Mäki-Turja-Rostedt S, Stolt M, Leino-Kilpi H, Haavisto E, et al.
Journal of clinical nursing. Date of publication 2018 Dec 27;volume ():.
1. J Clin Nurs. 2018 Dec 27. doi: 10.1111/jocn.14767. [Epub ahead of print]
Preventive interventions for pressure ulcers in long-term older people care
facilities: A systematic review.
Mäki-Turja-Rostedt S(1)(2), Stolt M(1), Leino-Kilpi H(1)(3), Haavisto E(1)(2).
Author information:
(1)Department of Nursing Science, University of Turku, Turku, Finland.
(2)Satakunta Hospital District, Pori, Finland.
(3)Turku University Hospital, Turku, Finland.
AIMS AND OBJECTIVES: To explore the effectiveness of interventions aimed at
pressure ulcer (PU) prevention in long-term older people care facilities (LOPC).
BACKGROUND: Pressure ulcers cause suffering for patients and constitute a major
financial burden. Although most PUs could be prevented, their number has remained
high. To avoid unnecessary suffering and costs, PU prevention must be effective.
DESIGN: A systematic review.
METHODS: A systematic search was conducted in six electronic databases PubMed
(MEDLINE), CINAHL, Web of Science Core Collection, Scopus, Cochrane Wounds Group
Specialized Register and Cochrane Central Register of Controlled Trials. The
inclusion criteria were: (a) study published in 2005-2017, (b) intervention with
pre- and post-tests, focusing on PU prevention, (c) implemented in LOPC
facilities, (d) persons >65 years as study population, and (e) outcomes reported
as PU incidence or prevalence or healing time. The PRISMA guidelines were
followed. The methodological quality of the studies was evaluated using the
Joanna Briggs Institute's MAStARI critical appraisal checklist. The data were
analysed with narrative synthesis.
RESULTS: The review included eighteen studies. The study designs were RCTs
(n = 10), comparable cohort or case-control studies (n = 3), and descriptive or
case series (n = 5). PU incidence in LOPC facilities decreased by using
computerised decision-making support systems, PU prevention programmes,
repositioning or advanced cushions. PU prevalence decreased with PU prevention
programmes, by using advanced mattresses and overlays, or by adding protein and
energy supplements to diet.
CONCLUSIONS: There are many ways to prevent PUs in LOPC facilities; no single
effective way can be identified. One-third of the preventive interventions in
LOPC facilities were effective. However, systematic evidence from randomised
trials on preventive interventions of PUs in LOPC settings is still lacking.
RELEVANCE TO CLINICAL PRACTICE: The findings can be used in practice for
selecting and in research for developing effective preventive interventions of
PUs in LOPC facilities.
© 2018 John Wiley & Sons Ltd.
DOI: 10.1111/jocn.14767
PMID: 30589987
