Prevention of Pressure Injuries and Nursing Interventions in Critical Care Settings: a Synthesis Without Meta-Analysis (SWiM)

Purpose: This review aims to update the evidence regarding optimal nursing interventions for mitigating pressure injuries in critical care patients. Method: A synthesis without a meta-analysis design was used. A systematic review was performed on several databases such as PubMed, SCOPUS, CINAHL, MEDLINE, and Web of Science to find nursing research publications related to pressure injury prevention interventions between January 2007 and May 2023. Data were extracted for each study regarding study aim, study characteristics, intervention details, and finding. Result: In our comprehensive review, we examined twenty studies encompassing 305,149 patients that investigated nursing interventions for pressure injuries. These studies were categorized into four main groups: (a) the implementation of pressure injury prevention bundles, (b) regular repositioning with supportive surfaces, (c) strategies targeting the prevention of pressure injuries associated with medical devices, and (d) facilitating access to specialized expertise. All the studies demonstrated a reduction in pressure injuries attributed to the implemented interventions. It is crucial to acknowledge, however, that the strength of the evidence varied across the studies, with ratings ranging from moderate to very low. Despite the potential challenges in translating these findings into practice, the consistent trend observed from 2007 to 2023 suggests that adherence to evidence-based nursing care is pivotal. Efforts must be directed towards ensuring the integration of these recommendations into practical healthcare settings. Conclusion: Nurses have the necessary expertise to prevent pressure injuries in critical care units. Every critically ill patient requires interventions to prevent pressure injuries, which makes prevention a complex process. Nurses are responsible for developing and implementing care plans based on evidence to prevent all types of pressure injuries, including those caused by medical devices. The importance of education and training programs for nurses in pressure injury prevention cannot be overstated. Keywords: nurses, nursing interventions, pressure ulcer, pressure injury, critical care, ICU