The Implementation of Countermeasures to Reduce Noninvasive Pressure Injuries at a Small Community Hospital

Background: Pressure injuries associated with noninvasive ventilation (NIV) cause suffering, increased hospital duration, and even morbidity. During FY 2017-FY 2021 twelve facial pressure injuries, per 1,824 NIV days, associated with NIV were documented. To address this problem, we implemented proactive countermeasures. Methods: Countermeasures included the use of a protective barrier placed between the patient’s face and mask, the rotation of the NIV mask every 4 hours from full face mask to regular BPAP mask, enhanced staff education germane to the recognition of pressure injuries, and QH4 hrs assessment for NIV liberation. Also, we implemented daily wound care assessment rounds to be conduct by a nurse wound specialist. Results: Post implementation of the countermeasures we saw a significant reduction in facial pressure injures. (Table 1) Conclusions: With the implementation the above countermeasures, our hospital was able to reduce the occurrences of NIV-related pressure injures. It was a multiple pronged approach to address this problem. It is unclear if one measures was more effective than any other single one in reducing this issue. Enhanced staff educated increased both the awareness of pressure injuries and the criteria for NIV liberation contributed greatly. Daily wound round assessment was very beneficial in addressing potential patients who were at high risk with proactive protective measures. Based on our above data our countermeasures significantly reduced the number of NIV pressure injuries. We continue to conduct daily wound assessment rounds and search for additional countermeasures to maintain and even reduce these occurrences.Table 1TimePressure InjuriesNIV DaysMonthsFY17-FY2112182448FY21-FY231170539