Medical-Device-Related Pressure Injury on Adults: An Integrative Review

Abstract

Objective: to identify factors associated with medical-device-related pressure injury. Method: an integrative review of published articles on the subject related to the adult population in the databases of PUBMED, Scopus, MEDLINE, Latin American and Caribbean Health Sciences Literature (Literatura Latino-Americana e do Caribe em Ciências da Saúde, LILACS), Web of Science and Nursing Database (Banco de Dados em Enfermagem, BDENF), between 2013 and 2018. Results: medical-device-related pressure injuries were common in adults, especially in the elderly, due to capillary fragility, among other changes. Other observed factors were length of stay, critically ill patients or those requiring any type of medical device. Numerous medical devices have been associated with skin lesions; among the most frequent were breathing, feeding, and orthopedic devices, tubes, oximeters, neck collars, patches and nasogastric tubes. Conclusion: the first step towards prevention is exploration in terms of identifying the types of injury-causing devices and evidence-based interventions, and disseminating information to the entire multidisciplinary team.

Medical device-related pressure injuries in critical patients: prevalence and associated factors

“…In Brazil, scientific publications focusing on the prevalence and incidence of MDRPI are still incipient. In an integrative review study (10) aimed at adult patients conducted recently by Brazilian nurses, only international research on the subject was identified. At the national level, a study (11) of a pediatric population showed a prevalence of PI of 32.8% in the ICU.…”

“…Thus, it is imperative to pay attention to the problem of MDRPI in care settings, especially in the ICU, because although they are not a new phenomenon, research on the frequency of these injuries in Brazil is still limited (10,12) . In other countries, there are studies that seek scientific evidence on preventive care with the implementation of clinical guidelines aimed at controlling the factors associated with its development (14) .…”

Percepção de profissionais de enfermagem sobre lesões por pressão relacionadas a dispositivos médicos

“…In view of the above, the need for greater surveillance and awareness of the Nursing and multi-professional team for MDR PI cases is emphasized, as satisfactory results are achieved when all team members understand and value their role in preventing this harm, 7 prevention that requires evidence-based interventions and dissemination of information to the entire multidisciplinary team. 14 As it recognizes that the identification and prevention of MDR PIs is the responsibility of the entire multidisciplinary team, a limitation of the study was the approach restricted to Nursing professionals. Also pointed out as a limitation is the fact that the interviews were not submitted to validation by the participants which, associated to the peer review carried out, could give more credibility to the study.…”

Pressure wounds in a cohort of critical patients: incidence and associated factors

“…There is no consensus in literature about PW associated factors, especially in ICU patients. After adopting many different designs, and not always employing a statistic capable of isolating the independent effect of each variable, literature shows some factors that can be associated to PW: (1) the impossibility of noticing or communicating pressure discomfort (5)(6)(7) ; (2) the use of devices that can provoke wounds in the skin and its adjacent tissues, such as tubes, catheters, and others (8)(9) ; (3) malnutrition (10) ; (4) advanced age (10) ; (5) the inability to move in the bed or chair (11) ; (6) humidity, friction, and shear (12) ; (7) hemodynamic instability (7) ; and (8) longer hospitalization periods (13) .…”