Pressure injuries related to medical devices—including feeding or oxygen delivery tubes, catheters, orthopedic devices, bedpans and casts—now account for more than 30% of all hospital-acquired pressure injuries, and are a known significant cause of patient morbidity. Preventing them is the focus of a new advisory from The Joint Commission. Quick Safety, Issue 43: “Managing medical device-related pressure injuries” provides strategies for health care professionals to prevent these injuries.
Historically, preventing and treating health care-acquired pressure injuries have been a challenge for health care organizations. Identifying them can be difficult, and treatment can be costly. However, they can be prevented through evidence-based nursing practice.
Recommended identification, prevention, and treatment actions address:
- Assessment. A comprehensive skin assessment can lead to proper identification and early prevention. It is critical to assess the skin underneath a medical device to identify the early signs of pressure.
- Education. Educate the patient and family about the medical device, where it is located, why it is there, how it functions, and how long it will stay in place.
- Positioning. Position and reposition the patient and the device to help redistribute pressure and decrease shear force. Determine repositioning frequency with consideration of the patient’s general medical condition, comfort, and level of activity and mobility.
- Device care. Ensure that the patient receives the proper size and type of device; that the device is secure; and that the manufacturer’s recommendations for use and care of the device are followed.
- Documentation and communication. Ensure that the patient’s assessment, interventions and continuing care needs are passed from one caregiver to the next.
- Teamwork. Pressure injury prevention requires activities and coordination among many individuals, including the multiple disciplines and teams involved in developing and implementing the patient’s care plan.
- Continuous monitoring. Observe baseline and progression or healing over time. Pressure injuries are painful, and patients are suffering more than health care providers know. Consider performing periodic physical, psychological and psychosocial reassessments of the patient.
The Quick Safety is available on The Joint Commission website. It may be reproduced if credited to The Joint Commission.