Effectiveness on hospital‐acquired pressure ulcers prevention: a systematic review

Abstract

The effective approach on pressure ulcer (PU) prevention regarding patient safety in the hospital context was evaluated. Studies were identified from searches in EBSCO host, PubMed, and WebofScience databases from 2009 up to December 2018. Studies were selected if they were published in English, French, Portuguese, or Spanish; incidence of PUs was the primary outcome; participants were adults (≥18 years) admitted in hospital wards and/or units. The review included 26 studies. Studies related to prophylactic dressings applied in the sacrum, trochanters, and/or heels, education for health care professionals, and preventive skin care and system reminders on‐screen inpatient care plan were effective in decreasing PUs. Most of the studies related to multiple intervention programmes were effective in decreasing PU occurrence. Single interventions, namely support surfaces and repositioning, were not always effective in preventing PUs. Repositioning only was effective when supported by technological pressure‐mapping feedback or by a patient positioning system. Risk‐assessment tools are not effective in preventing PUs. PUs in the hospital context are still a worldwide issue related to patient safety. Multiple intervention programmes were more effective in decreasing PU occurrence than single interventions in isolation. Single interventions (prophylactic dressings, support surfaces, repositioning, preventive skin care, system reminders, and education for health care professionals) were effective in decreasing PUs, which was always in compliance with other preventive measures. These results provide an overview of effective approaches that should be considered when establishing evidence‐based guidelines to hospital health care professionals and administrators for clinical practice effective in preventing PUs.

Impact of a Swiss pressure ulcer prevention breakthrough collaborative

“…From the five included studies, the authors concluded that they were uncertain whether educating healthcare professionals about pressure ulcer prevention makes any difference to the incidence of pressure ulcers, or to nurses' knowledge of their prevention, because of the very low certainty of evidence. Another systematic review indicated that if single preventive interventions were most often unsuccessful alone, multiple intervention programmes were usually more effective in decreasing the occurrence of pressure ulcers 29 . An overview of systematic reviews of non‐pharmacologic interventions to prevent pressure ulcers indicated a high risk of bias and imprecision in existing studies 30 .…”

Pressure injury data in Australian acute care settings: A comparison of three data sets

“…Contemporary Australian data on PI prevention and management became a priority to justify the allocation of funds in this field . There is a consensus that PI is largely preventable, particularly if multiple intervention programmes are implemented in acute care settings . Harm from PI is a high risk on most hospital risk registers.…”

Patient education materials on pressure injury prevention in hospitals and health services in Victoria, Australia: Availability and content analysis

“…However, this review examined community‐based people with spinal injuries, which may not be applicable to acute inpatient settings where a care bundle partnership between clinicians and patients may be more achievable. A recent systematic review reported that complex intervention programmes that included an element of education were more effective in decreasing occurrence of HAPIs than single interventions.…”