Abstract：
OBJECTIVE: To survey the literature to gain insight into nursing facilitators of and barriers to implementation of positioning/turning strategies to prevent hospital-acquired pressure injuries (PIs) in adult critical care patients.
METHODS: This integrative review surveyed literature across databases including PubMed, CINAHL, Embase, and Cochrane Library, and through hand searching.
METHODS: Key terms included \"pressure ulcer\" OR \"pressure sore*\" OR \"pressure injur*\" AND \"patient positioning\" OR \"turn\" OR \"turning\" OR \"patient repositioning\" AND \"critical care\" OR \"intensive care unit*\" OR \"inpatient*\" AND \"prevent*.\" Peer reviewed, English language articles published within the past 10 years were included. Inclusion and exclusion criteria narrowed the database yield to 432 articles. After title/abstract and full text review, 11 articles were included.
METHODS: Articles were appraised using the PRISMA flow diagram and the Johns Hopkins Nursing Evidence-Based Practice appraisal tool. Data was extracted and major themes were identified.
RESULTS: The identified themes were synthesized into factors that facilitated or impeded the nursing implementation of turning/repositioning strategies to prevent hospital-acquired PIs. Facilitators were the use of verbal cues and alerts to improve compliance and nursing education on PI prevention. Barriers to successful implementation were increased nursing workload or burden, lack of staff, and perceived hemodynamic instability in ICU patients.
CONCLUSIONS: Future interventions can be tailored to mitigate barriers and reinforce facilitators to improve nursing compliance with repositioning/turning strategies. Increased compliance with these measures could aid in PI prevention in adult ICU patients.
METHODS: This integrative review surveyed literature across databases including PubMed, CINAHL, Embase, and Cochrane Library, and through hand searching.
METHODS: Key terms included \"pressure ulcer\" OR \"pressure sore*\" OR \"pressure injur*\" AND \"patient positioning\" OR \"turn\" OR \"turning\" OR \"patient repositioning\" AND \"critical care\" OR \"intensive care unit*\" OR \"inpatient*\" AND \"prevent*.\" Peer reviewed, English language articles published within the past 10 years were included. Inclusion and exclusion criteria narrowed the database yield to 432 articles. After title/abstract and full text review, 11 articles were included.
METHODS: Articles were appraised using the PRISMA flow diagram and the Johns Hopkins Nursing Evidence-Based Practice appraisal tool. Data was extracted and major themes were identified.
RESULTS: The identified themes were synthesized into factors that facilitated or impeded the nursing implementation of turning/repositioning strategies to prevent hospital-acquired PIs. Facilitators were the use of verbal cues and alerts to improve compliance and nursing education on PI prevention. Barriers to successful implementation were increased nursing workload or burden, lack of staff, and perceived hemodynamic instability in ICU patients.
CONCLUSIONS: Future interventions can be tailored to mitigate barriers and reinforce facilitators to improve nursing compliance with repositioning/turning strategies. Increased compliance with these measures could aid in PI prevention in adult ICU patients.
摘要：
目的：调查文献，以深入了解在成人重症监护患者中预防医院获得性压力性损伤（PIs）的定位/转向策略的实施的护理促进者和障碍。
方法：这篇综合综述调查了包括PubMed在内的数据库中的文献，CINAHL,Embase,和Cochrane图书馆,通过手搜索。
方法：主要术语包括\"压疮\"或\"压疮*\"或\"压伤*\"和\"病人定位\"或\"转\"或\"转\"或\"病人重新定位\"和\"重症监护\"或\"重症监护病房\"或\"住院\"和\"预防*。\"同行审查，包括在过去10年中发表的英语文章。纳入和排除标准将数据库收益率缩小到432篇文章。经过标题/摘要和全文审查，共包括11篇文章。
方法：使用PRISMA流程图和约翰霍普金斯护理循证实践评估工具对文章进行评估。提取了数据并确定了主要主题。
结果：确定的主题被综合为促进或阻碍护理实施转向/重新定位策略以防止医院获得性PI的因素。促进者使用口头提示和警报来改善PI预防的依从性和护理教育。成功实施的障碍是增加护理工作量或负担，缺乏工作人员,ICU患者的血流动力学不稳定。
结论：可以调整未来的干预措施以减轻障碍并加强促进者，从而通过重新定位/转向策略提高护理依从性。提高对这些措施的依从性可以帮助成年ICU患者预防PI。
方法：这篇综合综述调查了包括PubMed在内的数据库中的文献，CINAHL,Embase,和Cochrane图书馆,通过手搜索。
方法：主要术语包括\"压疮\"或\"压疮*\"或\"压伤*\"和\"病人定位\"或\"转\"或\"转\"或\"病人重新定位\"和\"重症监护\"或\"重症监护病房\"或\"住院\"和\"预防*。\"同行审查，包括在过去10年中发表的英语文章。纳入和排除标准将数据库收益率缩小到432篇文章。经过标题/摘要和全文审查，共包括11篇文章。
方法：使用PRISMA流程图和约翰霍普金斯护理循证实践评估工具对文章进行评估。提取了数据并确定了主要主题。
结果：确定的主题被综合为促进或阻碍护理实施转向/重新定位策略以防止医院获得性PI的因素。促进者使用口头提示和警报来改善PI预防的依从性和护理教育。成功实施的障碍是增加护理工作量或负担，缺乏工作人员,ICU患者的血流动力学不稳定。
结论：可以调整未来的干预措施以减轻障碍并加强促进者，从而通过重新定位/转向策略提高护理依从性。提高对这些措施的依从性可以帮助成年ICU患者预防PI。
