Exploring Effective Pressure Injury Prevention Practices in the Paediatric Intensive Care Setting: An Integrative Review
Pressure injuries are a common health issue affecting patients of all ages across different healthcare settings. Hospital-acquired pressure injuries are an indicator of the quality of healthcare in hospitals and can have physiological and psychological impacts for the individuals affected. Hospitalised children, especially those who are critically unwell, are of particular risk of developing pressure injuries. Pressure injuries have been associated with increased morbidity, mortality, length of stay, risk of infection and costs of treatment. This creates strain on the healthcare system, but more importantly for patients, this impacts their quality of life and delays their recovery journey. Consequently, this can have a significant negative impact psychologically on patients and their families/whānau. Prevention of pressure injuries has been a priority across healthcare settings to tackle the issues associated with pressure injuries. However, pressure injuries still remain a longstanding patient safety issue today and are costly to the healthcare system. Nurses play a vital role in the assessment, prevention and management of pressure injuries. This practice project aimed to explore effective pressure injury prevention practices in paediatric intensive care units (PICU). The integrative review method guided by Whittemore and Knafl’s five-stage framework, was used in this project. A total of fourteen studies (all quantitative) were included in this review. Each study was independently and critically appraised using the Mixed Methods Appraisal Tool. The findings of this integrative review highlighted that understanding the risk factors in a PICU patient and up-to-date knowledge about pressure injuries are foundational to prevention. Furthermore, risk assessment tools, education, care bundles and skin champions aid in the implementation of the current recommended prevention strategies. This integrative review provides an overview of the existing literature on the topic and paves the way to understanding what requires further attention and research in the future.