scholarly journals Comment on “International consensus on pressure injury preventative interventions by risk level for critically ill patients: A modified Delphi study”

Author(s):  
Jan Kottner ◽  
Janet Cuddigan ◽  
Katrin Balzer ◽  
Emily Haesler
2021 ◽  
Author(s):  
Frank A Rasulo ◽  
Philip Hopkins ◽  
Francisco Almeida Lobo ◽  
Pierre Pandin ◽  
Basil Matta ◽  
...  

Abstract BackgroundThe literature related to the use of processed EEG (pEEG) for depth of sedation (DOS) monitoring is increasing, however it is unclear how to use this type of monitoring for critical care patients within the intensive care unit (ICU).MethodsWe performed a systematic review of the literature according to the Grade of Recommendation assessment, Development, and Evaluation (GRADE) approach. The modified Delphi method was utilised by a team of experts to produce statements and recommendations derived from study questions. Three separate online rounds discussing 89 statements categorized into four domains were formulated. The panelists rated the appropriateness of each statement and were able to suggest modifications or addition of statements. An analysis of anonymised ratings of the statements by part of the panel followed each Delphi round and previously validated criteria were used to define appropriateness and consensus.ResultsLevel of evidence regarding the four domains was very low. Fourteen panelists participated in the Delphi rounds and consensus was reached for 28 out of 89 statements, from which the reccomendations were created. The main findings were that DOS monitoring should be performed in critically ill patients whenever clinical evaluation is not possible, it should be performed by continuous pEEG techniques and the resulting data depicted with graphical tools to facilitate detection of excessive sedation, a potential cause of burst-suppression, and finally, structured training is suggested to achieve a basic pEEG competency.ConclusionsAlthough evidence on using DOS monitors in ICU is scarce and further research is required in order to better define the benefits of using pEEG, the results of this consensus highlight the general agreement that critically-ill patients would benefit from this type of neuromonitoring.


2020 ◽  
Vol Volume 13 ◽  
pp. 59-65
Author(s):  
Zohreh Karimi ◽  
Ali Mousavizadeh ◽  
Hossein Rafiei ◽  
Naeem Abdi ◽  
Mohammad Behnammoghadam ◽  
...  

Medicine ◽  
2019 ◽  
Vol 98 (42) ◽  
pp. e17534
Author(s):  
Alessandra Fabiane Lago ◽  
Ada Clarice Gastaldi ◽  
Amanda Alves Silva Mazzoni ◽  
Vanessa Braz Tanaka ◽  
Vivian Caroline Siansi ◽  
...  

2021 ◽  
Vol 11 (2) ◽  
pp. 154-176
Author(s):  
Wenny Trisnaningtyas ◽  
Retnaningsih Retnaningsih ◽  
Nana Rochana

Background: Many studies on pressure injury prevention bundles have been conducted outside the Intensive Care Unit (ICU). The bundles, which include multi interventions, have proven effective in reducing pressure ulcer incidents compared to a single intervention. However, the existing review studies on pressure injury prevention in ICUs still only investigate a single intervention rather than multi interventions. Only few reviews, to our knowledge, involves prevention bundle strategies in the ICU.Purpose: This study aims to review the effects of the pressure injury prevention bundles of care on the incidents of pressure injury in critically ill patients and the intervention measures of the care bundles.Methods: This review searched published articles from several databases, namely EBSCO, ScienceDirect, PubMed, ProQuest, Google Scholar, and Scopus from 2009 up to 2020. PRISMA flowchart was used to select relevant articles using several inclusion and exclusion criteria, resulting in 17 article from 50 eligible full-text articles for assessment. The included studies were assessed for their quality using Joanna Briggs Institute (JBI) critical appraisal tools. The synthesis was then conducted narratively.Results: As many as 17 studies, which mostly had good quality yet evidence level of II, were included in the analysis. The findings showed that the pressure injury prevention bundles of care decreased pressure injury incidents as many as 4.3%-36.2% in developed countries and 4.16%-21% in developing countries. Moreover, the bundles of care which significantly reduced the incidents of pressure injury consisted of 7 intervention measures, which were pressure injury risk assessment using Cubbin Jackson scale, skin assessment and care, repositioning, nutrition, education, support surface, and medical device care.Conclusion:The review concluded that the pressure injury prevention bundles of care in critically ill patients significantly reduced the incidents of pressure injury. The study recommends more studies with stronger evidence levels to carry out and utilize 7 intervention measures as a preventive standard of care in critically ill patients. 


Sign in / Sign up

Export Citation Format

Share Document