Incidence of hospital acquired pressure injury in critically ill patients with COVID-19 in prone position admitted to the intensive care unit.

Critical patients have conditions that may favor the occurrence of hospital-acquired pressure injury (HAPI). The objective of this study was to identify the incidence and factors associated with the occurrence of HAPI in patients with coronavirus disease 2019 admitted to the intensive care unit (ICU) who used the prone position. Retrospective cohort study carried out in an ICU of a tertiary university hospital. Two hundred four patients with positive real-time polymerase chain reactions were evaluated, of which 84 were placed in the prone position. All patients were sedated and submitted to invasive mechanical ventilation. Of the prone patients, 52 (62%) developed some type of HAPI during hospitalization. The main place of occurrence of HAPI was the sacral region, followed by the gluteus and thorax. Of the patients who developed HAPI, 26 (50%) had this event in places possibly associated with the prone position. The factors associated with the occurrence of HAPI in patients prone to coronavirus disease 2019 were the Braden Scale and the length of stay in the ICU. The incidence of HAPI in prone patients was extremely high (62%), which denotes the need to implement protocols in order to prevent the occurrence of these events.

Factors associated with the use of personal protective equipment among Brazilian physicians during the COVID-19 pandemic.

INTRODUCTION: The objective was to analyze the factors associated with use of Personal Protective Equipment (PPE) among Brazilian physicians during the COVID-19 pandemic. METHODOLOGY: An analytical cross-sectional study was conducted from October to December 2020 with 1298 Brazilian physicians. The respondent driven sampling technique was used by sharing the survey through social media. RESULTS: Factors associated with the use of PPE while caring for COVID-19 patients were: being female (AOR = 1.57; 95% CI: 1.24-1.98; p ≤ 0.001); working in Intensive Care Unit (ICU) (AOR = 2.78; 95% CI: 2.06-3.75; p ≤ 0.001); training (AOR = 1.62; 95% CI: 1.25-2.09; p ≤ 0.001); access to sufficient PPE (AOR = 2.22; 95% CI: 1.27-3.90; p = 0.0050), and PPE of good quality (AOR = 1.84; 95% CI: 1.16-2.92; p = 0.009). The following factors were associated with the use of recommended PPE during procedures that generate aerosols in the context of COVID-19: working in the ICU (ORA=2.73; 95% CI: 2.06-3.62; p < 0.01); working in a field hospital (AOR = 1.37; 95% CI: 1.06-1.79; p = 0.018;) training (AOR = 1.72 95% CI: 1.32-2.24; p < 0.01); access to sufficient PPE (AOR = 1.63; 95% CI: 0.91-2.92; p < 0.01), PPE of good quality (AOR = 2.07; 95% CI: 1.28-3.35; p = 0.003). CONCLUSIONS: The factors associated with the use of necessary PPE with COVID-19 patients and for procedures that generate aerosols were identified. Educational interventions for professionals and managers must be implemented to direct them towards protecting themselves and others.