Preventing pressure ulcer in hospital : a systematic review on pressure relieving devices application in risk patient group

Abstract

Background Pressure ulcer is one of many health problems in the healthcare system. Pressure ulcer prolongs the suffering of patients and the cost of treating them is high. In 2006, in the USA almost US$11 billion was spent on hospitalizations in which the patient was dignosed with pressure ulcer as primary or secondary causes, excluding neonatal and maternal conditions. This reflects an increase of nearly 80% since 1993. Most pressure ulcers are potentially preventable; early and proper intervention to high risk groups can decrease the incidence of newly developed pressure ulcer and its consequence impacts. Moreover, pressure ulcer is a key performance index for assessing the quality of hospital service and patient safety. Maintaining a low incidence and prevalence of the pressure ulcer leads to both reduced health expenditure and patient’s suffering from wound pain.

Aims and objectives The paper aims to study the current literature of pressure relieving devices application and its effectiveness to risk group. There are lots of pressure relieving devices in the market and here to assess its effectiveness to the risk group in hospital.

Methods The electronic search was done through searching of electronic database, PubMed, MEDLINE ProQest; and hand search through Google Scholar and other online resources. Search strategies and criteria for inclusion and exclusion had been applied. The key words were used in retrieving studies through databases: (pressure ulcer OR decubitus ulcer) AND(prevention) AND (pressure relieving OR repositioning OR mattress OR cushion OR overlay OR re-distributing)

Results There were twelve English articles for reviewing finally. Those articles were grouped into three pressure relieving device categories; they are cushion, re-positioning and mattresses for the review. In Defloor 2005, it found an obvious reduction in newly developed pressure ulcer if it combines4-hourly turning with pressure reliefing mattress; only 3% of participants had newly developed pressure ulcer. Furthermore, the frequect turning may not reduce the pressure ulcer development in lower risk group. The proper intervention of pressure relieving and tailor to individuals are essential.

Conclusions It demonstrated the effectiveness of pressure relieving devices to patient at risk, but the present of significant differences is not consistent. It is essential to ensure the utilization of the pressure relieving support surfaces function with right skill to the right person in order to maximize patient’s benefit during hospitalization. Further clinical trial is preferable.