Skin damage prevention in the prone ventilated critically ill patient: A comprehensive review and gap analysis (PRONEtect study).
Anika Fourie, Maarit Ahtiala, Joyce Black and 8 others
PMID 34583874WHAT IT FOUND
Few open-access, simple guidelines exist to prevent skin damage in patients lying face down on a ventilator.
Devices and education vary with little evidence of benefit. Nurses should verify whether their unit has skin-care guidance for prone patients.
Key findings
01The review identified 24 guidance documents, but found no open-access, holistic, simple evidence-based guidance for preventing skin damage in prone ventilated patients.
02Few listed devices were designed specifically for prone positioning to prevent skin damage, and prophylactic dressings have not been extensively studied in this setting.
03Sixteen digital educational resources were identified; five showed practical hands-on training, and 31.3% were shorter than 10 minutes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a review of guidance documents and resources, not a trial of any treatment, so it does not show that any device, dressing or education package prevents skin damage. The internet search was limited to a set period, and hospital protocols are often on private intranets, so some guidance was missed. Only English-language, full-text records were searched, and some listed resources were not publicly accessible. Expert panel views were used to identify gaps because many documents could not be appraised with a validated tool. Products and educational resources were inventoried, but their effectiveness was not evaluated.
Declared interests
Authors AF, DB, AG, SS, YW, HHC, FC and KL declared no competing interests. JB declared being a consultant and speaker for Mölnlycke, Sage: A Division of Stryker, and Mobility is Medicine. KV declared being a consultant and speaker for Sage: A Division of Stryker and Mobility is Medicine. MA declared being a speaker for Mölnlycke. The tables also list sponsored product training videos and industry websites.
The easy way to misread this
Do not read the listed devices or dressings as proven to prevent pressure injury in prone patients. This paper did not test them, and evidence for their efficacy was not evaluated.