Community-Acquired Pressure Injuries: Prevalence, Risk Factors and Effect of Care Bundles - An Integrative Review

Aims: To examine (i) incidence and prevalence of PI in the community; (ii) risk factors associated with community-acquired pressure injury (CAPI); and (iii) the components and outcomes of a PI care bundle in the community.

Design: Integrative review

Data sources: PubMed, Medline, CINAHL and Web of Science were searched. Studies published in the English language between 2012 and 2022 and in English were retrieved.

Review methods: This integrative review is guided by Whittemore and Knafl framework and adheres to PRISMA reporting guidelines. Quality appraisal was applied to assess the quality of selected articles. Data relevant to the review aims were extracted, and thematic analysis was used to synthesise and present the findings.

Results: A total of 386 articles were retrieved; 30 met the inclusion criteria. Most studies reported the point-prevalence and period -prevalence of CAPI, and only one study reported the incidence of CAPI. The point-prevalence and period-prevalence of CAPI were 0.02% to 10.8% and 3.3% to 86.4%, respectively, and the cumulative incidence was 1.3 %. The risk factors for CAPI assessed vary between studies; older age, poor nutrition, immobility and multiple comorbidities are commonly reported. Socioeconomic and caregiving factors were rarely included. Very few studies evaluated PI care bundles in the community. Even so, the components of the PI care bundle vary between studies.

Conclusion: There is a complex interplay of factors associated with PI development. A multicomponent PI preventive care bundle needs to be implemented and evaluated in the community setting.

Implications for the profession and/or patient care: Community-acquired PI are common but often underreported due to a lack of follow-up and reporting systems in the community. A PI preventive care bundle will ensure a more coordinated and efficient way to manage PI in the community.