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hospital acquired, medical devices, nurses, pressure injuries, pressure ulcers, respiratory



  1. Mahramus Hunt, Tara L. MSN, APRN-CNS, CCNS, CCRN
  2. Penoyer, Daleen A. PhD, RN, CCRP, FCNS, FCCM


Purpose/Aim: To evaluate a collaborative skin assessment intervention between respiratory therapists and registered nurses.


Design: A quality improvement design was used to determine feasibility of a collaborative skin assessment.


Methods: The collaborative skin assessment intervention included skin assessments, documentation of findings, and use of a treatment guideline for patients using a respiratory care device. Perceptions of the collaborative intervention and pressure injury numbers were measured after a 2-month intervention period.


Results: Respiratory therapists and registered nurses reported satisfaction with the collaborative intervention; stating it was best practice and could prevent respiratory care device-related pressure injuries. However, timing the skin assessment together was difficult. One device-related pressure injury occurred during the intervention period.


Conclusions: Respiratory therapists and nurses should partner to perform skin assessments under respiratory devices each shift and develop a plan of care to prevent skin injury. Protocol orders to prevent and treat skin alterations found under respiratory care devices and a dedicated area in the medical record to document skin assessments may be helpful to support efforts to prevent injuries. Additionally, as a result of these efforts, pressure injuries specific to endotracheal tubes declined greater than 50% in 2 critical care units in the year following this quality improvement project.