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Risk factors for pressure injury development in critically ill patients in the intensive care unit: a systematic
Fiona Coyer1,2,3, Nahla Tayyib4,5
1School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia. f.coyer@qut.edu.au.
Insights
Pressure injuries (PIs) significantly impact critically ill patients. This review identifies patient-centered risk factors for PIs in intensive care units to improve prevention strategies and patient outcomes.
Area of Science:
- Critical Care Medicine
- Nursing Research
- Patient Safety
Background:
- Pressure injuries (PIs) affect up to 49% of critically ill patients.
- Identifying patient-centered risk factors is crucial for effective PI prevention.
- Understanding these factors is essential for mitigating risk in intensive care settings.
Purpose of the Study:
- To identify patient-centered clinical factors associated with PI development in adult intensive care.
- To determine the effect size of the relationship between identified factors and PI development.
Main Methods:
- Systematic review following PRISMA guidelines.
- Comprehensive search of multiple electronic databases and grey literature.
- Quality appraisal of prognostic and observational studies by independent reviewers.
Main Results:
- Evidence synthesis will identify person-centered risk factors for PIs in critically ill patients.
- Findings will highlight potential patient risk factors influencing clinical practice.
- The review aims to inform research priorities for PI prevention.
Conclusions:
- The review will provide a comprehensive understanding of patient-centered risk factors for PIs in intensive care.
- Results will guide the development of targeted prevention strategies.
- Improved identification of risk factors can enhance the quality of care for critically ill patients.
Background:
Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population.
Method/Design:
The review will follow the PRISMA reporting guidelines for systematic reviews. Electronic databases (Cochrane; PubMed/MEDLINE; CINAHL (EBSCOhost); Embase; Scopus; PsycINFO; Proquest; Networked Digital Library of Theses and Dissertations; Australian Digital Theses Program, Grey literature, Google scholar, and Clinical Trial Registries) will be systematically searched. A suite of search terms will identify articles that have examined the patient-centred risk factors for PI development in adult intensive care units. The search strategy will be designed to retrieve studies published since inception to 2016 in English language. Quality of the studies will be assessed by using an assessment framework designed to appraise quality in prognostic studies and methodological considerations in the analysis and publication of observational studies. Screening, study selection process, and data extraction will be undertaken by two independent reviewers. Disagreement will be resolved by discussion and, if required, a third independent reviewer. Clinical and methodological heterogeneity across studies will be assessed and, if possible, meta-analyses will be performed.
Discussion:
The evidence synthesis arising from this review will identify person-centred risk factors that are associated with PI development among critically ill patients in intensive care. Findings from this review will demonstrate potential patient risk factors that may influence practice and research priorities to prevent PI development and improve the quality of care provided.
Systematic Review Registration:
PROSPERO CRD42016037690.
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