• Marilyn Schallom, Lisa Cracchiolo, Antoinette Falker, Jennifer Foster, JoAnn Hager, Tamara Morehouse, Peggy Watts, Linda Weems, and Marin Kollef.
• Marilyn Schallom is a clinical nurse specialist and research scientist in the Department of Research, Lisa Cracchiolo and Linda Weems are registered respiratory therapists and supervisors in the Respiratory Care Services Department, Antoinette Falker is a clinical nurse specialist for trauma, acute care surgery, and bariatrics, Jennifer Foster is a nurse educator in the neuroscience intensive care unit, JoAnn Hager is a certified wound/ostomy/continence nurse, Tamara Morehouse is a certified would care nurse with the wound/ostomy/continence team, and Peggy Watts is a registered respiratory therapist and manager in the Respiratory Care Services Department at Barnes-Jewish Hospital, St Louis, Missouri. Marin Kollef is a professor of medicine at Washington University School of Medicine, St Louis, Missouri. mes4143@bjc.org.
• Am. J. Crit. Care. 2015 Jul 1;24(4):349-56; quiz 357.

BackgroundDevice-related pressure ulcers from noninvasive ventilation masks alter skin integrity and cause patients discomfort.ObjectiveTo examine the incidence, location, and stage of pressure ulcers and patients' comfort with a nasal-oral mask compared with a full-face mask.MethodsA before-after study of a convenience sample of patients with noninvasive ventilation orders in 5 intensive care units was conducted. Two groups of 100 patients each received either the nasal-oral mask or the full-face mask. Skin was assessed before the mask was applied and every 12 hours after that or upon mask removal. Comfort levels were assessed every 12 hours on a Likert scale of 1 to 5 (1, most comfortable).ResultsA pressure ulcer developed in 20% of patients in the nasal-oral mask group and 2% of patients in the full-face mask group (P < .001). Comfort scores were significantly lower (more comfortable) with the full-face mask (mean [SD], 1.9 [1.1]) than with the nasal-oral mask (mean [SD], 2.7 [1.2], P < .001). Neither mean hours worn nor percentage adherence differed significantly: 28.9 (SD, 27.2) hours and 92% for full-face mask and 25 (SD, 20.7) and 92% for nasal-oral mask. No patients who had a pressure ulcer develop with the nasal-oral mask had a pressure ulcer develop with the full-face mask.ConclusionThe full-face mask resulted in significantly fewer pressure ulcers and was more comfortable for patients. The full-face mask is a reasonable alternative to traditional nasal-oral masks for patients receiving noninvasive ventilation.©2015 American Association of Critical-Care Nurses.

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