Medical Device-Related Pressure Injuries Associated With Endotracheal Tube Securement Practices: A Retrospective Study

Abstract

Medical device-related pressure injuries (MDRPIs) are a significant and preventable source of patient harm, particularly in critically ill patients requiring endotracheal intubation. The method of endotracheal tube (ETT) securement may influence the development, location, and severity of these injuries. This retrospective quality improvement study examined the incidence and characteristics of MDRPIs associated with different ETT securement practices—commercial devices versus traditional ties and adhesive tapes—in adult intensive care unit (ICU) patients. The study also explored patient-related risk factors contributing to MDRPI development and clinical outcomes. Data was collected from 51 adult ICU patients with documented MDRPIs between January 2023 and June 2024 at a tertiary care hospital. Descriptive and inferential statistics were used to analyze associations between securement methods, patient characteristics, and outcomes. A significant association was found between securement methods and injury location (p = .012). Ties/tape were more often linked to ear injuries, while commercial devices were associated with lip and oral mucosa injuries. Intubation duration of seven days or more significantly increased MDRPI risk (p < .001). Lower Braden scores, male gender, vasopressor use, and low albumin levels were common among affected patients. Although older patients had higher mortality, a greater proportion of MDRPI cases occurred in patients under age 65. Patients with ties/tape securement had higher in-ICU mortality, while those with commercial holders were more often transitioned to a lower-acuity level of care (p = .016). These findings highlight the importance of prevention strategies tailored to securement methods and patient risk profiles.

Disciplines

Medicine and Health Sciences | Nursing

Subject Area

Nursing; Health care management; Medicine

Department

Nursing (NUR)

First Advisor

Stager, Sharon

Second Advisor

Capasso, Virginia

Date of Award

2025

Document Type

Dissertation

Degree Name

D.N.P.

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