重症监护病房危重症患者发生压力性损伤的危险因素：一项系统评价方案
Risk factors for pressure injury development in critically ill patients in the intensive care unit: a systematic review protocol.
作者信息
Coyer Fiona, Tayyib Nahla
机构信息
School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
Intensive Care Services, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland, 4006, Australia.
出版信息
Syst Rev. 2017 Mar 20;6(1):58. doi: 10.1186/s13643-017-0451-5.
BACKGROUND
Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population.
METHOD/DESIGN: The review will follow the PRISMA reporting guidelines for systematic reviews. Electronic databases (Cochrane; PubMed/MEDLINE; CINAHL (EBSCOhost); Embase; Scopus; PsycINFO; Proquest; Networked Digital Library of Theses and Dissertations; Australian Digital Theses Program, Grey literature, Google scholar, and Clinical Trial Registries) will be systematically searched. A suite of search terms will identify articles that have examined the patient-centred risk factors for PI development in adult intensive care units. The search strategy will be designed to retrieve studies published since inception to 2016 in English language. Quality of the studies will be assessed by using an assessment framework designed to appraise quality in prognostic studies and methodological considerations in the analysis and publication of observational studies. Screening, study selection process, and data extraction will be undertaken by two independent reviewers. Disagreement will be resolved by discussion and, if required, a third independent reviewer. Clinical and methodological heterogeneity across studies will be assessed and, if possible, meta-analyses will be performed.
DISCUSSION
The evidence synthesis arising from this review will identify person-centred risk factors that are associated with PI development among critically ill patients in intensive care. Findings from this review will demonstrate potential patient risk factors that may influence practice and research priorities to prevent PI development and improve the quality of care provided.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016037690.
背景
压疮给医疗保健系统带来了沉重负担。高达49%的重症患者会发生压疮。识别和了解潜在风险因素对于提供有效的针对性预防策略以降低风险至关重要。本综述的目的是确定在成人重症监护环境中可能与压疮发生相关的以患者为中心的临床因素，并确定所识别因素与这一特殊人群压疮发生之间关系的效应大小。
方法/设计：本综述将遵循系统评价的PRISMA报告指南。将系统检索电子数据库（Cochrane；PubMed/MEDLINE；CINAHL（EBSCOhost）；Embase；Scopus；PsycINFO；Proquest；学位论文网络数字图书馆；澳大利亚数字学位计划、灰色文献、谷歌学术和临床试验注册库）。一组检索词将用于识别研究成人重症监护病房中压疮发生的以患者为中心的风险因素的文章。检索策略旨在检索自数据库建立至2016年发表的英文研究。将使用一个评估框架评估研究质量，该框架旨在评估预后研究的质量以及观察性研究分析和发表中的方法学考量。筛选、研究选择过程和数据提取将由两名独立评审员进行。如有分歧将通过讨论解决，如有必要，将由第三位独立评审员解决。将评估各研究之间的临床和方法学异质性，如有可能，将进行荟萃分析。
讨论
本综述产生的证据综合将识别重症监护病房中重症患者压疮发生相关的以人为本的风险因素。本综述的结果将展示可能影响预防压疮发生的实践和研究重点并改善所提供护理质量的潜在患者风险因素。
系统评价注册
PROSPERO CRD42016037690
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