Effectiveness of Organisational Strategies for Pressure Injury Prevention and Treatment in Acute Hospital Settings: A Systematic Review.

The overall certainty of evidence is low due to serious methodological limitations, imprecision, and inconsistency across studies. Heterogeneity in study designs and intervention components prevented meta-analysis and made it difficult to identify the most effective combination of strategies. Non-randomised studies had serious or critical risk of bias, which may overestimate the true effect of the interventions. The review only included studies in acute hospital settings, limiting generalisability to other care environments. No studies reported on treatment or healing of existing pressure injuries, nor on patient satisfaction or adverse events.

Elizabeth McInnes, an author of the review, was also an author of one of the included studies but was not involved in its data extraction or bias assessment. The review was funded by an NHMRC Centre of Research Excellence PhD Scholarship.

Do not assume that any specific organisational strategy will definitely reduce pressure injuries in your unit. The evidence is inconclusive and heterogeneous, with only three of seven studies showing significant effects, and the overall certainty is low. The review did not identify an optimal combination of strategies, so local context and resources must guide implementation.