scholarly journals Medical Device-Related Pressure Injury to the Ear from a Mask

2021 ◽  
Vol 34 (7) ◽  
pp. 380-383
Author(s):  
Jeffrey M. Levine ◽  
Elizabeth A. Ayello ◽  
Balwant Persaud ◽  
Ruth Spinner
2018 ◽  
Vol 24 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Amit Gefen ◽  
Nick Santamaria ◽  
Sue Creehan ◽  
Joyce Black

This paper addresses a fundamentally important issue in health care, namely how to make informed decisions on product selection when two products, from different manufacturers, appear to be similar and have medical claims that sound comparable. In such cases, manufacturers of competing products often use each other’s evidence. They argue that the published evidence is generally applicable even if the original bioengineering tests and clinical trials were performed on a specific product, and no equivalence was obtained for their product that has similar medical claims. In this work, we use prophylactic dressings for pressure injury prevention as a good demonstrative example on how patient safety may be compromised if study conclusions are generally projected to such unstudied products. The medical device industry is regulated differently than the pharmaceutical industry, and consequently, voids in current medical device regulation are sometimes used to promote commercial interests. This paper analyzes gaps and potential pitfalls that occur where guiding documentations (e.g. guidelines, standards) do not cope well with medical technology. We explain how that can eventually lead to potential compromises to the well-being of patients, primarily if nurses are unaware of the aforementioned pitfalls. We conclude that currently, there is no alternative to rigorousness: Clinicians and decision-makers need to scrutinize up-to-date literature, decide which products have the best portfolio of bioengineering and clinical research to support the claims made, and which products have the best cost–benefit models. This is fundamentally different from simply buying the least expensive product because of appealing sale arguments.


2018 ◽  
Vol 1 (21;1) ◽  
pp. E235-E246 ◽  
Author(s):  
Nerea Sanchis-López

Background Chronic back pain is a prevalent disease and has a high impact in daily life. Implantable devices (IDs) for chronic pain management include spinal cord stimulation (SCS) systems and intrathecal drug delivery (ITDD) pumps. The number of ITDD implants have increased exponentially in the last decade. The number of complications, such as infections, are also more prevalent. Infection management guidelines are needed to standarize our clinical practice and define protocols of explantation. Objectives: The primary outcome is to define the likelihood of device explantation regarding some covariates related to the patient, antibiotic therapy or surgerical procedures. The secondary outcome is to evaluate performance compared to the results published in the literature. Study Design: Retrospective study. Setting: Hospital General of Valencia. Valencia. Spain. Methods: A retrospective study of 288 implantable device surgeries was conducted at the Hospital General Universitary of Valencia (Spain) from 1994 to 2015. Demographical and infection data were collected. We have followed the “guidelines for the diagnosis, prevention and management of implantable electronic cardiac device infection” due to the lack of a specific guideline in our field. Results: Forty-three out of 288 procedures were identified as suspected device-infected interventions. Half of the patients had microbiologically confirmed infection after wound, blood or lumbar fluid culture. The odds ratio (OR) for explantation of the device was 19 for the presence of decubitus, a sign of medical device related pressure injury (P < 0.0005) and 5 for positive wound culture (P < 0.0452). Medical indication leading to device implantation and the antibiotics on discharge also played a role in the decision of device explantation. Limitations: Lack of external validity and others. Conclusion: In this study, presence of decubitus is the defining variable for device explantation when a infection is suspected rather than waiting to culture results. Due to a high variability in infection rates, multidisciplinary guidelines are needed to provide an approach that focuses on accurate data monitoring, rigurous implantation technique and standardized protocols. Key Words: Chronic pain, spinal cord stimulation infection, neurostimulator, intrathecal drug delivery pump, complication, infection, explantation


2021 ◽  
Vol 31 ◽  
pp. S614-S617
Author(s):  
Sintawati Majid ◽  
Saldy Yusuf ◽  
Yuliana Syam ◽  
Muhammad Darwis ◽  
Deliaty Bagenda Ali

2021 ◽  
Vol 67 (11) ◽  
pp. 26-32
Author(s):  
Itaricely de Assis ◽  
Jonathan Estevam dos Santos ◽  
Maria Valadares Sinicio Abib ◽  
Luana Furtado Bueno ◽  
Manuela de Mendonça Figueirêdo Coelho ◽  
...  

BACKGROUND: Medical devices can cause pressure injuries. PURPOSE: This study was conducted to determine the prevalence of and factors associated with medical device-related pressure injury (MDRPI) in an intensive care unit (ICU). METHODS: A cross-sectional study was performed among adult patients (at least 18 years of age) admitted to an ICU in a referral hospital in Brazil between December 2019 and February 2020. The skin of patients who consented to participate was assessed for the presence of an MDRPI, and the use of all medical devices was noted. Other independent variables (sociodemographic variables, medical history, pressure injury risk factors, medications, and length of hospitalization) were abstracted from the medical records. Bivariate data analysis included Pearson’s chi-square test or Fisher’s exact test; odds ratio and a confidence interval of 95% also were established. Correlation among independent variables and MDRPI was determined using the ρ Spearman correlation test, and a hierarchical binary logistic regression analysis was performed using statistically significant variables from the bivariate analysis. P < .05 was considered statistically significant. RESULTS: The 125 study participants ranged in age from 15 to 97 years (mean, 63.02 ± 19.2), 76 (60.8%) were men, and 76 (60.8%) were White. Of the 125 participants, 43 (34%) experienced MDRPI; the total number of MDRPIs was 58 (3 patients had 3 injuries, and 7 patients had 2 injuries). Of those 58 MDRPIs, 46 were stage 1, and 12 were stage 2. Polypharmacy (> 4 medications) was a significant risk factor for MDRPI. Use of a nasal catheter, cord for orotracheal tube fixation, oximeter, intra-abdominal pressure equipment, and indwelling urinary catheter was significantly associated with the presence of MDRPI. Renal and respiratory diseases and the presence of infection were positively related to the presence of MDRPI. CONCLUSION: Medical device-related pressure injury was prevalent in this patient population. Most of these injuries were stage 1, which suggests that frequent monitoring and device repositioning (when possible) may help prevent more serious injuries. Additional research involving other hospitals in Brazil is needed to increase the understanding of the prevalence and risk factors of MDRPIs in patients in the ICU.


Author(s):  
Wen Dang ◽  
Yuan Liu ◽  
Qing Zhou ◽  
Yuyu Duan ◽  
Huaxiu Gan ◽  
...  

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Sabrina Guterres da Silva Galetto ◽  
Eliane Regina Pereira do Nascimento ◽  
Patrícia Madalena Vieira Hermida ◽  
Josefine Busanello ◽  
Luciana Bihain Hagemann de Malfussi ◽  
...  

ABSTRACT Objectives: to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients. Methods: this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used. Results: six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible. Final Considerations: nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.


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