Medical Device-Related Pressure Injuries in the Perioperative setting: A Scoping Review
Creators: name: HUANG, TAI-YANG
name: Tobiano, G
name: Ou, Su-Fei
name: Lee, Bih-O
name: M Gillespie, Brigid
Publisher: name: figshare
Year: 2023
Subjects: Acute care

description: This scoping review of the breadth of literature describing medical device-related injuries (MDRPI) in perioperative patients during surgery relative to the incidence, types, risk factors and prevention strategies. Scoping reviews focus on the breadth of literature (Arksey &amp; O'Malley, 2005; Peters, Godfrey, Khalil, et al., 2015). They allow reviewers to summarise and synthesise the literature, to determine a research gap or recommend the direction of further studies (Davis et al., 2009; Tricco et al., 2016). This review will follow the six methodological stages outlined by Arksey and O’Malley (2005) and further developed by Bradbury-Jones et al. (2022). These stages include: (1) identification of research question, (2) identification of relevant studies, (3) study selection, (4) charting the data, (5) collating, summarising and reporting the results, and an optional stage, (6) consulting with stakeholders regarding findings. The PAGER framework (Bradbury-Jones et al., 2021) is used to consolidate the results of the scoping review, which consists of five areas: patterns, advances, gaps, evidence for practice, and research recommendations (Bradbury-Jones et al., 2021). This framework facilitates a thorough analysis and evaluation of the data and complemented the five-step procedure of Arskey and O'Malley (2005) (Bradbury-Jones et al., 2021). The review protocol is registered in Figshare (https://figshare.com/). 1. Identifying the research questions: This scoping review used the population, concept and context (PCC) approach(Bradbury-Jones et al., 2022)to develop the research aim, which is to map the existing literature describing medical device related injuries in perioperative patients during surgery. Underpinning the review aim, this review includes the following questions: · What is the incidence of medical device related pressure injuries in perioperative patients? · What types of medical devices are associated with pressure injuries development during surgery? · What are the risk factors for medical device related pressure injuries development in perioperative patients? · What strategies are used to prevent/minimize the risk of medical device related pressure injuries in perioperative patients? 2 Identifying Relevant Studies Inclusion and exclusion criteria are based on all components of PCC.Quality improvement articles were also eligible if they included a statement about ethical approval or approval waiver (waiver by ethical review board). Inclusion Adult patients (≧16 years old) undergoing surgical procedures. Legal age to classify as an adult and provide consent for surgery in many countries (https://aifs.gov.au/resources/resource-sheets/age-consent-laws-australia ). Planned (i.e., elective) and emergency surgeries. Scoping reviews are broad and we want to explore a wide range of admission surgeries. Laparoscopic and open surgical procedures. Major surgical procedures are laparoscopic or open. All types of medical devices (i.e., Respiratory, Orthopedic, Urinary/fecal collection, Reposition, tubes and drains) used during surgery. Scoping reviews are broad and we want to explore a wide range of medical devices. Peer reviewed primary research and QI articles QI articles will provide local data about practical strategies being implemented in hospitals. Articles published during 2014-2023 Since 2014, medical device-related pressure injuries are increasingly being recognised as a major concern for healthcare facilities (Jackson et al., 2019) Studies published in English and Chinese with full text available The team does not have the resources to translate articles into other languages. Exclusion Patients undergoing ambulatory surgery Procedures are usually short and are mostly done under local anesthesia, not allowing time to develop MDRPI. The duration of the surgical procedure is less than 1 hour. National Pressure Ulcer Advisory Panel are updating the 'Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline' (CPG) in 2019: The pressure injury in the operating room develops between several hours to three to five days. The computerised database search was developed by referring to key articles in this field, which informed identification of keywords and subject headings. The search was developed in consultation with a health librarian. Searches will be conducted in Medline (Ovid), CINAHL (Ovid) and EMBASE (Elsevier). An example of the search strategy for the Medline (Ovid) database is shown in Table 2. 3. Study selection Prior to study selection, search results will be exported into EndNote 20 and then uploaded into the Covidence systematic review software (www.covidence.org). The Covidence systematic review software package will be used for removing duplicates and screening studies (titles and abstracts, and then full texts). Study selection will be based on the inclusion and exclusion criteria. For studies with unclear reporting components, authors will be contacted via e-mail for clarification. Two researchers will independently screen titles and abstracts and then full texts. Any disagreements will be resolved by discussion and consensus. Unresolved disagreements will be adjudicated by a third researcher. Description of the study selection will be presented narrative and a flow diagram following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) statement(Peters et al., 2021). 4. Charting the data Before extracting data, the reviewers will determine which data to extract based on the review questions. The extracted data will include author, year, study design, population, information about medical devices, risk factors for MDPRI information, strategies for MDPRI and primary outcome data. One researcher will extract all data using the charting tables, and one other members of the review team will check the data extractions. If there were any discrepancies between the two researchers, a third researcher arbitrated. 5. Collating, summarising and reporting the results First, descriptive summaries of the characteristics on included studies will be presented, to provide an overview of included studies. Next, the PAGER framework (Bradbury-Jones et al., 2021) will be used to consolidate the results of the scoping review, which consists of five areas: patterns, advances, gaps, evidence for practice, and research recommendations (Bradbury-Jones et al., 2021). This framework facilitates a thorough synthesis and evaluation of the data, and complements the five-step procedure of Arskey and O'Malley (2005). First, pattern charting methods will be used (i.e. patterns). For example, a table will be created showing the presence or absence of certain MDPRI strategies across included studies, allowing our review team to see patterns in the literature. Second, advances will be discussed, defined as how patterns show theoretical/methodological changes over time (i.e. advances). Third, patterns will be discussed in relation to the existing research landscape, allowing identification of gaps that are focused and contextualized (i.e. gaps). Forth, to make sure the review is useful implications for patients, caregivers, physicians, and academics, will be provided (i.e. evidence for practice). Finally, our review team will offer specific recommendations for future research based on the gaps found and the reported evidence for practice (i.e. research recommendations).