For a study, researchers sought to conduct a literature review to better understand the nursing facilitators and barriers to implementing positioning/turning methods to reduce hospital-acquired pressure injuries (PIs) in adult critical care patients. The integrative review searched the literature in databases such as PubMed, CINAHL, Embase, and the Cochrane Library, as well as by hand. “Patient placement” OR “turn” OR “turning” OR “patient repositioning” AND “critical care” OR “intensive care unit*” OR “inpatient*” AND “prevent*” were key phrases. English language peer-reviewed publications published during the last ten years were included. The database output was reduced to 432 articles using inclusion and exclusion criteria. About 11 papers were included after a title/abstract and full-text evaluation. The PRISMA flow diagram and the Johns Hopkins Nursing Evidence-Based Practice evaluation tool were used to evaluate the articles. The data was extracted, and important themes were discovered.
The selected themes were combined to form characteristics that aided or hindered nurse adoption of turning/repositioning methods to avoid hospital-acquired PIs. The use of verbal cues and alarms to increase compliance and nurse education on PI prevention were facilitators. Increased nursing strain or stress, a shortage of manpower, and perceived hemodynamic instability in ICU patients were barriers to successful deployment. Future interventions can be targeted to reduce obstacles and strengthen facilitators to increase nurse compliance with repositioning/turning procedures. Increased adherence to these strategies may benefit the prevention of PI in adult ICU patients.