본문 바로가기
KERD
논문KCI 등재

중환자실 욕창예방 프로그램 효과의 비교순위: 네트워크 메타분석

Comparative Effects and Ranks of Pressure Ulcer Preventive Programs in Intensive Care Units: A Network Meta-analysis

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류학제간연구

초록

본 연구의 목적은 네트워크 메타분석 방법을 활용하여 중환자실 환자들의 욕창예방 중재의 비교효과와 순위를 평가하기 위하여 수행하였다. 네트워크 메타 분석은 R software의 “netmeta” 패키지를 이용한 빈도주의 방법을 이용하였다. 최종적으로 10편의 논문이 선정되었으며. 네트워크 메타 분석에 결과에 따른 욕창예방의 프로그램의 중재 간 비교우위는 욕창 표준중재와 비교하여 순위는 피부보호 용품 사용이(P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49) 가장 효과적일 확률이 높았으며 두 번째는 실리콘 폼 드레싱(P-Score 84.5%: OR=0.14 , 95% CI: 0.05, 0.38)으로 나타났다. 그 다음으로는 통합중재 (P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), 체위변경 (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) 그리고 마찰을 감소시킬 수 있는 직물의 사용(P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65) 순이었다. 본 연구의 결과는 중환자실 욕창예방 프로그램의 효과적인 적용을 위한 정보를 제공 할 수 있을 것으로 생각된다.

Abstract

This study conducted a network meta-analysis to compare the effectiveness and ranking of pressure ulcer preventive programs in intensive care units. A frequency network meta-analysis was performed to identify evidence from relevant randomized control trials. A total of 10 randomized control trials involving 5 intervention subgroups were included in this study. Based on the ranking probabilities(P-Score), preventive materials was ranked as the most effective among all programs (P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49). Next was silicone foam dressing(P-Score 84.5%: OR=0.14 , 95% CI: 0.05, 0.38), care bundle(P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), reposition (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) and synthetic fabrics (P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65). It is necessary to develop practical and efficient interventions that can prevent pressure ulcers in intensive care unit patients, improve patient safety, and reduce nurses' workload.

참고문헌 (20)

  1. Mary Montague-McCown, "Effect of Hospital Linens on Unit-Acquired Pressure Injuries for Adults in Medical ICUs: A Cluster Randomized Controlled Trial", Critical Care Explorations, 3(3), pp.e0336~ (2021), Ovid Technologies (Wolters Kluwer Health)[DOI]
  2. Zohreh Karimi, "The Effect of Using Olive Oil and Fish Oil Prophylactic Dressings on Heel Pressure Injury Development in Critically Ill Patients", Clinical, Cosmetic and Investigational Dermatology, Volume 13, pp.59~65 (2020), Informa UK Limited[DOI]
  3. National Pressure Ulcer Advisory Panel, "Prevention and Treatment of Pressure Ulcers : Clinical Practice Guideline" (2014), Cambridge Media
  4. Hassan Babamohamadi, "The effects of peppermint gel on prevention of pressure injury in hospitalized patients with head trauma in neurosurgical ICU: A double-blind randomized controlled trial", Complementary Therapies in Medicine, 47, pp.102223~ (2019), Elsevier BV[DOI]
  5. Yoo‐Hyung Choi, "The effect of uncoated paper application on skin moisture, risk of pressure injury and incidence of pressure injury in neurologic intensive care unit patients: A randomized controlled trial", International Journal of Nursing Practice, 27(4), pp.e12919~ (2021), Wiley[DOI]
  6. E. Hahnel, "The effectiveness of two silicone dressings for sacral and heel pressure ulcer prevention compared with no dressings in high‐risk intensive care unit patients: a randomized controlled parallel‐group trial", British Journal of Dermatology, 183(2), pp.256~264 (2020), Wiley[DOI]
  7. Peggy Kalowes, "Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit", American Journal of Critical Care, 25(6), pp.e108~e119 (2016), AACN Publishing[DOI]
  8. Yun J. Lee, "Use of prophylactic silicone adhesive dressings for maintaining skin integrity in intensive care unit patients: A randomised controlled trial", International Wound Journal, 16, pp.36~42 (2019), Wiley[DOI]
  9. Francisco Manzano, "Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses", Intensive Care Medicine, 40(11), pp.1679~1687 (2014), Springer Science and Business Media LLC[DOI]
  10. David Pickham, "Effect of a wearable patient sensor on care delivery for preventing pressure injuries in acutely ill adults: A pragmatic randomized clinical trial (LS-HAPI study)", International Journal of Nursing Studies, 80, pp.12~19 (2018), Elsevier BV[DOI]
  11. Nick Santamaria, "A randomised controlled trial of the effectiveness of soft silicone multi-layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: the border trial", International Wound Journal, 12(3), pp.302~308 (2015), Wiley[DOI]
  12. Nahla Tayyib, "A Two-Arm Cluster Randomized Control Trial to Determine the Effectiveness of a Pressure Ulcer Prevention Bundle for Critically Ill Patients", Journal of Nursing Scholarship, 47(3), pp.237~247 (2015), Wiley[DOI]
  13. 심성률, "Network meta-analysis: application and practice using R software", Epidemiology and Health, 41, pp.1~10 (2019), 한국역학회
  14. "Scottish Government Clinical Advise:Methodology checklist2 randomised controlled trials" (2014)[URL]
  15. "Network Meta-Analysis using Frequentist Methods" (2021)[URL]
  16. S. R. Shim, "R meta-analysis for medicine and public health researchers" (2019), Hannarae
  17. M. Egger, "Bias in meta-analysis detected by a simple, graphical test", BMJ, 315(7109), pp.629~634 (1997), BMJ[DOI]
  18. E. Robb, "Using care bundles to reduce in-hospital mortality : quantitative survey", BMJ, 31(340), pp.c1234~ (2010)[DOI]
  19. D. L. Horner, "Care bundles in intensive care. Continuing education in anaesthesia", Critical Care &Pain, 12(4), pp.199~202 (2012)
  20. 강현욱, "중환자실의 욕창 예방 중재 프로그램의 효과 : 메타 분석", 중환자간호학회지, 11(1), pp.67~78 (2018), 한국중환자간호학회

관련 논문AI추천

이 간행물의 다른 논문 (59건)