PRESSURE INJURY RISK PREDICTION IN CRITICAL CARE PATIENTS: AN INTEGRATIVE REVIEW

ABSTRACT

Objective:

to identify instruments used to assess pressure injury risk in adult critically ill patients in an intensive care unit and analyze their predictive capacity.

Method:

an integrative review was carried out, observing the following criteria for study selection: pressure injury risk assessment in patients hospitalized in adult intensive care units by means of a scale or index; predictive capacity measurement of the instrument used; English, Portuguese, or Spanish languages; period between 1962 and 2016. The descriptors used were: pressure ulcer or pressure sores and risk assessment. The variables of interest were: sensitivity; specificity; positive predictive value; negative predictive value; and area under the receiver operating characteristic curve.

Results:

a total of 1,032 publications were identified, of which 13 studies were selected for analysis. Pressure injury risk prediction was only measured with generic scales in seven of the 13 studies. In the comparative studies of intensive care unit specific scales with generic scales, the negative predictive value was high and they all presented an area of receiver operating characteristic curve with values higher than 0.700. There was a prevalence of the Braden scale among generic scales. Six scales that presented good predictive capacity to assess pressure injury risk in intensive care patients were identified.

Conclusion:

the present review showed a range of predictive, generic, and specific scales used for pressure injury risk assessment in intensive care unit patients.

DESCRIPTORS:
Pressure ulcer; Risk assessment; Predictive value; Nursing care; Intensive care units