Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
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J Wound Ostomy Continence Nurs · Nov 2020
Prophylactic Dressings for Maintaining Skin Integrity of Healthcare Workers When Using N95 Respirators While Preventing Contamination Due to the Novel Coronavirus: A Quality Improvement Project.
Extended use of N95 respirator masks is far more prevalent during the coronavirus disease 2019 (COVID-19) pandemic. As WOC nurses, we were tasked with formulating procedures for protecting the facial skin integrity of healthcare workers (HCWs) using personal protective devices when caring for patients with suspected or active COVID-19, while avoiding contamination when the masks are donned or doffed. This quality improvement project describes how we approached this project within the limited time frame available as we cared for patients with established and suspected COVID-19. ⋯ Based on these experiences, we recommend application of an alcohol-free liquid acrylate film to prevent facial skin injury associated with friction from the extended use of an N95 respirator mask. We further recommend performing a fit test and user-performed seal check with the use of any topical dressing and especially those that add cushion. For the duration of the COVID-19 pandemic, we recommend use of protective dressings to maintain skin integrity and protection from coronavirus infection as HCWs continue to provide care to all of patients under their care.
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COVID-19 symptoms mimic many other common conditions, making it difficult to identify patients infected with COVID-19. Adult patients may exhibit what is called "COVID toes" later in their course of illness. Noteworthy is that COVID toes may be the only symptom in otherwise asymptomatic young adults and children. ⋯ Familiarity with COVID toes will help foot care providers to identify patients who may not have been diagnosed with COVID-19 but could still be infectious and need to be isolated. COVID toe signs may be subtle and often mimic other conditions such as chilblains/pernio, thus a thorough history and physical examination are required.