Nursing interventions to prevent pressure ulcers in intensive care units : systematic review

Abstract

Introduction: It is estimated that Pressure Ulcer (PU) ranges from 0.4% to 38% in acute care worldwide, causing high costs in treatments, delaying functional recovery and deferring discharge hospital. Objective: To identify and synthesize primary studies which comprehend interventions focused on prevention of PU in critical care units. Methods: A systematic review followed PICOS method in PUBMED database and in gray literature. 922 articles were identified, 26 retrieved, 5 of which were included based on the inclusion criteria established by the authors, i.e., adults (+18) in critical care units, high risk of development of PU and clinical trials designs. Studies were assessed for risk of bias in seven domains. Results: Five papers met the inclusion criteria. The interventions used were heterogeneous and multi-faceted. Most delivered solely by nurses and were based on the use of devices (mattress) or on the impact of a nutritional formula enriched with several components. The number of irreversible heel pressure ulcers was lower with devices. A diet enriched with some components was also associated with a significantly lower occurrence of new pressure ulcer in critically ill patients. Conclusions: The non-pharmacological interventions at critical care units are a key area considering its potential in PU prevention. Further research should be developed in this field to keep gold standards of quality in critical care units.