Joint appointment Intensive Care Services, Royal Brisbane and Women's Hospital and School of Nursing, Queensland University of Technology, Australia.
Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK.
Int Wound J. 2020 Dec;17(6):1566-1577. doi: 10.1111/iwj.13432. Epub 2020 Jun 28.
Medical device-related pressure injuries are the most common cause of pressure injuries within the intensive care unit, in particular those caused by nasogastric tubes and endotracheal tubes. There are several known methods, which can alleviate the pressure of these devices on the skin surface to reduce the rate of these injuries. To determine the feasibility of conducting a larger, adequately powered trial testing, several clinically effective interventions to reduce the incidence of medical device-related pressure injuries caused by these devices. Patients were recruited into both study arms and received one of three different methods of skin protection for both arms. Outcome measures included fidelity to the processes of care protocol, recruitment potential, and the number of medical device-related pressure injuries. Recruitment (n = 87) was slower than expected with less than 10% of screened potential patients available for enrolment. Fidelity to the process of care for each subgroup was variable with better adherence in the nasogastric tube arm compared to the endotracheal tube arm. This feasibility study has revealed concerns about the intervention designs and effectiveness as well as challenges for the adherence of the nursing staff to the protocol.
医疗器械相关性压力损伤是重症监护病房中最常见的压力损伤原因，特别是由鼻胃管和气管内管引起的压力损伤。有几种已知的方法可以减轻这些设备对皮肤表面的压力，从而降低这些损伤的发生率。为了确定进行更大规模、充分有力的试验测试的可行性，研究人员采用了几种临床有效的干预措施来降低这些设备引起的医疗器械相关性压力损伤的发生率。将患者招募到两个研究组中，并对双臂使用三种不同的皮肤保护方法。结果测量包括护理协议流程的忠实程度、招募潜力和医疗器械相关性压力损伤的数量。与预期相比，招募速度较慢，只有不到 10%的筛选出的潜在患者可入组。每个亚组的护理流程忠实程度各不相同，与气管内管组相比，鼻胃管组的依从性更好。这项可行性研究揭示了对干预设计和效果的关注，以及护理人员遵守方案的挑战。
