Article Text

NASAL PRESSURE ULCERS: A NATIONAL SURVEY OF CURRENT PRACTICE AND OCCURRENCE IN PAEDIATRIC AND NEONATAL
  1. I M C Ventilacion1,
  2. I M Thruston1,
  3. F Lynch1,
  4. A Durward1,
  5. S Tibby1
  1. 1Evelina Children’s Hospital, London, UK

Abstract

Background Pressure ulcers have detrimental effects on our patients both physically and emotionally and have financial implications for health care providers. A five-year audit of pressure ulcers reported in the Evelina Children’s Hospital, Paediatric Intensive Care Unit (PICU) identified that almost 50% were as a consequence of nasal endotracheal tubes.

Objective A national survey was conducted to collect information on management of nasal endotracheal tubes and the perceived risk factors contributing to the formation of nasal pressure ulcers. The data gathered facilitated comparison of different techniques in methods of safe securement, skin protection and reduction of iatrogenic injury from nasal endotracheal tubes. The results add to existing knowledge around nasal pressure ulcers to contribute to the reduction of incidents.

Method An electronic questionnaire was devised and circulated to twenty five Paediatric and Neonatal Intensive Care Units (NICU) in the United Kingdom and Republic of Ireland to gather information on current practice.

Results The response rate was 88.5% (23/25). The results indicated that the incidents of nasal pressure ulcers in comparable units were similar. However, securement techniques, skin protection and methods to reduce injury were variable. This survey also identified no consistent method used for grading or reporting of pressure ulcers.

Conclusion The survey identified nasal pressure ulcers as a national problem with no clear evidence of best practice, therefore, highlighting this issue as a priority for nursing research in PICU and NICU.

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