The Incidence and Epidemic Characteristics of Medical Staff's Skin Injuries Caused by Personal Protective Equipment for Fighting against 2019-nCoV Infection

ABSTRACT

Background: The medical device-related pressure injury(DRPI), which mainly occurs in critical patients and orthopedic patients, has been a research hotspot for the safety management and specialized care of inpatients worldwide, but there have been few reports on DRPI of medical staff. During the prevention and control of COVID-19, a large number of medical staff are fighting at the front. However, wearing protective equipment for a long time can easily cause skin injury, which seriously harms the medical staff and increases their risk of infection. Therefore, how to protect medical personnel from skin damage is an urgent problem. Objective: To investigate the incidence and epidemic characteristics of medical staff's skin injuries caused by personal protective equipment in fighting against the COVID-19 in order to provide a basis for the formulation of effective protection countermeasures. Methods: A research questionnaire was developed by our research group, including the basic information of medical staff, the wearing situation of protective equipment, the skin damage situation, preventive measures against skin damage, and the post-injury treatment. The questionnaire was released through the Questionnaire Star website to front-line medical staff fighting against the COVID-19 through Wechat app from February 8 to 15 in 2020.The survey was completed by voluntary participation and online filling. The survey data were collected in one week and a database was established. Statistical analysis was made on the incidence of skin injuries, the types of injuries, and epidemic characteristics. Results: A total of 2 901 effective questionnaires were collected from 145 hospitals in 19 provinces, 3 autonomous regions and 4 municipalities in China. Among them, there were 214(7.38%) males and 2 687(92.62%) females, and 147(5.07%) doctors and 2 754(94.93%) nurses. And 825(28.44 %) cases of the medical staff suffered skin injuries due to wearing protective equipment, and the total number of skin damage sites was 2 794.The main types of skin injuries were pressure injury〔771(26.58%)cases, 2.53 per capita〕, moisture-associated skin damage〔256(8.83%)cases, 2.77 per capita〕, and skin tear〔42(1.45%)cases, 3.12 per capita〕.Of the 825 medical staff who had skin injuries, 221(26.79%) cases had skin injuries≥2 types. Univariate analysis showed that the incidence of skin injuries caused by protective equipment was higher in men than in women(P 0.05), in those aged 31-45 than in those ≤30(P 0.016 7), in those who worked 10 years than in those who worked 5 years(P 0.016 7), in doctors than in nurses(P 0.05), in designated epidemic prevention hospitals in Wuhan than in other hospitals(P 0.003 3)and among other hospitals, in Infectious Disease Department than in other departments(P 0.003 3), and in tertiary protection than in secondary protection followed by primary protection(P 0.016 7).However, there was no significant difference in the incidence of skin injuries among medical staff with different continuous wearing time of protective equipment(P 0.05).Conclusion The incidence of skin injuries caused by personal protective equipment in fighting against COVID-19 is high among medical staff. Multiple types and multiple sites of skin injuries are coexisted. It is recommended to take comprehensive preventive measures of pressure relief, friction reduction, moisture absorption, and skin care to reduce skin damage of medical staff. Meanwhile, it is suggested to pay attention to human resource management factors such as gender, age, and job position. Copyright © 2020 by the Chinese General Practice.