Discussion on Pressure Injury in Adult Intensive Care Unit by Quality Analysis

^Purpose:

^{During the hospitalization of patients, different medical instruments and sanitary therapies must be provided for the purpose of treatment and increasing incidents of medical device related pressure injury (MDRPIs) have become a serious issue of making nursing care even more difficult than before. The aims of this study was to regularly monitor the pressure injury in the intensive care unit, and to report indicator of abnormal data for that quality manager unit and clinical caregivers could analyze relevant predictive factors for implementing early intervention in skin care to improve the quality of care.}

^Methods:

^{The research subjects were from the intensive care unit of a medical center in Southern Taiwan and data of pressure injury due to medical devices during hospitalization period were collected into the secondary database. By retrospective analysis of 107 incidents of such injuries when using facial medical devices between January 1, 2017 and September 30, 2018, patient traits and the applicability of medical device were analyzed.}

^Results:

^{1.That the use of Facial Medical Devices accounted for 92.72% of the Medical device related pressure injury (MDRPI), where BIPAP (54.4%) accounted for the highest ratio, followed by Nasal/Oral Endotube (12.3%) and HFNC/Face Mask (10.5%). The locations of injuries, in order of frequency, were ears (22.54%), cheek (19.61%), nose (14.70%) and nostrils (14.70%).}

^{2.There are significant differences between cases scored Less than or equal to 16 points on Braden scale.}

^{3.There are significant differences between scored greater or equal to 17 points on APACHE II.}

^{4.The professional awareness of medical device related pressure injury by nursing staffs was low, as they had insufficient education and training on the subject.}

^{5.The lack of proper anti-pressure protection for medical devices.}

^Conclusion:

^{Continuous surveillance and quality management for pressure injury, combined with evidence and Nation Pressure Ulcer Advisory Panel (NPUAP) care guideline, would provide correct educational training and regular inspection of nursing care. By choosing appropriate decompression dressing as preventive measure, it is an important part of managing pressure injury from medical device and it is recommended that medical institutions should not neglect the quality indicators.}