Respiratory Devices Unmasked: A Comprehensive Approach to Prevention

Background: Hospital-acquired pressure injuries (HAPIs) significantly impact millions of patients in the U.S. annually, with over 2.5 million reported cases. The financial burden is considerable, with costs for severe pressure injuries ranging from $75,000 to $150,000 per patient. ECU Health Medical Center diligently reports these injuries to government agencies. Notably, over 30% of HAPIs are medical device-related pressure injuries (MDRPIs), with respiratory devices contributing to 70% of these. In 2018, it was found that respiratory devices were implicated in 47% of all reported MDRPIs at ECU Health Medical Center, highlighting the need for targeted prevention and improved patient care. Methods: Data gathered by the ECU Health skin and wound team is used for incident reporting to the Agency of Healthcare Research and Quality (AHRQ) and shared with the respiratory care department at ECU Health Medical Center. This data collection has received ethical approval. Results: The data collected from 2018 to 2023 offers a comprehensive overview of reportable pressure injuries associated with various respiratory medical devices. A significant rise in injuries, particularly with high-flow oxygen therapy (HFOT) and HFOT combined with non-rebreather mask (HFOT + NRB), was observed during the COVID-19 pandemic. However, targeted prevention education led to a substantial reduction in subsequent years. This underscores the importance of continuous monitoring and proactive interventions in managing these injuries. The respiratory care department at ECU Health Medical Center, in collaboration with the skin and wound care team, achieved a 50% reduction in total respiratory MDRPIs through strategic implementation in healthcare settings to enhance patient outcomes. In 2023, the devices accounted for 28% of reported MDRPIs, a reduction of 19%. Conclusions: ECU Health Medical Center’s commitment to patient safety is exemplified by its collaborative approach. Open communication, shared expertise, and aligned goals have fostered a synergy that transcends individual efforts. Despite challenges such as the COVID-19 pandemic, staff turnover, and resource constraints, the center continues to adapt and strive for safe, high-quality care. The multidisciplinary team’s dedication, coupled with evidence-based practices, has led to a 50% reduction in respiratory MDRPIs since 2018 through increased awareness, targeted education, and thorough assessments. This journey serves as a guiding light for safer healthcare practices.Data from 2018 to 2023 MDRPIs associated with a range of respiratory medical devices, including ETT Holder, High Flow Oxygen Therapy (HFOT), HFOT combined with Non-Rebreather Mask (HFOT + NRB), NIPPV Mask, Tracheostomy Tubes, and Ventimask. Each device type is distinctly represented on the graph with a unique color. A significant rise in injuries, particularly associated with HFOT + NRB and HFOT, was observed, coinciding with the COVID-19 pandemic when the use of heated high-flow oxygen therapy was intensified. However, the introduction of targeted prevention education effectively increased awareness and understanding of the risk areas for pressure injuries related to this treatment, leading to a substantial reduction in injuries in the subsequent years.An analysis of all pressure injuries from 2018 to 2023, with a detailed categorization into Mucosal, DTI (Deep Tissue Injury), Stage 2, Stage 3, Stage 4, and Unstageable injuries. A key finding is the significant surge in pressure injuries in 2021, coinciding with the COVID-19 pandemic. This surge is attributed to the escalated use of specific respiratory medical devices during this period. Despite the 2021 spike, the data reveals a considerable reduction in the total incidence of Respiratory Medical Device-Related Pressure Injuries (MDRPIs) over the five-year span. Specifically, there is an approximate 50% decrease from the 2021 peak to the projected figures for 2023. The graph effectively demonstrates the COVID-19 pandemic’s impact on MDRPI incidence and the efficacy of implemented strategies in reducing these injuries over time. The importance of ongoing monitoring and proactive measures in managing MDRPIs is emphasized.