer Vs Device Related Vs Medical Adhesive Related

Preventing device related pressure injuries

To reduce the risk of medical device-related pressure injuries, review and select medical devices with consideration to

  • The device’s ability to minimize tissue damage
  • Correct sizing/shape of the device for the individual
  • Ability to correctly apply the device according to manufacturer’s instruction
  • Ability to correctly secure the device

Safety actions to consider

  • Assessment
  • Education
  • Positioning
  • Device Care
  • Documentation and Communication
  • Team work
  • Continuous monitoring

How to prevent medical device related pressure injury

  • Calculate the hour of device on place
  • Release the device during assessment (if applicable)
  • Document the findings to track the skin integrity
  • Assess the patient condition – to free from device at the earliest
  • Prophylactic dressing under medical device
  • Proper cushioning and padding
  • Skin assessment
  • Regular monitoring (Q2h)
  • Proper positioning of device
  • Seek Individual feedback – to know?
  • Patient comfort , not the device comfort

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