Preventive interventions for pressure ulcers in long‐term older people care facilities: A systematic review

Abstract

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.

Consistent practice for pressure ulcer prevention in long‐term older people care: A quasi‐experimental intervention study

“…In LOPC facilities, the incidence and prevalence of PUs have been reduced with PU prevention bundles or programmes (15,37‐38). A review (39) concluded that one third of the PU prevention interventions used in LOPC facilities were reported as effective. However, recent studies have stated that not only PU rates should be reported as an outcome of the intervention, but also compliance of the PU prevention bundle.…”

Canonical Correlation between Knowledge-Barriers/Facilitators for Pressure Ulcer Prevention Nursing Variables and Attitude-Performance Variables

“…정 등의 간호행위나 의사결정지원 시스템과 같은 다양한 욕창예방간 호수행 프로그램 적용이 효과적인 것으로 보고되었다 [5,6] [16]. 욕창예방간호는 개인의 간호행위뿐만 아 니라 조직역할 수행의 체계적 측면에 영향을 받는다 [3,6].…”

Two-years of home based functional electrical stimulation recovers epidermis from atrophy and flattening after years of complete Conus-Cauda Syndrome

“…Dermatological complications may, indeed, be present in SCI, and some of them are life-threatening and need prevention and long-term care. [2,12,15,[23][24][25] The harvested skin biopsies were not exposed to compression ischemia/hypoxia, but only to the general neurovegetative dysfunction of the leg circulation related to SCI and to a wheel-chair life style. Although a group of control normal adult skin biopsies were not available, our humble opinion is that the skin of SCI persons enrolled during the first year after trauma, may be taken as almost normal skin samples (or certainly the less exposed to atrophic changes).…”