Interventions and strategies to prevent medical device‐related pressure injury in adult patients: A systematic review

Abstract

BackgroundCurrent evidence shows that medical device‐related pressure injury (MDRPI) has a high prevalence (10%) and incidence (12%), and much research has been done to prevent MDRPI in recent years. However, to our knowledge, there is limited systematic review available on interventions and strategies to prevent MDRPI.AimTo synthesise research evidence on interventions and strategies used to prevent MDRPI.MethodsThis systematic review adhered to the PRISMA Guidelines. We searched six databases including Medline, CINAHL, EMBASE, Cochrane library, Web of Science and ProQuest with no restriction to year of publication. Data were extracted and checked by two authors independently. A narrative summary technique was used to describe the findings. Implementation strategies were grouped into six classifications: dissemination/implementation process/integration/capacity building/sustainability/scale‐up strategies.ResultsTwenty‐four peer‐reviewed papers met the inclusion criteria, which comprised of 11 quality improvement projects and 13 original research. Types of devices included respiratory devices (non‐invasive ventilation mask, CPAP/BiPAP mask, endotracheal tube), gastrointestinal/urinary devices and other devices. Interventions used included the use of dressing, hyperoxygenated fatty acids, full‐face mask, training, and/or multidisciplinary education, use of special securement devices or tube holder, repositioning, application of stockinette, early removal and foam ring use. Common implementation strategies included ongoing staff education, audit and standardising documentation or guideline development.ConclusionMuch work on MDRPI prevention strategies has been undertaken. There were a variety of devices reported, however, it is evident that higher quality research is needed.Relevance to clinical practiceCurrent evidence shows that interventions including use of dressing or special securement device, repositioning, and training/multidisciplinary education can be beneficial for MDRPI prevention. High‐quality research, such as randomised controlled trials are needed to test the effectiveness of the interventions and their implementation strategies.No patient or public contribution.

Development of a Nomogram for Predicting the Risk of Hospital-Acquired Pressure Injuries in Patients in the Cardiovascular Intensive Care Unit

“…The reason for this may be differences in pressure ulcer reporting mechanisms and omission and concealment of some cases. 13 Existing research on the occurrence of pressure ulcers in hospitals are mostly limited to evaluation of the declaration system and the formulation of management processes, most of which are focused on the introduction of management experience and lack of clinical epidemiological research on risk factors for pressure ulcers. Moreover, assessment of pressure ulcer risk tools used in various hospitals differ, and the evaluation of risk grade is inconsistent and lacks accuracy and objectivity, which can easily cause excessive or insufficient nursing.…”