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Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review
- Source :
- Worldviews on Evidence-Based Nursing. 13:432-444
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Free to read 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.
- Subjects :
- medicine.medical_specialty
Evidence-based practice
030504 nursing
business.industry
Incidence (epidemiology)
MEDLINE
General Medicine
CINAHL
Intensive care unit
law.invention
03 medical and health sciences
Regimen
0302 clinical medicine
Randomized controlled trial
law
Intensive care
medicine
030212 general & internal medicine
0305 other medical science
Intensive care medicine
business
General Nursing
Subjects
Details
- ISSN :
- 1545102X
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Worldviews on Evidence-Based Nursing
- Accession number :
- edsair.doi...........ef3c57fa6ff9bf190d67c0fc7fc742f5