What is the impact of care bundles on the prevalence or incidence of pressure ulcers among at‐risk adults in the acute care setting? A systematic review

Curtis, Áine, Derwin, Rosemarie, Milne, Gráinne, Connor, Ann Marie, Nugent, Linda and Moore, Zena ORCID: https://orcid.org/0000-0002-4692-9718 2025. What is the impact of care bundles on the prevalence or incidence of pressure ulcers among at‐risk adults in the acute care setting? A systematic review. International Wound Journal 22 (6) , e70693. 10.1111/iwj.70693

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Abstract

A pressure ulcer is an injury to the skin and underlying tissues caused by pressure, shear or a combination of the two. In Europe, the mean prevalence rate of pressure ulcers is 10.8%, in Ireland, it is less than 12%. Using systematic review methodology, original research studies written in English were included, employing pre‐ and post‐studies, quality improvement initiatives or projects, randomised controlled trials and experimental studies. Data was extracted using a pre‐designed data extraction tool and quality appraisal was undertaken using the Evidence‐Based Librarianship (EBL) tool. Where appropriate, a meta‐analysis was undertaken using RevMan. The study protocol was pre‐registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42023442711). Following the search, 628 records were returned, of which 25 met the inclusion criteria. The studies were conducted in a variety of acute healthcare settings. Of the included studies, 16 presented data on incidence and 12 presented data on prevalence of pressure ulcers post‐implementation of a care bundle. A meta‐analysis of 10 studies discussing incidence indicates the RR of PU is 0.40 (95% CI: 0.21–0.78; p = 0.007), supporting the use of a care bundle. A meta‐analysis of seven studies discussing prevalence indicates the RR of PU is 0.34 (95% CI: 0.21–0.56; p = 0.0001), demonstrating the reduction in the RR of PU development in favour of the care bundle group. A variety of care bundle elements were found in the studies. Although results indicated the use of a care bundle was advantageous in preventing a pressure ulcer in the acute care setting, it was unclear which of these elements were most effective.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by-nc/4.0/
Publisher:	Wiley
ISSN:	1742-4801
Date of First Compliant Deposit:	16 June 2025
Date of Acceptance:	14 May 2025
Last Modified:	16 Jun 2025 13:30
URI:	https://orca.cardiff.ac.uk/id/eprint/179093

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