Pressure Injury Prevention: A Survey

ESTIMA, Brazilian Journal of Enterostomal Therapy

The present study aimed to analyze in the literature the technologies implemented to prevent pressure injuries in the context of hospital care. This is an integrative literature review carried out from October to December 2021, in the databases: Virtual Health Library; MEDLINE via PubMed; Scopus; Web of Science; Embase and Cochrane Library, and 192 articles were included and 179 excluded. The final sample consisted of 13 articles, that met the eligibility criteria and answered the objective and research question. The main technologies used were air mattresses, permanent education mediated by e-learning, a computer system that facilitates the identification of risk factors, a light signal system for activating the team, a computer system for monitoring tissue pressure, a software for implementing computerized guidelines, an informative catalog, clinical guidelines, and a virtual learning environment. These technologies have shown positive results, however, as identified in the analys...

BMJ Open Quality, 2019

Hospital-acquired pressure injury is a common preventable condition. Our hospital is a 144-bed governmental hospital in the Kingdom of Saudi Arabia that was found to have a 7.5% prevalence of hospital-acquired pressure injury in 2016. The aim of the improvement project was to reduce the prevalence of pressure injuries in our hospital from 7.5% to below 4% by the end of 2017. Our strategy for improvement was based on the Institute for Healthcare Improvement Model for Improvement. The change strategy was based on implementing an evidence-based risk assessment tool and a bundled evidence-based pressure injury prevention (PIP) intervention termed PIP bundle. After implementing the change package, we observed a reduction in the prevalence of pressure injuries by 84% (RR 0.16;95% CI 0.07 to 0.3; p value <0.0001) over a period of 12 weeks, in addition to an improvement in the compliance of pressure injury risk assessment and PIP interventions. The use of an evidenced-based bundled approach to prevent hospital-acquired pressure injuries has resulted in a significant reduction in the rate of pressure injuries. Improvement results were sustainable. In addition, our outcome measure exhibited minimal variability.

The paper aims at designing equipment for the prevention of pressure injuries in bedridden people. Pressure ulcers, also known as decubitus ulcers, pressure lesions, or bedsores, are lesions that occur on the skin of patients by the pressure caused by the contact of a bone surface with, in the case of bedridden, a hospital bed. Some factors aggravate the risk of developing these lesions and require special care, such as nutrition, hydration, mobility, moisture, and the use of certain medications. For decubitus ulcer prevention, the most suitable method is to change the person's position every two hours, as this procedure will relieve the pressure in the places of most significant contact, thus reducing the chances of developing ulcers. However, in hospitals, nurses are responsible for checking the patient's skin and changing the position of the patient, an activity that requires strength, making the process stressful, and increasing the time a bedridden stays in the same location. Pressure injuries can be aggravated by increasingly weakening the health of the patient suffering from the injury. Thus, the search for a means to prevent such lesions is undoubtedly possible. Investigation on the injuries and motors that used to solve the problem occurs. The movement of the equipment happens since the machine would change the points of highest pressure in the patient's body through the change of height in parts of the hospital bed. After research, the device was scaled and designed virtually in Autodesk Inventor 2018 software. The theoretical results possibility equipment construction. It is not possible to affirm the efficiency of the equipment in the prevention of pressure injuries, since the project did not leave the literature, not being built prototype and not being performed tests to prove its effectiveness.

JBI Evidence Synthesis, 2020

This document was downloaded from https://openair.rgu.ac.uk JBI Evidence Synthesis Barriers and enablers to implementation of pressure injury prevention in hospitalized adults: a mixed methods systematic review protocol

International Journal of Health Economics and Management, 2021

More than 2.5 million people in the United States develop pressure injuries annually, which are one of the most common complications occurring in hospitals. Despite being common, hospital-acquired pressure injuries (HAPIs) are largely considered preventable by regular patient turning. Although current methodologies to prompt on-time repositioning have limited efficacy, a wearable patient sensor has been shown to optimize turning practices and improve clinical outcomes. The purpose of this study was to assess the cost-effectiveness of patient-wearable sensor in the prevention of HAPIs in acutely ill patients when compared to standard practice alone. A decision analytic model was developed to simulate the expected costs and outcomes from the payer’s perspective using data from published literature, including a recently published randomized controlled trial. Both univariate and probabilistic sensitivity analysis were conducted. The patient-wearable sensor was found to be cost saving (d...

Revista Da Escola De Enfermagem Da Usp, 2022

Objective: Summarizing the evidence from systematic reviews regarding the comparison the effectiveness of interventions to prevent pressure injuries. Method: Overview of systematic reviews conducted in accordance with Cochrane guidelines. A search was performed in databases, repositories and systematic review registration sites. Results: 15 reviews were included in this overview. The sensitivity analysis showed a reduction in the incidence of pressure injuries with nutritional supplementation compared to the standard hospital diet (Relative Risk (RR) = 0.83; 95% Confidence Interval (CI): 0.72-0.95). There was evidence of the superiority of constant low-pressure surfaces (RR = 0.38; 95% CI;0.24-0.61), alternating pressure devices (RR = 0.31; 95% CI:0.17-0.58) and alternative foams (RR = 0.40; 95% CI:0.21-0.74) when compared to the standard hospital mattress or standard foam. The use of a silicone cover reduced the incidence of pressure injuries by 75% (RR = 0.25; 95%CI:0.16-0.41) when compared to no cover. Conclusion: Although some interventions have been shown to be effective in reducing the incidence of pressure injury, the evidence is limited or very limited and subject to change. Registration CRD42017064586.

Advances in Skin &amp; Wound Care, 2018

OBJECTIVE: The goal of this quality improvement project was to reduce the number of hospital-acquired pressure injuries (HAPIs) by flagging extremely high-risk patients with a pink paper reminder system and implementing a pressure injury prevention order set. METHODS: The pink paper reminder system is an innovative, cost-neutral, simple approach to identify patients at highest risk of pressure injury development who meet specific criteria. There are 2 steps to this intervention. First, study authors developed a new risk assessment tool, the pink paper criteria. When a patient met the specified criteria, a pink piece of paper titled “SKIN AT RISK” in a large font was hung at the head of his/her bed to reinforce preventive strategies. Next, a set of pressure injury preventive measures was ordered. PATIENTS: This quality improvement project included all adult hospitalized patients of all specialties based in 2 Kaiser Permanente hospitals. RESULTS: There was a 67% reduction in HAPI inci...

Nursing Clinics of North America, 2019

Nationally, 2.5 million patients are affected by pressure injuries every year and it is estimated nearly 60,000 patients die each year from hospital-acquired pressure injury complications. 1 Research demonstrates most pressure injuries are preventable, therefore lives are saved by implementing and adhering to evidence-based pressure injury prevention strategies. 2 A pressure injury is defined as "localized tissue damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device." 3(px) Research has found patients with pressure injuries are at an increased risk of infection, experience pain from the pressure injuries, and stay in the hospital longer than patients without pressure injuries. 4,5 With the recent focus on decreasing patient harm in hospital settings following the Institute of Medicine's landmark report To Err is Human, 6 The Joint Commission and the Institute for Healthcare Improvement have called attention to the importance of pressure injury prevention in health care facilities. 7,8 Disclosure Statement: No disclosures.

2016

Pressure injuries are acknowledged worldwide as a quality care indicator and a patient safety issue. Pressure injuries have negative impacts for patients, nurses and healthcare organisations in terms of physical and emotional distress, increased workloads and economic burden. Additionally, pressure injuries result in reduced community confidence in the healthcare system. Internationally and in Australia, pressure injury prevalence rates are concerning, with sustained reductions difficult to achieve despite the availability of prevention resources. International clinical practice guidelines recommend pressure injury prevention strategies that are widely adopted by clinicians. There is agreement these strategies may help prevent the development of pressure injuries, however, nurses’ planning and implementation of these strategies often does not reflect best practice standards, possibly placing patients at risk. This mixed methods, multicentre study had two aims: first, to describe the...

SOAR@USA: Scholarship and Open Access Repository, 2020

Practice Problem: Hospital-Acquired Pressure Injury (HAPI) is a serious problem in patient care and has deleterious implications for the patient and the healthcare system. A 530-bed acute care hospital in the Rio Grande Valley identified a similar challenge and implemented a HAPI preventive program. PICOT: This evidence-based practice (EBP) project was guided by the following PICOT question: In the Intensive Care Unit/Medical Intensive Care Unit (ICU/MICU) patients aged 18 and older, does a pressure preventive bundle, compared to routine pressure injury care, reduce the incidence of pressure injury, within 21 days? Evidence: The reviewed literature supported evidence of effective use of a pressure injury preventive bundle in reducing the incidence of pressure injuries in an acute care setting. Seven articles met the inclusion criteria and were used for this literature review. Intervention: The evidence-based pressure injury preventive bundle are interventions that included consisten...