Pressure Injury Survey Guide

Types of Pressure Injury Prevention Interventions



Preventing Medical Device-Related Pressure Injury

This describes the etiology of the injury. Medical device related pressure injuries (MDR PI) result from the use of devices designed and applied for diagnostic or therapeutic purposes. The resultant pressure injury generally conforms to the pattern or shape of the device. The injury should be staged using the staging system.1, 2


Risk Assessment

  • Consider anyone with a medical device to be at risk for MDR PI.
  • Risk is higher in patients with sensory impairment who cannot feel or respond to discomfort, with existing non-MDR PI, with high risk Braden scores and those hospitalized in critical care units.3

Device Selection and Application

  • Ensure all medical devices are correctly sized and applied according to manufacturer specifications.4
  • Secure medical devices sufficiently to prevent dislodgement without creating additional pressure or shear. Avoid placement of a device directly over the site of a prior or existing pressure injury.4
  • Purchase medical devices for the facility which are least likely to cause damage from pressure and shear.4, 5

Monitoring

  • Inspect skin under and around any removable medical device at least twice daily.
  • Inspect skin more frequently and adjust device in the presence of generalized or localized edema.
  • Investigate patient complaints of pain under devices.
  • • Remove device as soon as medically feasible.4

  1. Edsberg, L. E., Black, J. M., Goldberg, M., McNichol, L., Moore, L. , & Sieggreen, M. (2016). Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System. J Wound Ostomy Continence Nurs, 43(6), 1-13. doi: 10.1097/WON.0000000000000281
  2. National Pressure Ulcer Advisory Panel. (2016b). National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury. Retrieved June 14, 2016, from http://www.npuap.org/resources/educational-and-clinical-resources/npuap-pressure-injury-stages/
  3. Hanonu, S., & Karadag, A. (2016). A Prospective, Descriptive Study to Determine the Rate and Characteristics of and Risk Factors for the Development of Medical Device-related Pressure Ulcers in Intensive Care Units. Ostomy Wound Manage, 62(2), 12-22.
  4. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, & Pan Pacific Pressure Injury Alliance. (2014). Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline (Emily Haesler Ed.). Osborne Park, Western Australia: Cambridge Media.
  5. National Pressure Ulcer Advisory Panel. (2016a, April 2016). Best Practices for Prevention of Medical Device Related Pressure Injuries. Retrieved November 8, 2016, from http://www.npuap.org/resources/educational-and-clinical-resources/best-practices-for-prevention-of-medical-device-related-pressure-ulcers/