COVID-19 related pressure injuries in patients and personnel: A systematic review.
Jia-Ning Yu, Bing-Bing Wu, Li-Ping Feng and 1 others
PMID 33895045WHAT IT FOUND
COVID-19 pressure injuries clustered on staff faces from masks and on prone patients' faces and chest.
The review suggests barrier dressings, shorter PPE wear, and frequent repositioning, but evidence is mostly observational.
Key findings
01Sixteen studies reported pressure injuries in two main settings: healthcare workers wearing protective equipment and patients placed prone for treatment.
02Among healthcare workers, pressure injuries often occurred on the nose, cheeks, forehead and ears, and the review reported dressings and shorter protective equipment wearing time as preventive measures.
03Among prone patients, pressure injuries were reported on the forehead, chin, cheeks, lips and chest, with dressings, head cushions, repositioning and debridement described.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 16 studies were included, and the authors reported no randomized controlled trials, so the review cannot establish that any measure prevented pressure injuries. The evidence base was mainly prospective cohort studies and case reports, and the authors noted that including case reports added heterogeneity. The patient-care evidence was limited to four studies of prone positioning, so it says little about broader patient populations. Pressure injury identification and grading were difficult, and many included studies did not report enough detail to compare injuries across settings.
Declared interests
The study was supported by the Humanities and Social Sciences of Ministry of Education Planning Fund and a Nantong city general project, and the authors declared no competing interests.
The easy way to misread this
Do not read this as proof that foam dressings, hydrocolloid dressings or shorter PPE wear prevent pressure injuries. The review included observational studies and case reports, and the authors reported no randomized trials.