The use of a protein network analysis to explore the complexity of early skin inflammation after oronasal mask application- A pilot study.

Medical devices, such as non-invasive ventilation masks, save lives in health care settings but can be a cause of tissue injuries due to the pressure and shear loads on skin and soft tissue. These pressure injuries could be painful for the individual and cause a significant economic impact on healthcare providers. In the etiology of device related pressure ulcers, inflammation plays an important role. However, the exact nature and timing of inflammatory biomarker upregulation is still unknown in the early stages of skin damage. This study aimed to explore the inflammatory profile of vulnerable skin sites following non-invasive mask application on a convenience sample of eleven hospital patients. Seventy-one inflammatory proteins were explored from sebum sampled at the skin surface after oronasal mask application. A multivariate analysis to investigate differences between loaded and control site was conducted, with a protein network analysis used to explore interactions in the early inflammation. The study revealed that 21 cytokines and chemokines were important for the separation between loaded and control site. These proteins were associated with remodeling of tissue, vascular wound healing and/or cell death.

Nurses' strategies to enable continuous positive airway pressure therapy in a general medical ward context: A qualitative study.

BACKGROUND: Continuous positive airway pressure is a non-invasive therapy beneficial for patients with acute respiratory failure. The need for this therapy outside intensive care units is growing, but nurses face many challenges to enable this therapy in general medical wards. AIMS AND OBJECTIVES: The aim of the study was to explore nurses' strategies for enabling continuous positive airway pressure therapy in a general medical ward context. METHOD: An explorative qualitative design was used including semi-structured interviews with 15 Swedish nurses. Data were analysed using a conventional content analysis. RESULTS: The nurses' strategies included a non-hierarchical approach when utilising an intra- and interprofessional collaboration. Inexperience was compensated for by collaboration. Nurses' strategies involved advanced patient-centred care using interventions to manage and ease the patient's treatment and discomfort. The creation of an alliance with the patient was crucial to prevent treatment failure. The strategies were interrelated and considered as parts of a whole. CONCLUSION: Nurses described the strategy of a dynamic team that could be enlarged or decreased in tandem with other professionals, depending on the situation and the nurses' needs. Nurses need to have an attentive response to the patients' physical, psychosocial and relational needs and to maintain trust for a positive therapy outcome.