The Effectiveness of Pressure Injury Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review

Abstract

Background: Pressure injuries are a common and serious complication in critically ill patients, with a significance impact on patient outcomes and resources. Effective prevention strategies are crucial to minimise their occurrence in intensive care units (ICUs). This systematic review aimed to identify and evaluate the effectiveness of pressure injury prevention strategies in critically ill patients, compare outcomes with standard care, and highlight gaps in the current literature. Methods: A systematic review included studies published between 2000 to 2024. The search strategy included all the major databases such as: PubMed, CINAHL, LILACS, Web of Science, Scopus, JBI and Cochrane Database of Systematic Reviews. Thirty-three (n=33) quantitative studies were included, covering various interventions such as silicone foam dressings, repositioning protocols, pressure redistribution mattresses, and multi-component prevention programmes. The primary outcome was the incidence of pressure injuries and secondary outcomes included the severity of injuries, patient comfort, and cost-effectiveness. Results: The review found that silicone foam dressings, regular repositioning, and pressure redistribution devices were the most effective interventions in preventing pressure injuries. Multi- component prevention programs combined several interventions and demonstrated superior effectiveness compared to single interventions. However, there was considerable variability in the outcomes across studies, and many studies lacked long-term follow-up or cost-effectiveness analysis. Few studies incorporated patient-centred outcomes, such as comfort and quality of life. Conclusions: The study confirmed the effectiveness of several pressure injury prevention strategies, particularly in the ICU setting, but highlighted the need for standardised protocols, consistent implementation, and further research into long-term outcomes and cost-effectiveness. Future research should focus on multi-center, longitudinal studies with standardised outcome measures and the inclusion of patient-centered outcomes.