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      The prevalence, characteristics, and related factors of pressure injury in medical staff wearing personal protective equipment against COVID‐19 in China: A multicentre cross‐sectional survey

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          Abstract

          Since December 2019, the medical staff fighting against COVID‐19 frequently reported the device‐related pressure injury (DRPI) caused by personal protective equipment (PPE). We conducted a cross‐sectional survey online to investigate the prevalence and characteristics of DRPI among medical staff. Univariate and multivariate logistic regression analyses were employed to explore the risk factors associated with DRPI. A total of 4308 participants were collected and 4306 participants were valid from 161 hospitals in China. The overall prevalence of DRPI caused by PPE among medical staff was 30.03% (95% CI 28.69%‐31.41%). The prevalence of male was more than that of female (42.25%, 95% CI 37.99‐46.51% vs 26.36%, 95% CI 26.93‐29.80%, P < .001).The categories were mainly stages 1 and 2, and the common anatomical locations were nose bridge, cheeks, ears, and forehead. Logistic regression analysis revealed that the risk factors were sweating (OR = 43.99, 95% CI 34.46‐56.17), male (OR = 1.50, 95% CI 1.12‐1.99), level 3 PPE (OR = 1.44, 95% CI 1.14‐1.83), and longer wearing time (OR = 1.28, 95% CI 0.97‐1.68). The prevalence of DRPI was high among medical staff wearing PPE against COVID‐19, and the risk factors were sweating, male, wearing level 3 PPE, and longer wearing time. Comprehensive preventive interventions should be taken.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Prevalence and Analysis of Medical Device-Related Pressure Injuries: Results from the International Pressure Ulcer Prevalence Survey

            Susan Kayser, Catherine VanGilder, Elizabeth A. Ayello … (2018)
            ABSTRACT OBJECTIVE: To examine the prevalence and characteristics of medical device–related pressure injuries (MDR PIs) in a large, generalizable database. METHODS: This study is a retrospective analysis of the 2016 International Pressure Ulcer Prevalence data. Data were limited to US and Canadian facilities. Facilities included acute care, long-term care, rehabilitation, long-term acute care hospitals, and hospice. Analysis included 102,865 adult patients; 99,876 had complete data and were the focus of the analysis and are reported in the results below. RESULTS: The overall PI prevalence was 7.2% (n = 7189), and the facility-acquired prevalence was 3.1% (n = 3113). The prevalence of MDR PIs was 0.60% (n = 601), which included both mucosal and nonmucosal MDR PIs. In this study, 75% of MDR PIs were facility acquired, whereas non-MDR PIs were most commonly present on admission. Facility-acquired MDR PIs formed 3 days faster than facility-acquired non-MDR PIs (12 vs 15 days; P < .05). By stage, most MDR PIs were superficial (58% were Stage 1 or 2), 15% were deep-tissue PIs, and 22% were full-thickness PIs (Stage 3 or 4 or unstageable). The most common anatomic locations for MDR PIs were the ears (29%) and the feet (12%). The most common devices associated with MDR PIs were nasal oxygen tubes, 26%; other, 19%; cast/splints, 12%; and continuous positive airway pressure/bilevel positive airway pressure masks, 9%. CONCLUSIONS: Because MDR PIs form faster than non-MDR PIs, timely proactive assessment and prevention measures are critical. Most MDR PIs occurred at the face and head region, and the ears specifically. The most common devices linked with MDR PIs were oxygen tubing and masks, making assessment and prevention efforts critical for patients who require those devices.
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              The incidence, risk factors and characteristics of pressure ulcers in hospitalized patients in China.

              Qixia Jiang, Xiaohua Li, Xiaolong Qu … (2014)
              Pressure ulcers are very common in hospital patients. Though many studies have been reported in many countries, the large-scale benchmarking prevalence of pressure ulcers in China is not available. The aim of this study is to quantify the prevalence of pressure ulcers and the incidence of hospital-acquired pressure ulcers and analyze risk factors in hospitalized patients in China. A multi-central cross-sectional survey was conducted in one university hospital and 11 general hospitals in China. The Minimum Data Set (MDS) recommended by European Pressure Ulcer Advisory Panel (EUPAP) was used to collect information of inpatients. All patients stayed in hospital more than 24 hours and older than 18 years signed consent form and were included. Data from 39952 out of 40415 (98.85%) inpatients were analyzed. Of the 39952 patients, 631 patients (including 1024 locations) had pressure ulcers. The prevalence rate of pressure ulcers in 12 hospitals was 1.58% (0.94-2.97%). The incidence of hospital-acquired pressure ulcers (HAPU) was 0.63% (0.20-1.20%). The most common locations developed pressure ulcers were sacrum, heels, and iliac crests. The common stages of pressure ulcers were stage I and II. Patients in Intensive Care Unit, Geriatric and Neurological Department were easier to develop pressure ulcers. The prevalence and incidence of pressure ulcers in China was lower than that reported in European and other countries. The stages of pressure ulcers in China were different than that reported in European countries. Our study provides with a baseline value for intensive research on pressure ulcer in China.
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                Author and article information

                Contributors
                Qixia Jiang: jiangqixia1963@163.com
                Journal
                Journal ID (nlm-ta): Int Wound J
                Journal ID (iso-abbrev): Int Wound J
                Journal ID (doi): 10.1111/(ISSN)1742-481X
                Journal ID (publisher-id): IWJ
                Title: International Wound Journal
                Publisher: Blackwell Publishing Ltd (Oxford, UK )
                ISSN (Print): 1742-4801
                ISSN (Electronic): 1742-481X
                Publication date (Electronic): 12 May 2020
                Electronic Location Identifier: 10.1111/iwj.13391
                Affiliations
                [ 1 ] Department of Burns and Plastic Surgery Jinling Hospital Nanjing Jiangsu China
                [ 2 ] Department of Medical Statistics Jinling Hospital Nanjing Jiangsu China
                [ 3 ] Medical School, Nanjing University Nanjing Jiangsu China
                [ 4 ] Nursing Department Jinling Hospital Nanjing Jiangsu China
                [ 5 ] Department of Anorectic Surgery Wenzhou Medical University Second Affiliated Hospital Wenzhou Zhejiang China
                [ 6 ] Nursing Department Wuxi Second People's Hospital Wuxi Jiangsu China
                [ 7 ] Nursing Department Shanghai Yangpu District Central Hospital Shanghai China
                [ 8 ] Nursing Department Zunyi Medical College Affiliated Hospital Zunyi Guizhou China
                [ 9 ] Nursing Department Zhongshan Hospital Xiamen University Xiamen Fujian China
                [ 10 ] Clinical Academic Department Zhejiang Top‐medical Dressing Co. Ltd. Wenzhou Zhejiang China
                [ 11 ] Nursing Department Wuxi Third People's Hospital Wuxi Jiangsu China
                [ 12 ] Nursing Department Dalang Hospital of Dongguan Dongguan Guangdong China
                [ 13 ] Nursing Department Shanxi Medical University Second Affiliated Hospital Taiyuan Shanxi China
                [ 14 ] Depertment of General Surgery Xinyang Central Hospital Xinyang Henan China
                [ 15 ] Orthopaedics Department Jinling Hospital Nanjing Jiangsu China
                Author notes
                [*] [* ] Correspondence

                Qixia Jiang, Department of Burns and Plastic Surgery, Jinling Hospital, Nanjing, Jiangsu, China.

                Email: jiangqixia1963@ 123456163.com

                Article
                Publisher ID: IWJ13391
                DOI: 10.1111/iwj.13391
                PMC ID: 7273008
                PubMed ID: 32396265
                SO-VID: 123e0798-1423-48fe-88b5-55d9161c9a55
                Copyright © © 2020 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 28 March 2020
                Date revision received : 21 April 2020
                Date accepted : 21 April 2020
                Page count
                Figures: 8, Tables: 3, Pages: 10, Words: 4926
                Funding
                Funded by: Shanghai Wang Zhengguo Trauma Medicine Development Foundation Project
                Award ID: 20WQ027
                Award ID: WZGF20200101
                Categories
                Subject: Original Article
                Subject: Original Articles
                Custom metadata
                source-schema-version-number 2.0
                edited-state corrected-proof
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.3 mode:remove_FC converted:05.06.2020

                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: covid‐19,cross‐sectional survey,personal protective equipment,pressure injury
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: covid‐19, cross‐sectional survey, personal protective equipment, pressure injury

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