Curtis Áine, Derwin Rosemarie, Milne Gráinne, Connor Ann Marie, Nugent Linda, Moore Zena
School of Nursing and Midwifery, RCSI, University of Medicine and Health Sciences, Dublin, Ireland.
Maternity Unit, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland.
Int Wound J. 2025 Jun;22(6):e70693. doi: 10.1111/iwj.70693.
A pressure ulcer is an injury to the skin and underlying tissues caused by pressure, shear or a combination of the two. In Europe, the mean prevalence rate of pressure ulcers is 10.8%, in Ireland, it is less than 12%. Using systematic review methodology, original research studies written in English were included, employing pre- and post-studies, quality improvement initiatives or projects, randomised controlled trials and experimental studies. Data was extracted using a pre-designed data extraction tool and quality appraisal was undertaken using the Evidence-Based Librarianship (EBL) tool. Where appropriate, a meta-analysis was undertaken using RevMan. The study protocol was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42023442711). Following the search, 628 records were returned, of which 25 met the inclusion criteria. The studies were conducted in a variety of acute healthcare settings. Of the included studies, 16 presented data on incidence and 12 presented data on prevalence of pressure ulcers post-implementation of a care bundle. A meta-analysis of 10 studies discussing incidence indicates the RR of PU is 0.40 (95% CI: 0.21-0.78; p = 0.007), supporting the use of a care bundle. A meta-analysis of seven studies discussing prevalence indicates the RR of PU is 0.34 (95% CI: 0.21-0.56; p = 0.0001), demonstrating the reduction in the RR of PU development in favour of the care bundle group. A variety of care bundle elements were found in the studies. Although results indicated the use of a care bundle was advantageous in preventing a pressure ulcer in the acute care setting, it was unclear which of these elements were most effective.
压疮是由压力、剪切力或两者共同作用导致的皮肤及皮下组织损伤。在欧洲，压疮的平均患病率为10.8%，在爱尔兰则低于12%。采用系统评价方法，纳入了用英文撰写的原始研究，包括前后对照研究、质量改进举措或项目、随机对照试验和实验研究。使用预先设计的数据提取工具提取数据，并使用循证图书馆学（EBL）工具进行质量评估。在适当情况下，使用RevMan进行荟萃分析。该研究方案已在国际前瞻性系统评价注册库（PROSPERO CRD42023442711）进行预注册。检索后，返回了628条记录，其中25条符合纳入标准。这些研究在各种急性医疗环境中进行。在纳入的研究中，16项提供了护理包实施后压疮发病率的数据，12项提供了患病率的数据。对10项讨论发病率的研究进行的荟萃分析表明，压疮的相对危险度为0.40（95%置信区间：0.21 - 0.78；p = 0.007），支持使用护理包。对7项讨论患病率的研究进行的荟萃分析表明，压疮的相对危险度为0.34（95%置信区间：0.21 - 0.56；p = 0.0001），表明护理包组压疮发生相对危险度降低。研究中发现了多种护理包要素。尽管结果表明在急性护理环境中使用护理包有利于预防压疮，但尚不清楚这些要素中哪些最有效。
