Bedside Technologies to Enhance the Early Detection of Pressure Injuries: A Systematic Review.

BACKGROUND

Hospital-acquired pressure injuries strain organizational resources and negatively impact the quality of life of affected patients. However, early detection of pressure injuries is limited due to challenges with visual assessment, particularly in individuals with dark skin.

PURPOSE

The purpose of this systematic review was to determine whether sufficient research evidence exists to support the use of bedside technologies for early detection of pressure injures, which is inclusive of pressure-related blanchable erythema (PrBE), pressure-related nonblanchable erythema (PrNBE), and deep tissue pressure injury (DTPI).

SEARCH QUESTION

What available bedside technologies enhance the early detection of pressure injuries?

METHODS

A systematic search of Medline, CINAHL, Web of Science, and Cochrane databases was executed. Quantitative studies were included that examined whether accessible technologies could indicate the presence of PrBE, PrNBE, and DTPI. The quality of the research was evaluated using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale.

FINDINGS

We identified 18 eligible studies that represented a variety of technologies, including ultrasound (n = 5), thermography (n = 7), subepidermal moisture (SEM) measurement (n = 5), reflectance spectrometry (n = 2), and laser Doppler (n = 1). The methodological rigor in study quality was variable. Subepidermal moisture measurement provided the most consistent findings in the early detection of pressure injury.

CONCLUSIONS

Objective methods that provide accurate and timely assessment of DTPIs augment early implementation of optimal prevention and treatment measures. Evidence identified in this systematic review supports the use of SEM measurement devices as effective tools for early pressure injury detection. However, more research in the field of technology-enhanced, pressure injury detection is needed to support the use of existing and emerging devices.