Tayyib N, Coyer F, et al.
Worldviews on evidence-based nursing. Date of publication 2016 Dec 1;volume 13(6):432-444.
1. Worldviews Evid Based Nurs. 2016 Dec;13(6):432-444. doi: 10.1111/wvn.12177. Epub
2016 Oct 6.
Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in
Intensive Care Units: A Systematic Review.
Tayyib N(1)(2), Coyer F(3)(4).
Author information:
(1)Doctoral Candidate, School of Nursing, Queensland University of Technology,
Queensland, Australia.
(2)Lecturer, School of Nursing, Umm Al-Qura University, Saudi Arabia.
(3)Professor of Nursing, School of Nursing, Queensland University of Technology,
Queensland, Australia.
(4)Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital,
Metro North Hospital and Health Service, Brisbane, Australia.
BACKGROUND: Pressure ulcers are associated with substantial health burden, but
could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has
become a priority for all healthcare settings, as it is considered a sign of
quality of care providing. Intensive care unit (ICU) patients are at higher risk
for HAPUs development. Despite the availability of published prevention
strategies, there is a little evidence about which strategies can be safely
integrated into routine standard care and have an impact on HAPUs prevention.
AIMS: The aim was to synthesize the best available evidence regarding the
effectiveness of single strategies designed to reduce the incidence and
prevalence of HAPUs development in ICUs.
METHODS: The search strategy was designed to retrieve studies published in
English across CINAHL, Medline, Cochrane Central Register of Controlled Trials,
Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were
aged 18 years or over. This review included randomized controlled trials,
quasi-experimental and comparative studies. The studies that were selected for
retrieval were assessed by two independent reviewers for methodological validity
prior to inclusion in the review using standardized critical-appraisal
instruments.
RESULTS: The review included 25 studies, and the meta-analysis revealed a
statistically significant effect of a silicon foam dressing strategy in reducing
HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p < .00001, effect size =
4.50; 95% CI: 0.05-0.31; p = .00001, respectively) in critically ill patients.
Evidence of the effectiveness of nutrition, skin-care regimen, positioning and
repositioning schedule, support surfaces, and the role of education in prevention
of HAPUs development in the ICU was limited, which precludes strong conclusions.
LINKING EVIDENCE TO ACTION: The review provides an evidence-based guide to future
priorities for clinical practice. In particular, a silicone foam dressing has
positive impact in reducing sacrum and heel HAPUs incidence in the ICU.
© 2016 Sigma Theta Tau International.
DOI: 10.1111/wvn.12177
PMID: 27712030 [Indexed for MEDLINE]
