The incidence, prevalence, and risk factors of medical device-related pressure injuries in paediatric inpatients: A systematic review and meta-analysis

BACKGROUND: Medical device-related pressure injuries (MDRPIs) represent an increasing safety concern for paediatric inpatients, yet evidence regarding their epidemiology remains inconsistent. This study aimed to systematically review and meta-analyse the incidence, prevalence, and risk factors for MDRPIs in hospitalised children, and to identify the most common medical devices implicated. METHODS: Databases including PubMed, Medline, Embase, Web of Science, Scopus, and CINAHL were searched from inception to December 18, 2024, with an update on April 1, 2025. Two reviewers independently screened studies, extracted data, and assessed bias using Joanna Briggs Institute (JBI) tools. Pooled incidence and prevalence were estimated using random-effects meta-analysis. Heterogeneity was assessed; and for outcomes with ≥10 studies, subgroup, publication bias, and sensitivity analyses (including Bayesian meta-analysis) were performed. Commonly implicated medical devices were categorized and their reporting frequencies summarized. RESULTS: Eighteen studies, involving 15,991 paediatric patients across nine countries, were included. The pooled MDRPI incidence was 11.0 % (95 % CI: 5.2 %-22.0 %), and prevalence was 12.6 % (95 % CI: 1.1 %-65.8 %), both with substantial heterogeneity. Neonatal and Paediatric Intensive Care Units (NICUs/PICUs) exhibited the highest incidence (15.3 %/12.9 %). Key risk factors included younger age, low birth weight, immobility, multiple devices, and prolonged hospitalization. Respiratory support devices, monitoring equipment, and vascular access lines were frequently implicated. CONCLUSIONS: MDRPIs pose a considerable burden on paediatric inpatients, especially in intensive care. This review provides updated epidemiological estimates, delineates key risk factors, and identifies common causative devices, highlighting the need for targeted preventive nursing strategies to improve patient safety.