COVID-19 Updates

NPIAP Position Statements On Preventing Injury With N95 Masks

Pressure injury prevention and treatment through evidence-based practice is the foundation of NPIAP. We applaud the heroes in the health care provider workforce. We are deeply concerned about the facial injuries we are seeing in fellow clinicians as a result of prolonged use of N95 respirator masks while caring for patients with COVID-19.

The NPIAP recently completed an evidence-based guideline in collaboration with our international colleagues from the EPUAP and PPPIA.1 While this guideline provides important evidence-based recommendations for prevention of pressure injuries in patients, any application of those recommendations to the current COVID-19 pandemic comes with an important caveat: The essential function of a Personal Protective Equipment (PPE) mask (i.e. to prevent COVID-19 transmission from patient to provider) cannot be compromised.

In order to develop best practice recommendations for clinicians on the front lines of the COVID-19 crisis, we have reviewed and analyzed current evidence on the prevention of pressure injuries as well as current safety standards and research on PPE. This position paper is unique in that it combines current evidence in both pressure injury prevention and PPE science as a basis for recommendations within the context of the COVID-19 crisis. COVID-19 is a novel virus with a relatively high rate of transmission, morbidity and mortality. Where direct evidence was lacking or inconclusive, we placed greater weight on the need to prevent COVID-19 infection. We analyzed the evidence using the Strength of Evidence ratings developed for the 2019 International Pressure Injury Guideline.1

NPIAP Position StatementMask Info-graphic