Abstract：
In a sixty-eight-bed level-IV NICU, an increased incidence of hospital-acquired pressure injuries (HAPIs) from noninvasive ventilation (NIV) devices was identified. The aim of this quality improvement project was to decrease HAPIs from NIV by 10%. A literature review and the Plan-Do-Study-Act were implemented. The intervention included a customized silicone foam dressing under NIV, an NIV skincare bundle, and multidisciplinary support. Hospital-acquired pressure injury rates were tracked over 3 years postinterventions. The incidence of HAPIs declined by 20% from 0.2 per 1,000 patient days to 0.05 per 1,000 patient days. Relative risk was 4.6 times greater prior to intervention (p = .04). Continuous positive airway pressure (CPAP) failure was not noted and measured by the percentage of patients on ventilators pre- and postintervention. Customized silicone foam dressings under NIV, NIV skincare bundle, and multidisciplinary team support may decrease HAPIs in neonates without CPAP failure.
摘要：
在68个病床的四级NICU中，本研究发现,无创通气(NIV)装置导致的医院获得性压力损伤(HAPI)发生率增加.该质量改进项目的目的是将NIV中的HAPI降低10%。实施了文献综述和计划学习法案。干预措施包括根据NIV定制的有机硅泡沫敷料，NIV护肤包，多学科支持。在干预后的3年内，对医院获得的压力损伤率进行了跟踪。HAPI的发病率下降了20％，从每1000名患者天0.2降至每1000名患者天0.05。相对风险是干预前的4.6倍（p=.04）。未注意到持续气道正压通气（CPAP）失败，并通过干预前后的呼吸机患者百分比来衡量。NIV下定制的硅胶泡沫敷料，NIV护肤包，多学科团队支持可减少无CPAP失败的新生儿的HAPI。
