Use of point-of-care subepidermal moisture devices to detect localised oedema and evaluate pressure injury risk: A scoping review

Abstract

Aims and objectives: To map current literature on bedside clinicians' use of point-of-care subepidermal moisture devices to identify increased pressure injury risk.

Background: Pressure injuries are a substantial healthcare burden. Localised oedema occurs before visible or palpable changes, and therefore is a biomarker of increased pressure injury risk. Novel bedside technologies that detect localised oedema may aid early pressure injury preventative practices.

Design: A scoping review.

Methods: Arksey and O'Malley's six-step framework and the PRISMA-ScR guidelines guided this scoping review. CINAHL Complete, Embase, SCOPUS, Cochrane (wounds) and PubMed databases were searched for primary research and quality improvement projects published in English between 2008-2022. Included studies focused on clinicians' bedside use of subepidermal moisture devices to quantify localised oedema and pressure injury risk. The PAGER framework supported narrative synthesis of the extracted data.

Results: Nine studies were selected from 1676 sources. Two point-of-care subepidermal moisture devices were identified in clinical use, largely by nurses. Inconsistent use and interpretations revealed significant knowledge gaps in clinical practice. Additionally, no included studies engaged patients or the public in their design.

Conclusions: Nurses recognise the value of objective measures in determining the risk of pressure injury and are the primary end-users of point-of-care subepidermal moisture devices. However, standardising procedural instructions and interpretive criteria to guide preventative measures requires further research.

Relevance to clinical practice: International pressure injury clinical practice guidelines advocate for subepidermal moisture devices as an adjunct to routine clinical skin assessment, although little is known about bedside use. This scoping review reveals low adoption of such devices and the need to develop standardised procedures in their use and interpretation.

Registration: Open Science DOI https://doi.org/10.17605/OSF.IO/AB6Y5-7th of March 2022.

Keywords: Pressure injury risk; SEM scanner; biocapacitance; localised oedema; skin assessment.