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Securement to prevent device‐related pressure injuries in the intensive care unit: A randomised controlled feasibility study
Authors:Fiona Coyer,Jane&#x  Louise Cook,Wendy Brown,Amanda Vann,Anna Doubrovsky
Affiliation:1. Joint appointment Intensive Care Services, Royal Brisbane and Women''s Hospital and School of Nursing, Queensland University of Technology, Australia ; 2. Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield UK ; 3. School of Nursing, Queensland University of Technology, Brisbane Australia ; 4. Department of Intensive Care, Redcliffe Hospital, Redcliffe Australia ; 5. Intensive Care Services, Royal Brisbane and Women''s Hospital, Brisbane Australia
Abstract: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.
Keywords:endotracheal tube, medical device‐  related pressure injury, nasogastric tube, prevention, securement
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