Many studies have identified that the most common devices associated with Medical Device Related Pressure Injuries (MDRPIs) are continuous positive airway pressure devices – CPAP Masks. The common areas affected with PAP-related pressure injuries are the areas where the mask contacts the skin on the face: the nasal bridge, cheeks, chin, above the ears and the forehead.An estimated 26% of all adults between the ages of 30 to 70 years-old are exposed to, or are experiencing, pressure injuries from wearing their CPAP device (which is being worn to improve their quality of life)! There is also a rising percentage of the pediatric population being diagnosed with obstructive sleep apnea. Many of those are wearing a CPAP device and are also experiencing pressure injuries.
Currently, medical teams (nurses, respiratory therapists and physicians) who see both "in-patient" and "out-patient" PAP users are witnessing a rise in the incidence of medical device-related pressure injuries in patients who are diagnosed with obstructive sleep apnea.
The Joint Commission (regulatory accrediting agency for hospitals) points out that nearly all hospital patients require at least one medical device per admission for care and treatment, putting each of these patients at risk for skin injury. One pediatric hospital found that there was a "double-digit" increase in the incidence of PAP-related pressure injuries, but after the Hospital Clinicians formed an interdisciplinary team to research this increase, they were able to provide a solution for this trend by introducing and using all ‘skin-friendly’ masks. There was a significant decrease in pressure injuries upon the introduction of this "Plan-Do-Study-Act" model of quality improvement.
In Pediatric Units, non-invasive ventilation (NIV) is used as a common first–line therapy for many pediatric respiratory conditions, which often includes using PAP therapy. Within the Pediatric Units it has been observed that discomfort and skin-breakdown were the most common causes for NIV failure. With the experience of skin-breakdown, some risk factors that contribute to pressure injuries include:
- Tight device connection resulting in poor circulation, friction or shearing
- Moisture under the device
- Incorrect fitting and sizing of devices
- Lack of awareness (by the patient or caregiver) to be alert for skin changes/assessments and early prevention
Because MDRPIs form faster than non-MDRPIs, being proactive is crucial. Patient education cannot be stressed enough. It is also crucial that the interface chosen for the patient is skin-friendly as well as being able to provide the appropriate PAP therapy.
There is a growing emphasis on skincare from all levels of healthcare because of the high costs associated with wound care and healing. Some estimates have healthcare costs ranging anywhere between $5,000 to $70,000 per patient! This has prompted a high demand for more skin-friendly PAP solutions in particular.One skin-friendly product line that solves all of these issues for the affected age groups is the SleepWeaver® Skin Friendly™ line of cloth PAP masks. If you're a medical professional or a PAP patient, we encourage you to try this product for yourself—you can feel the difference!