Fatores de risco para o surgimento de lesões por pressão em idosos acamados: uma revisão integrativa.

Abstract

Success in preventing and decreasing pressure injuries depends on knowledge of the predisposing factors and the skill of the health team, especially the nursing team that provides direct assistance to patients individually. Therefore, this study aimed to identify scientific evidence available in the literature about the risk factors for the emergence of pressure injuries in bedridden elderly and to present nursing care aimed at preventing them. The present study is an integrative literature review which aims to construct an analysis of the scientific bibliography. The search for indexed publications took place in the following databases: Latin American and Caribbean Literature and Health Sciences (LILACS); Scientific Electronic Library Online Library (SciELO); Nursing Database (BDENF) and MEDLINE / PUBMED. Two search strategies were used that resulted in 131 studies to be included or not for the final sample. During the selection of the studies, an instrument adapted from the Critical Apppraisal Skills Program (CASP) was used for the methodological rigor assessment, resulting in a sample end of 12 studies. To obtain the data, a data collection instrument constructed and validated by Ursi was used and for the assessment of the level of evidence, the hierarchical classification was used by the methodological approach adopted by Stillwell. Most studies have shown as risk factors for the development of pressure injuries: advanced age; chronic non-communicable diseases; immobility or restricted mobility; even lying in bed for more than two hours and folds in the bedding, which leave marks on the body; change in the skin; continuous use of medications; changes in the Body Mass Index (BMI); inadequate nutrition; incontinence; excess moisture; commitment to activities of daily living; presence of friction and shear and; limited sensory perception. Regarding preventive measures, the following stood out: hygienic- dietary; change of position, every two hours according to the schedule of hours; use of pressure relief surfaces; inspection, cleaning and moisturizing the skin; protect and not massage bone prominences; transferring the elderly from one place to another, raising them and not dragging them; elevating the individual's ankle; as well as the use of protocols and scales, such as the Braden scale and the Waterlow scale, in conjunction with the Nursing Care Systematization. The study allowed the identification of risk factors for pressure injuries in bedridden elderly and the main nursing care evidenced in the literature. In addition, it is clear that the work performed by health professionals is essential for better health care and for the implementation of preventive measures