Li, D. (2016). The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital‐acquired pressure ulcer patients in intensive care units. Journal of Clinical Nursing, 25(15-16), 2336-2347. | A retrospective, descriptive, comparative, correlational study. | 196 ICU patients, a relatively small sample size | Independent variables: quality and comprehensiveness of pressure ulcer documentation Dependent variable: incidence of pressure ulcers | Strengths: a comprehensive literature review, appropriate study design, well-founded conclusions Weaknesses: small sample size, which makes it impossible to generalize the results to other settings | VI | The study showed that pressure ulcer documentation quality or its comprehensiveness does not have a significant effect on the incidence of hospital-acquired pressure ulcers. |
O’Toole, T. R., Jacobs, N., Hondorp, B., Crawford, L., Boudreau, L. R., Jeffe, J.,… LoSavio, P. (2017). Prevention of tracheostomy-related hospital-acquired pressure ulcers. Otolaryngology–Head and Neck Surgery, 156(4), 642-651. | A quantitative, comparative, retrospective study | Intervention group: 155 patients Control group: 183 patients Moderate sample size, but adequate given the specificity of the intervention | Independent variable: the adoption of a quality improvement protocol Dependent variable: pressure ulcer incidence | Strengths: evidence-based protocol used for the intervention, reliable data analysis tools used Weaknesses: only one facility included, weak description of the study design | III | Evidence-based protocols can reduce the incidence of pressure ulcers following a tracheostomy tube placement. |
Mallah, Z., Nassar, N., & Badr, L. K. (2015). The effectiveness of a pressure ulcer intervention program on the prevalence of hospital acquired pressure ulcers: Controlled before and after study. Applied Nursing Research, 28(2), 106-113. | A quantitative, descriptive, prospective study | 468 patients in the intervention group, a sufficient sample size | Independent variable: the adoption of a multi-model intervention program Dependent variable: pressure ulcer incidence | Strengths: well-documented evidence from prior research, a comprehensive multidisciplinary intervention, data from 19 units was included Weaknesses: a descriptive design, did not consider organizational risk factors, documentation of procedures was provided by nurses | VI | Pressure ulcers are a significant problem affecting patient outcomes and their length of stay. A multi-model intervention is effective in reducing the incidence of hospital-acquired pressure ulcers. |
Lam, C., Elkbuli, A., Benson, B., Young, E., Morejon, O., Boneva, D.,… McKenney, M. (2018). Implementing a novel guideline to prevent hospital-acquired pressure ulcers in a trauma population: A patient-safety approach. Journal of the American College of Surgeons, 226(6), 1122-1127. | A quantitative, prospective study design | 9,755 patients, an excellent sample size | Independent variable: the adoption of an intervention program Dependent variable: the incidence of pressure ulcers | Strengths: a large sample size, accounted for organizational risks, such as the lack of specialized equipment and education, results supported by other studies Weaknesses: only included the data from trauma units, compared with chronological data rather than a control group | III | Applying a comprehensive program for hospital-acquired pressure ulcer prevention can help in reducing the incidence of pressure ulcers. |
Santamaria, N., Gerdtz, M., Sage, S., McCann, J., Freeman, A., Vassiliou, T.,… Knott, J. (2015). A randomised controlled trial of the effectiveness of soft silicone multi-layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: The border trial. International Wound Journal, 12(3), 302-308. | A randomized controlled trial | 440 patients, 220 in each group, an adequate sample size | Independent variable: the use of multi-layer soft silicone foam dressings Dependent variable: the incidence of pressure ulcers | Strengths: a randomized controlled trial with a good quality of evidence, a sufficient sample size, uses an evidence-based intervention, provides a thorough review of prior literature Weaknesses: data collectors were not blinded, the results cannot be applied to general patient populations, only to trauma and critically ill patients in emergency departments | II | The use of multi-layer soft silicone foam dressings assisted in the prevention of hospital-acquired patient ulcers. |