Alternating air pressure mattresses in comparison to repositioning for the prevention of pressure injury development in elderly individuals

Abstract

Background: Pressure Injuries (pressure sores, decubitus ulcers), are localised injuries to the skin barrier and underlying tissue, which are primarily caused by prolonged pressure on the skin. These injuries usually affect individuals who are confined to a bed or a wheelchair for a long period of time. Due to the fact that the skin becomes thin and dry, elderly individuals are more at risk of pressure sores. Immobility issues are one of the main causes of the rise in pressure sore formation. Research Question: Do alternating air mattresses prevent the occurrence of pressure injuries in elderly individuals in comparison to repositioning? PICO Elements: Population (P) Elderly Individuals. Intervention (I) the use of alternating air mattresses (C) repositioning (O) prevention of pressure injuries. Method: A detailed systematic search of the literature was done using reliable databases, including HyDi, ProQuest, PubMed, Scopus and, EBSCO Host. Using the PICO elements and alternative keywords found with Boolean operators, the inclusion and exclusion criteria were used to help eliminate the irrelevant articles. The inclusion criteria used were peerreviewed articles published in English within the last 10 years. This helped to provide eligible articles to obtain the best five studies for appraisal. The PRISMA Checklist was used to screen and exclude irrelevant articles. Relevant Critical Appraisal Skills Programme CASP tools were used to critically appraise the literature. Results: A total of five key articles were chosen for critical appraisal, which included two RCTs, two systematic reviews, and one meta-analysis. One RCT and the meta-analysis found significant improvement in pressure ulcer prevention amongst the participants. Conclusion: The utilisation of numerous intervention programs is the most successful strategy for minimising pressure ulcers in hospitalised patients, despite certain discrepancies and limitations in all the studies. Nonetheless, further research is needed to confirm the effectiveness of static air support surfaces in the prevention of Pus. The Implications and Recommendations: Conducting trials with a larger sample size and a longer study duration is some of the recommendations for future research. Given the lack of research available, further research on this subject in Malta is essential. Management recommendations include the development of policies and seminars/training programs to train healthcare professionals, particularly nurses in the importance of daily skin assessment and appropriate use of dressings for pressure ulcers.