Patient-Centered Approaches to Pressure Injury Prevention and Management for Adults in the Acute Care Hospital Setting: A Scoping Review

OBJECTIVE: To identify patient-centered approaches to pressure injury (PI) prevention and management for adults in acute care settings, including the strategies used and their effectiveness. DATA SOURCES: A comprehensive search strategy was developed using the JBI Participants, Concept, and Context framework. The authors searched EMBASE, CINAHL, MEDLINE, Scopus, Cochrane Library, ProQuest, the James Lind Alliance, Healthcare Excellence Canada, and PI-specific organizations for English-language publications from the past 10 years. STUDY SELECTION: The search identified 3055 articles, and 1422 duplicates were removed. Studies were excluded if they did not focus on patient-centered PI prevention and management, did not occur in acute care settings, or did not include data that could be extracted. Following abstract and full-text screening, 21 studies were included in this review. DATA EXTRACTION: Two independent reviewers extracted data on study design, interventions, and outcomes, and quality (using the Mixed Methods Appraisal Tool). DATA SYNTHESIS: The included studies reported 4 main PI prevention strategies: care bundles, educational interventions, technological interventions, or tools to assess or reduce PI risk. Quantitative findings consistently showed reduced PI incidence with patient-centered interventions. Qualitative studies emphasized the importance of knowledge, communication, and collaboration in enhancing patient involvement. Barriers to engagement included pain, cognitive impairment, and health care provider time constraints. The methodological quality of the included studies varied, with limitations due to a lack of blinding and incomplete outcome data. CONCLUSIONS: Patient-centered approaches can effectively reduce PI incidence in acute care. Future interventions should incorporate consistent education, tailored care plans, and effective communication to enhance patient engagement and improve PI prevention and management.