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

Background Medical devices are common causes of health care–associated pressure injuries in pediatric patients. Noninvasive ventilation masks are among the most frequently used medical devices that result in injury. Unique pediatric facial anatomy, limited noninvasive ventilation mask sizes, and lack of pediatric-specific guidelines all contribute to injury. Local Problem In 2021, the local pediatric intensive care unit reported that 66% of stage 2 or greater health care–associated pressure injuries were facial injuries related to noninvasive ventilation masks. An evidence-based practice project was conducted to prevent noninvasive ventilation mask–related pressure injuries in the pediatric intensive care unit. Methods An evidence-based bundle specific to the local pediatric intensive care unit was developed in accordance with the Iowa Model–Revised through interprofessional collaboration. Process and outcome data were collected to evaluate bundle implementation. Data included knowledge, attitude, and behavior indicators and health care–associated pressure injury outcome data. Results The number of health care–associated pressure injuries related to noninvasive ventilation masks decreased from 6 in 2021 to 0 in 2022 after bundle implementation in October 2022. Postimplementation survey data showed that unit staff members’ knowledge improved and behaviors to prevent health care–associated pressure injuries increased after implementation of the practice change. Conclusion An evidence-based practice approach guided development of a localized practice change. Bundle use and interprofessional team collaboration reduced pressure injuries related to noninvasive ventilation masks in the pediatric intensive care unit.