The Preventative Effect of Hydrocolloid Dressings on Nasal Bridge Pressure Ulceration in Acute Non-Invasive Ventilation.

Bishopp, Abigail and Oakes, Amy and Antoine-Pitterson, Pearlene and Chakraborty, Biman and Comer, David and Mukherjee, Rahul (2019) The Preventative Effect of Hydrocolloid Dressings on Nasal Bridge Pressure Ulceration in Acute Non-Invasive Ventilation. The Ulster medical journal, 88 (1). pp. 17-20. ISSN 0041-6193. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

Background

Non-invasive ventilation (NIV) is a valuable treatment in the management of acute hypercapnic respiratory failure. NIV is not without risks. One such adverse effect is the development of pressure ulcers over the nasal bridge which have an incidence of up to 20% of patients requiring NIV in this setting. The role of medical devices in the development of hospital acquired pressure ulcers has been increasingly recognised with 10-35% of all hospital acquired ulcers attributed to medical devices. Guidelines on acute NIV use suggest good skin care strategies. However, data on the magnitude of the problem of nasal bridge pressure ulceration and the effect of proactive preventative steps remains scant.

Method

A quality improvement project was designed to reduce the incidence of nasal bridge pressure ulcers during acute NIV. Hydrocolloid dressings were placed over the nasal bridge in all patients requiring NIV between 30 October 2015 and the 29 October 2016. Tissue viability was assessed daily with new pressure ulceration defined as grade 2 or above. Rates of nasal bridge pressure ulcers were compared to all patients requiring NIV in the 12-month period prior to intervention.

Results

In Group 1, there were 161 admissions and 9 grade 2 pressure ulcers from 666 NIV bed-days. In Group 2 there were 134 admissions and 0 pressure ulcers from 718 NIV bed-days. There was a statistically significant reduction in grade 2 pressure ulceration rates (p= 0.0013) in Group 2 compared to Group 1.

Conclusion

Application of an early prophylactic pressure-relieving hydrocolloid nasal dressing reduces the risk of developing grade 2 pressure ulcers in patients in patients requiring acute NIV.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WF Respiratory system. Respiratory medicine
WR Skin. Dermatology
Divisions: Emergency Services > Therapies
Planned IP Care > Respiratory Medicine
Related URLs:
Depositing User: Beth Connors
Date Deposited: 05 Feb 2019 11:10
Last Modified: 05 Feb 2019 11:10
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1825

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