Identification of Nursing-Sensitive Indicators on Pressure Injuries/Ulcers: A Systematic Review

Area of Science:

• Nursing Science
• Clinical Practice
• Healthcare Management

Background:

• Pressure ulcers represent a significant challenge in healthcare, impacting patient well-being and healthcare costs.
• Effective prevention and management strategies are essential but require a clear understanding of contributing factors.
• Nursing-sensitive indicators are vital for monitoring and improving care quality in pressure ulcer management.

Purpose of the Study:

• To develop a conceptual framework for identifying nursing-sensitive indicators in pressure ulcer prevention and management.
• To examine the relationships between these indicators and pressure ulcer outcomes.
• To synthesize evidence on factors influencing the management of pressure ulcers.

Main Methods:

• Systematic review of 956 articles published between 2012 and 2023 from major databases (Medline/PubMed, Scopus, Cochrane Library, CINAHL).
• Application of Structural State Theory to guide the conceptual framework development.
• Analysis of 29 selected studies to identify 241 relationships between variables.

Main Results:

• A conceptual framework was established, highlighting nursing-sensitive indicators (independent variables) across patient, nurse, management, and organizational domains.
• Patient-focused factors demonstrated the highest frequency of relationships with pressure ulcer outcomes (dependent variables).
• Complex interrelationships were identified, underscoring the multifaceted nature of pressure ulcer management.

Conclusions:

• Nursing care practices and interventions play a pivotal role in influencing pressure ulcer outcomes.
• There is a critical need for specialized wound care nurses and further research into nursing interventions.
• Healthcare organizations should invest in structural changes and continuous nurse education to enhance pressure ulcer prevention and management.