Non-invasive ventilation: pressure ulcer on the face - implications for clinical practice

Abstract

The non-invasive ventilation (NIV) represents a major evolution in the approach of respiratory failure. The nursing interventions during NVI are often a challenge for the team, since the care adaptation is focused in the individuality of each and every person. Based on available scientific knowledge there are complications associated with NIV, being the one related with interface – pressure ulcer the most serious. The nursing interventions are directed to the patient evaluation and action planning respecting the guidelines for clinical practice. With the goal of identifying the nursing interventions associated with the prevention of the face pressure ulcer in the patient undergoing NIV was developed a systematic review of the literature. For the development of this article were selected 8 full-text articles with time interval from January 2011 to March 2016 from the electronic databases CINAHL (The Cumulative Index to Nursing and Allied Health Literature), Nursing & Allied Health Collection, and MEDLINE. We used the method PI[C]O and selected 8 articles from a total of 150. The NIV has taken on a particular importance as a strategy in the treatment of the patient with respiratory pathologies and it should be based on whether there is a prospect of reversibility or, in case of end stage cancer patients, in patient’s comfort including dyspnoea improvement and maintaining autonomy. The ulcer due to face pressure emerges as the most serious y recurrent complication in every study. Nurses should prioritize an evaluation and a continuous
surveillance, the fit of the mask, switching between mask types, the choice of model and proper sizing, the application of the right amount of pressure, the repositioning, the hygiene and skin hydration. The nursing intervention is decisive in preventing and minimizing the complications, promoting safe and quality care.