Evidence on the effect of position change on pressure ulcer among hospitalized adult patients in Ethiopia: systematic review and meta-analysis

Abstract

Background Pressure ulcers (PU) affect millions of people worldwide and always occur over bony areas of the body where pressure and tissue distortion is greatest. The national pooled prevalence of pressure ulcer remains unknown. Hence, this meta-analysis aimed to determine the effect of position change on pressure ulcer among hospitalized clients in Ethiopia. Methods Studies were retrieved through search engines in PubMed, Scopus, WHO afro library, Google Scholar, Africa journal online, PsycINFO and web-science following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Analysis was done using STATA version 14 software. Heterogeneity between-study was checked using the I 2 and examined a potential publication bias by visual inspection of the funnel plot and Egger’s regression test statistic. The random-effect model was fitted to estimate the summary effects, odds ratios (ORs), and 95% confidence interval (CIs) across studies. Results Out of the reviewing 401 studies, 7 studies fulfilled the inclusion criteria and were included in the meta-analysis. The estimated pooled prevalence of pressure ulcer in Ethiopia was 11.7% (95% CI (7.28, 16.13%)). Based on the subgroup analysis, the estimated magnitude of pressure ulcer was 15.89% (95% CI: 35.34, 54.04) among studies their sample size were greater than or equals to 250. Those clients who have position change during hospitalization were 82% less likely to develop pressure ulcer [(OR: 0.18 (95% CI (0.07, 0.46)) than their counter part. Conclusion The overall prevalence of pressure ulcer in Ethiopia was relatively high. Position change of the client during hospitalization had paramount benefit to reduce the burden of pressure ulcer. Therefore, policymakers (federal minister of health) could give special attention to minimize the magnitude of pressure ulcer, and to improve the overall quality of healthcare service. Further, meta-analysis study could be conducted to identify individual and health care service related factors to the occurrence of pressure ulcer.