A systematic review of clinical practice guidelines and other best practice recommendations for pressure injury risk assessment in the United States.
Serafin, Anna Graziadio, Sara Velickovic, Vladica Milde, Thurid-Christiane Dinnes, Jacqueline Sitch, Alice Coombe, April McNichol, Laurie Armstrong, David G Lueck, Heather
Serafin, Anna
Graziadio, Sara
Velickovic, Vladica
Milde, Thurid-Christiane
Dinnes, Jacqueline
Sitch, Alice
Coombe, April
McNichol, Laurie
Armstrong, David G
Lueck, Heather
Affiliation
HARTMANN GROUP; Graziadio Consulting; UMIT; University of Birmingham; University Hospitals Birmingham NHS Foundation Trust; Cone Health; University of Southern California; Mercy Hospital; Charité-Universitätsmedizin
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Publication date
2025-03-22
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Abstract
Preventing pressure injuries (PIs) remains the most effective way to reduce their burden. A key element of prevention is the assessment of PI risk. The study aimed to investigate whether guidance documents relevant to the United States (US) advocated for specific risk assessment recommendations. We conducted a systematic review of guidance documents published between 2010 and 2024. Embase, Medline, Cinahl, and four key organisational websites were systematically searched to retrieve relevant articles. Two independent reviewers screened the articles for inclusion. One reviewer extracted the data, and a second reviewer checked all extracted data. Three reviewers assessed the guidance documents quality using the Appraisal of Guidelines for Research & Evaluation (AGREE II) tool. A narrative synthesis was used to describe and summarise findings. Six clinical practice guidelines (CPGs) and eight other best practice recommendations were included. The median scores of most AGREE II domains were higher for CPGs compared to other best practice recommendations. Risk assessment was consistently positioned as a critical first step in the prevention of PIs, emphasising its role in identifying at-risk individuals and informing targeted interventions. Although risk assessment was presented as a crucial step in PI risk prevention, there was no clear and unanimous recommendation for a specific risk assessment strategy across all guidance documents, either for the general population or for specific subgroups of patients in US healthcare settings. These findings suggest a need for national consensus on concepts, implementation, and language addressing PI risk assessment.
Citation
Serafin A, Graziadio S, Velickovic V, Milde TC, Dinnes J, Sitch A, Coombe A, McNichol L, Armstrong DG, Lueck H, Kottner J. A systematic review of clinical practice guidelines and other best practice recommendations for pressure injury risk assessment in the United States. Wound Repair Regen. 2025 Mar-Apr;33(2):e70016. doi: 10.1111/wrr.70016.
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Article