Summary of the best evidence for postural change in the prevention of pressure injury in critically ill adult patients

Background: This study sought to evaluate and summarize the best evidence on postural change in the prevention of pressure injuries among critically ill adult patients, to provide a reference for the treatment of these patients in clinical practice. Methods: An evidence-based approach was adopted to retrieve relevant articles from databases and professional websites. The Joanna Briggs Institute evidence appraisal and recommendation system was used to assess the quality and level of the evidence. Results: In total, 11 articles were included in the analysis, including 4 clinical practice guidelines, 2 expert consensus papers, 1 evidence summary, 3 systematic reviews, and 1 randomized controlled trial. 14 pieces of evidence on the feasibility and suitability of specific clinical situations were summarized, and the following 7 aspects were considered: (I) individual assessment; (II) postural change frequency; (III) postural change angle; (IV) postural change strategies for critically ill patients with hemodynamic instability; (V) assessment during postural change, (VI) multidisciplinary team cooperation; and (VII) education and training. Conclusions: Clinical nurses should pay attention to the prevention and management of pressure injuries in critically ill adult patients. The approach should be selected and applied according to the specific clinical situation and the individual situation of each patient to achieve better treatment effect.