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Pressure injuries (PIs) remain a problem for patient safety and the sustainability of healthcare systems. Difficulties persist in their assessment, prevention and monitoring by multidisciplinary teams. International recommendations point to this problem as a priority area for resolution in terms of patient safety. Research on the subject has been positive, resulting in several guidelines for clinical practice, but professionals' adherence remains below what is expected for their implementation. This scoping review aimed to identify interventions that increase multidisciplinary teams' adherence to the prevention and management of PIs between hospitals and the communities. The search was carried out in the MEDLINE (via PubMed), CINAHL, Scopus, Web of Science, JBI, Cochrane and grey literature databases by two independent reviewers, and led to the identification of 16 articles that met the eligibility criteria and made it possible to answer the research question. Strategies to improve adherence by health professionals include the creation and training of multidisciplinary teams, the implementation of new risk assessment models, Wound Boards, injury prevention reminders, video consultation apps, multidisciplinary rounds, documentation and recording. No studies were identified that assessed staff adherence to interventions aimed at preventing and managing PIs in the continuum between hospitals and communities, which is suggestive of the need for further research in this area.
Venous ulcers affect up to 3% of the global population, with a high impact on economies and quality of life. This is exacerbated by its recurrence rates, which reach 70% at 12 months after healing. The perpetuation of these cycles of healing and recurrence is not interrupted or even attenuated by the self-care activities recommended and directed toward their prevention. In this context, we sought to identify the effectiveness of interventions that promote adherence to self-care to prevent venous ulcer recurrence. In August 2022, we conducted a literature search via EBSCO in the following databases: CINAHL Complete, MEDLINE Complete, Cochrane Database of Systematic Reviews, Scopus, and Web of Science. The inclusion criteria were researched in the form of randomised controlled trials or systematic literature reviews, and 99 studies were identified. During the different times of selection, four studies met the defined inclusion criteria and were included. As the main conclusions, the emphasis goes to the importance of the use of compression and the greater effectiveness of higher compression classes for the prevention of recurrence. Different educational methodologies seem to be important to increase knowledge about prevention, specifically regarding the aetiology of recurrence and the implementation of prevention measures.
Este estudio tuvo como objetivos hacer que un panel de expertos diseñara y validara un algoritmo de soporte a la práctica clínica del enfermero promoviendo la transición segura entre el hospital y la comunidad. Se realizaron dos estudios: una revisión integrativa de literatura para diseñar el algoritmo, sometido a validación por un panel de 8 expertos, recurriendo a la técnica nominal. Fueron considerados los procedimientos éticos. El análisis y síntesis de los 30 estudios que conformaron la muestra bibliográfica permitió identificar las intervenciones eficaces para la prevención de caídas en la transición hospital-comunidad. El algoritmo final fue validado por el panel de expertos por unanimidad. La continuidad de los cuidados resulta vital para prevenir la caída o su recurrencia en los ancianos hospitalizados con alto riesgo de caída o que las sufrieron durante su internación. Las caídas después del alta hospitalaria requieren de investigación.
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