Effectiveness of specialised support surface modes in preventing pressure injuries in intensive care: A systematic review and meta-analysis.
Intensive Crit Care Nurs
; 83: 103713, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38749261
ABSTRACT
BACKGROUND:
Patients in intensive care units (ICU) are at an increased risk of pressure injuries. In ICUs, specialised support surfaces are an intervention often used to prevent pressure injuries. This systematic review and meta-analysis aimed to ascertain the effectiveness of different specialised support surface modes for preventing pressure injuries to adult ICU patients.METHODS:
Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, PEDro, Cochrane Library, Clinicaltrials.gov and eligible paper references were searched for appropriate studies. Studies were included if they investigated both dynamic support surface modes low-air-loss (LAL) and alternating pressure (AP), involved adult ICU patients (≥18 years old), and investigated pressure injury incidence. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Mixed Methods Appraisal Tool (MMAT) checklists were used for reporting and quality assessment. Risk ratios (RRs) with 95 % Confidence Intervals (CIs) were used to summarise pressure injury incidence. The pooled RR was calculated with the random-effects model using the Mantel-Haenszel method. Further secondary analysis examined length of stay (LoS) and severity of illness.RESULTS:
The four included studies involved 3,308 patients. These studies were heterogeneous in design. When AP surface mode was compared with LAL surface mode, there was no significant difference in the occurrence of pressure injury (8.9 % versus 10.9 %, RR 0.64). Mattress mode also had no direct association with length of stay and severity of illness.CONCLUSION:
This systematic review and meta-analysis found no significant difference in the effectiveness of LAL and AP support surface modes in preventing pressure injuries in adult ICU patients. IMPLICATIONS FOR CLINICAL PRACTICE Clinicians should remember that mattresses are just one element within strategies to prevent pressure injuries in ICUs. The equivocal findings of this systematic review highlight the complexity of preventing pressure injuries and underscore the importance of holistic nursing care.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Úlcera por Presión
/
Unidades de Cuidados Intensivos
Límite:
Humans
Idioma:
En
Revista:
Intensive Crit Care Nurs
/
Intensive and critical care nursing
/
Intensive crit. care nurs
Asunto de la revista:
ENFERMAGEM
/
TERAPIA INTENSIVA
Año:
2024
Tipo del documento:
Article