Incidence and influencing factors of head and face device-related pressure injuries: Findings from frontline nurses battling COVID-19.

In December 2019, Coronavirus Disease 2019 (COVID-19) caused by infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first identified in Wuhan City, Hubei Province, China, and rapidly spread across the globe, affecting millions and overwhelming global public health systems. To evaluate the incidence and severity of head and face device-related pressure injuries (DRPI) among front-line nurses and identify factors contributing to DRPI, from March to May 2020, 143 clinical first-line nurses from Guangdong Province who were deployed to Hubei Province were surveyed with a self-designed device-related pressure injury questionnaire. Frequent distributions and logistic regression were used to identify factors associated with injury incidence and severity. In summary, 75.5% of nurses reported DRPI, and continuous use of personal protective equipment (PPE) on the head and neck was a major contributing factor to injury. While protective strategies such as adjusting for the size of the equipment, applying dressing, and washing the affected areas with warm water were reported, there were inconsistencies in their effectiveness. It was noted that each additional hour of PPE use increased the risk of developing DRPI by 52.5% (OR 1.53, 95% CI 1.10-2.12). The high incidence of DRPI among participants highlights the need for focused and comprehensive intervention strategies in future research. Though the findings suggest that it may be helpful to develop acute care settings-appropriate individualized assessment tools, multicenter studies will need to be conducted before a standardized assessment tool can be developed.