Journal of muscle and joint health (근관절건강학회지)

Korean Society of Muscle and Joint Health (대한근관절건강학회)
권호 표지
DOI QR코드

DOI QR Code

Comparative Effects and Ranks of Repositioning for Pressure Ulcer Prevention in Adults: A Network Meta-analysis

욕창예방을 위한 체위변경 중재 효과의 비교순위: 네트워크 메타분석

  • Ko, Ji Woon (Department of Nursing Science, Sunmoon University)
  • Received : 2022.03.13
  • Accepted : 2022.04.15
  • Published : 2022.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: A network meta-analysis was conducted to assess the comparative effects and ranks of repositioning for pressure ulcer prevention in adults. Methods: A network meta-analysis was performed in a frequency method, using the "netmeta" package of R software version 4.1. The effects of repositioning intervention were confirmed by the odds ratio. The comparative ranking of the repositioning effects was confirmed using the cumulative probability (P-score). Results: Seven intervention studies were included in this study. Based on the P-score, the use of the repositioning system was ranked as the most effective among all interventions (P-score 78.7%). Next was 3~4-hour repositioning combined with memory foam mattress use (P-score 77.2%), use of wearable sensor (P-Score 61.4%), 2-hour repositioning combined with memory foam mattress use (P-score 59.1%), 2-hour repositioning combined with powered air pressure redistribution mattress use (P-score 18.0%), and 4-hour repositioning combined with powered air pressure redistribution mattress use (P-score 18.0%). Conclusion: This study provides information on the relative comparative value of various repositioning interventions to prevent pressure ulcers using network meta-analysis. This is expected to be useful for nurses' decision-making when applying repositioning interventions in clinical practice

Keywords

Acknowledgement

이 연구는 2020년도 선문대학교 교내학술연구비 지원에 의하여 이루어졌음.

References

  1. Avsar, P., Moore, Z., Patton, D., O'Connor, T., Budri, A. M., & Nugent, L. (2020). Repositioning for preventing pressure ulcers: A systematic review and meta-analysis. Journal of Wound Care, 29(9), 496-508. https://doi.org/10.12968/jowc.2020.29.9.496
  2. Bergstrom, N., Horn, S. D., Rapp, M. P., Stern, A., Barrett, R., & Watkiss, M. (2013). Turning for ulcer Reduction: A multisite randomized clinical trial in nursing homes. Journal of the American Geriatrics Society, 61(10), 1705-1713. https://doi.org/10.1111/jgs.12440
  3. Bergstrom, N., Horn, S. D., Rapp, M., Stern, A., Barrett, R., Watkiss, M., et al. (2014). Preventing pressure ulcers: A multisite randomized controlled trial in nursing homes. Ontario Health Technology Assessment Series, 14(11), 1-32.
  4. De Meyer, D., Van Hecke, A., Verhaeghe, S., & Beeckman, D. (2019). PROTECT - trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning to increase repositioning compliance. Journal of Advanced Nursing, 75(5), 1085-1098. https://doi.org/10.1111/jan.13932
  5. Edger, M. (2017). Effect of a patient-repositioning device in an intensive care unit on hospital-acquired pressure injury occurrences and cost: A before-after study. Journal of Wound, Ostomy, and Continence Nursing, 44(3), 236-240. https://doi.org/10.1097/WON.0000000000000328
  6. Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., et al. (2021). Repositioning for pressure injury prevention in adults: An abridged Cochrane systematic review and meta-analysis. International Journal of Nursing Studies, 120, 103976. https://doi.org/10.1016/j.ijnurstu.2021.103976
  7. Healthcare Improvement Scotland. (2014). Scottish Government Clinical Advise: Methodology checklist: Randomised controlled trials. https://www.sign.ac.uk/what-we-do/methodology/checklists/
  8. Jiang, Q., Liu, Y., Yu, H., Song, S., Li, G., Liu, H., et al. (2020). A multicenter, comparative study of two pressure-redistribution mattresses with repositioning intervals for critical care patients. Advances in Skin & Wound Care, 33(3), 1-9.
  9. Kang, D. W., Lee, E. K, & Park, S. K. (2021). Comparative effectiveness of smoking cessation intervention with pharmacist-delivered service: Systematic review and bayesian network meta-analysis. Journal of Korean Academy of Social and Managed Care Pharmacy, 9(1), 37-47.
  10. Kim, H. J., & Jeong, I. S. (2012). Optimal time interval for position change for ICU patients using foam mattress against pressure ulcer Risk. Journal of Korean Academy of Nursing, 42(5), 730-737. https://doi.org/10.4040/jkan.2012.42.5.730
  11. Maeng, E. Y. (2012). The effect of 30-degree tilt repositioning on pressure ulcer prevention for patients in intensive care unit. Unpublished master's thesis, Ajou University, Suwon.
  12. Manzano, F., Colmenero, M., Perez-Perez, A. M., Roldan, D., Jimenez-Quintana Mdel, M., Manas, M. R., et al. (2014). Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses. Intensive Care Medicine, 40 (11), 1679-1687. https://doi.org/10.1007/s00134-014-3424-3
  13. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. (2014). Prevention and treatment of pressure ulcers: Clinical practice guideline. In E. Haesler (Ed.). Osborne Park, Western Australia: Cambridge Media.
  14. Pickham, D., Berte, N., Pihulic, M., Valdez, A., Mayer, B., & Desai, M. (2018). Effect of a wearable patient sensor on care delivery for preventing pressure injuries in acutely ill adults: A pragmatic randomized clinical trial (LS-HAPI study). International Journal of Nursing Studies, 80, 12-19. https://doi.org/10.1016/j.ijnurstu.2017.12.012
  15. Powers, J. (2016). Two methods for turning and positioning and the effect on pressure ulcer development: A comparison cohort study. Journal of Wound, Ostomy, and Continence Nursing, 43(1), 46-50. https://doi.org/10.1097/WON.0000000000000198
  16. Powerss, J., Beaubien, R., Brunner, T., Girardot, K., Rechter, J., & Richardson, J. (2020). Comparing a patient positioning system to an overhead LIFT with pillows for impact on turning effectiveness. Intensive and Critical Care Nursing, 59, 102847. https://doi.org/10.1016/j.iccn.2020.102847
  17. Registered Nurses Association of Ontario (RNAO). (2005). Risk assessment & prevention of pressure ulcers. Toronto, ON: RNAO.
  18. Rich, S. E., Margolis, D., Shardell, M., Hawkes, W. G., Miller, R. R., Amr, S., et al. (2011). Frequent manual repositioning and incidence of pressure ulcers among bed-bound elderly hip fracture patients. Wound Repair and Regeneration, 19(1), 10-18. https://doi.org/10.1111/j.1524-475X.2010.00644.x
  19. Shim, S. R, Kim, S. J. Lee, J., & Rucker, G. (2019). Network meta-analysis: application and practice using R software. Epidemiology and Health, 41, e2019013. https://doi.org/10.4178/epih.e2019013
  20. Shim. S. R. (2019). R meta-analysis for medicine and public health researchers. Seoul: Hannarae.