Pressure injury prevention measures: overview of systematic reviews.
Franciele Soares Pott, Marineli Joaquim Meier, Janislei Giseli Dorociaki Stocco and 3 others
PMID 38133528WHAT IT FOUND
Most pressure injury prevention comparisons did not clearly reduce injuries.
Some support surfaces and nutrition after excluding high-risk studies showed lower incidence, but evidence was low or very low certainty.
Key findings
01Most comparisons did not show a statistically significant difference in pressure injury incidence.
02A sensitivity analysis of nutritional support found lower pressure injury incidence in the intervention group (RR = 0.83, 95%CI: 0.72–0.95).
03Constant low-pressure support surfaces showed lower pressure injury incidence than standard hospital mattresses (RR 0.38, 0.24–0.61).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence was mostly low or very low certainty. Future studies could change the estimates. Primary studies had risk of bias from allocation, blinding, attrition and analysis. This weakens the findings. Several included reviews were empty or had overlapping primary studies. This limits what can be concluded. The included reviews used different definitions, populations, interventions and follow-up times. This made comparisons difficult. Some reviews did not report GRADE certainty. The quality of their evidence cannot be fully judged. The overview searched five databases and included only systematic reviews of randomized, quasi-randomized or cluster-randomized trials. Non-randomized evidence was not included.
The easy way to misread this
Do not conclude that pressure injury prevention measures are proven effective. Most comparisons did not show a significant difference, and the positive findings were based on low or very low certainty evidence or sensitivity analyses.