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Pediatrics |

Hospital Acquired Skin Injury Related to the Use of Noninvasive Positive Pressure Ventilation

Laura Miske*, MSN; Eileen Hickey, MSN; Judy Stellar, MSN; Beth Kramer, BSN
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Children's Hospital of Philadelphia, Philadelphia, PA


Chest. 2012;142(4_MeetingAbstracts):772A. doi:10.1378/chest.1389931
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Abstract

SESSION TYPE: Pediatric Critical Care Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Documentation of the number of incidents of hospital acquired skin injury for all inpatients utilizing non-invasive positive pressure ventilation (NIPPV).

METHODS: A hospital-wide Skin Injury Prevalence Survey (SIPS) was conducted to identify areas for practice improvement related to all areas of skin care. Data was collected by hospital trained skin champions beginning June 2010. A random date was chosen quarterly to perform the SIPS skin assessment survey on every hospitalized patient. Concurrently, a multidisciplinary team consisting of respiratory therapists and nurses reviewed the nursing standard of care for NIPPV. The revised NIPPV standard of care was effective April 2011. Based on best practice, revisions were made in 4 areas of care: skin assessment, use of silicone barrier, bedside collaboration and documentation.

RESULTS: There were 6 different units that cared for patients who utilized NIPPV. Skin injuries related to NIPPV devices were distributed across units. For 2010, quarterly SIPS data point assessments for NIPPV related skin injury compared to total device related injuries showed the following; June (23%), Sept (29%), Dec (45%). Quarterly SIPS assessments were repeated in 2011 and demonstrated the following decrease in NIPPV related injury; June (14%), Sept 0%, and Dec (25%).

CONCLUSIONS: Heightened awareness of the potential for skin injury and the implementation of practice changes for patients who required NIPPV may have resulted in decreased skin injury.

CLINICAL IMPLICATIONS: A standardized approach to assessment, use of silicone barrier, bedside collaboration and documentation can impact the reduction of NIPPV related skin injuries.

DISCLOSURE: The following authors have nothing to disclose: Laura Miske, Eileen Hickey, Judy Stellar, Beth Kramer

No Product/Research Disclosure Information

Children's Hospital of Philadelphia, Philadelphia, PA

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