The Effectiveness of Care Bundles Including the Braden Scale for Preventing Hospital Acquired Pressure Ulcers in Older Adults Hospitalized in ICUs: A Systematic Review

Background: Despite technological and scientific advances, Hospital Acquired Pressure Ulcers (HAPUs) remain a common, expensive, but preventable adverse event. The global prevalence ranges from 9% to 53% while three million people develop HAPUs in the United States 60,000 die associated complications. HAPU is reported as high 42% ICUs (ICU) costing on average $48,000 clinically manage. Objective: purpose of this systematic review was evaluate effectiveness multi-component interventions (care bundles), incorporating Braden scale for assessment, reducing older adults hospitalized ICUs. Methods: This literature using Cochrane method. A search performed six databases (CINAHL, Library, Google Scholar, JBI Evidence-Based Practice Database, PubMed, ProQuest) January 2012 until December 2018. Bias assessed with Critical Appraisal Skills Programme Checklist, quality evidence evaluated American Association Critical-Care Nurses Levels Evidence. Results: identified 453 studies evaluation; 9 were reviewed. From analysis, pressure ulcer prevention programs incorporated strategies: 1) Evidence-based care bundles risk assessments upon admission ICU; 2) Unit-based skincare expertise; 3) Staff education auditing feedback. Common clinical management processes included frequent reassessments, daily skin inspections, moisture removal treatments, nutritional hydration support, offloading techniques, protective surface protocols. an effective assessment ICU. Through early identification preventative strategies, resulted reduction, less severe ulcers, reduced costs. Conclusion: Older ICU are most vulnerable developing HAPUs. Early accurate factors essential prevention. Care five evidence-based interventions, scale, preventing intensive settings. Higher better understanding impact patient outcomes financial results.