title: Efficacy of Monitoring Devices in Support of Prevention of Pressure Injuries: Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  To present a systematic review of the literature assessing the efficacy of monitoring devices for reducing the risk of developing pressure injuries.
  
  
  BACKGROUND
  This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.
  
  
  OBJECTIVE
  After participating in this educational activity, the participant should be better able to:1. Explain the methodology of the literature review and its results.2. Discuss the scope of the problem and the implications of the research.
  OBJECTIVE: To assess the efficacy of monitoring devices for reducing the risk of developing pressure injuries (PIs).
  
  
  METHODS
  The authors systematically reviewed the literature by searching PubMed/MEDLINE and CINAHL databases through January 2016.
  
  
  METHODS
  Articles included clinical trials and cohort studies that tested monitoring devices, evaluating PI risk factors on patients in acute and skilled nursing settings. The articles were scored using the Methodological Index for Non-randomized Studies.
  
  
  METHODS
  Using a standardized extraction form, the authors extracted patient inclusion/exclusion criteria, care setting, key baseline, description of monitoring device and methodology, number of patients included in each group, description of any standard of care, follow-up period, and outcomes.
  
  
  RESULTS
  Of the identified 1866 publications, 9 met the inclusion criteria. The high-quality studies averaged Methodological Index for Non-randomized Studies scores of 19.4 for clinical trials and 12.2 for observational studies. These studies evaluated monitoring devices that measured interface pressure, subdermal tissue stress, motion, and moisture. Most studies found a statistically significant decrease in PIs; 2 studies were eligible for meta-analysis, demonstrating that use of monitoring devices was associated with an 88% reduction in the risk of developing PIs (Mantel-Haenszel risk ratio, 0.12; 95% confidence interval, 0.04-0.41; I = 0%).
  
  
  CONCLUSIONS
  Pressure injury monitoring devices are associated with a strong reduction in the risk of developing PIs. These devices provide clinicians and patients with critical information to implement prevention guidelines. Randomized controlled trials would help assess which technologies are most effective at reducing the risk of developing PIs.
authors.affiliation: Gurjot S. Walia, BS • Research Fellow • Department of Plastic and Reconstructive Surgery • Johns Hopkins University School of Medicine • Baltimore, Maryland Alison L. Wong, MD, MSE • Plastic Surgery Resident • Division of Plastic Surgery • Dalhousie University • Halifax, Nova Scotia, Canada • Graduate Student • Center for Bioengineering Innovation and Design • Johns Hopkins University Whiting School of Engineering • Baltimore, Maryland Andrea Y. Lo, BS • Summer Research Fellow • Department of Plastic and Reconstructive Surgery • Johns Hopkins University School of Medicine • Baltimore, Maryland Gina A. Mackert, MD • Plastic Surgery Resident • Department of Hand, Plastic, and Reconstructive Surgery • Burn Center, Trauma Center • Ludwigshafen, Germany • Department of Plastic Surgery • University of Heidelberg, Germany • Heidelberg, Germany Hannah M. Carl, BS • Medical Student • Department of Plastic and Reconstructive Surgery • Johns Hopkins University School of Medicine • Baltimore, Maryland Rachel A. Pedreira, BA • Medical Student • Department of Plastic and Reconstructive Surgery • Johns Hopkins University School of Medicine • Baltimore, Maryland Ricardo Bello, MD, MPH • Postdoctoral Fellow • Department of Plastic and Reconstructive Surgery • Johns Hopkins University School of Medicine • Baltimore, Maryland Carla S. Aquino, MSN, RN • Coordinator • Nursing Clinical Quality and Magnet Program • Department of Nursing Administration • Johns Hopkins Hospital • Baltimore, Maryland William V. Padula, PhD • Assistant Professor • Department of Health Policy and Management • Johns Hopkins University Bloomberg School of Public Health • Baltimore, Maryland Justin M. Sacks, MD, MBA • Assistant Professor • Department of Plastic and Reconstructive Surgery • Johns Hopkins University School of Medicine • Baltimore, Maryland.
authors.forename: Gurjot S
authors.initials: GS
authors.lastname: Walia
authors.forename: Alison L
authors.initials: AL
authors.lastname: Wong
authors.forename: Andrea Y
authors.initials: AY
authors.lastname: Lo
authors.forename: Gina A
authors.initials: GA
authors.lastname: Mackert
authors.forename: Hannah M
authors.initials: HM
authors.lastname: Carl
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Pedreira
authors.forename: Ricardo
authors.initials: R
authors.lastname: Bello
authors.forename: Carla S
authors.initials: CS
authors.lastname: Aquino
authors.forename: William V
authors.initials: WV
authors.lastname: Padula
authors.forename: Justin M
authors.initials: JM
authors.lastname: Sacks
mesh_terms: D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D003668:Pressure Ulcer / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D015203:Reproducibility of Results