11.00
Hdl Handle:
http://hdl.handle.net/10755/211629
Type:
Research Study
Title:
USE OF A SILICONE DRESSING TO REDUCE PRESSURE ULCERS: A RANDOMIZED TRIAL
Abstract:
Background: Skin integrity is identified as a measure of nursing care quality, yet hospital acquired pressure ulcers (HAPUs) are a major health problem, due to patient morbidity, treatment/legal costs and reimbursement issues.  Development of HAPUs is related to pressure, shear and/or friction.  These can be prevented/treated if identified in the early stages. HAPUs cause harm to patients, impact their quality of life, prolong length of stay; and may prove fatal.  In the acute care setting, HAPU incidence ranges from 14% to 17%, thus more scientific interventions to decrease pressure ulcer rates are being sought. Aims of the Study: The primary aim of this randomized, controlled trial (RCT) is to determine whether prophylactic application of Mepilex® Border Sacrum dressing (intervention) will reduce the incidence of pressure ulcers (PUs) in ICU patients, by reducing (Moisture; Friction; & Shear), compared to a control group receiving usual care (SKIN BUNDLE). Primary endpoint is to demonstrate a reduction in PU incidence. Secondary aims are to examine the role of multiple explanatory variables (age, sex, condition related factors; treatment and patient related factors) as correlates to the development of HAPUs. Research Hypotheses: H1.1    The rate of pressure ulcer prevalence will be significantly lower in the intervention group compared to the control group. H2.1    There will be a reduction in medical costs and resource utilization as measured by number of days of hospitalization. Study Design: A two-group study design was used with 734 critically ill patients, who were randomized in a 1:1 ratio, either to a prophylactic application of the Mepilex® Border Sacrum dressing intervention or a control group. All patients admitted to the ICUs, with a Braden Scale Score < 13, and intact skin, were enrolled in the study. Demographic data and severity of illness was collected at baseline. Patients remain in the study during their ICU stay, and  are tracked (post-ICU discharge) through the EMR, for HAPU incidence/mortality, until hospital discharge. Intervention Group – Subjects receive Usual Care (SKIN BUNDLE) and application of the Mepilex® Border Sacrum dressing, which is changed every 3 days and prn. Each shift, skin assessment is done on all subjects, including lifting the edge of the dressing to check the sacral area beneath the dressing. We also examine the integrity of the Mepilex® Border dressing. Control Group – Usual Care including daily evidence-based care identified in the SKIN BUNDLE. The Braden score, use of SKIN bundle & skin condition is recorded daily. This RCT study is in progress. Descriptive statistics will be used to describe the sample population demographics, co-morbidities, and HAPU incidence rate. Pearson’s Correlation will be used to examine for particular risks, as correlates to the development of HAPUs. Statistical significance is p <.05. Implications for Nursing: By analyzing all HAPUs, education/ interventions can be implemented with a goal of zero HAPUs, which is part of the national Bold Safety Goals and the Institute for Healthcare Improvement’s “5 Million Lives”. Findings contribute to nursing science and also serve as a driver for evidence based changes in our current clinical practices.
Keywords:
Hospital acquired pressure ulcers; HAPUs; Prevention
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5588
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleUSE OF A SILICONE DRESSING TO REDUCE PRESSURE ULCERS: A RANDOMIZED TRIALen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211629-
dc.description.abstractBackground: Skin integrity is identified as a measure of nursing care quality, yet hospital acquired pressure ulcers (HAPUs) are a major health problem, due to patient morbidity, treatment/legal costs and reimbursement issues.  Development of HAPUs is related to pressure, shear and/or friction.  These can be prevented/treated if identified in the early stages. HAPUs cause harm to patients, impact their quality of life, prolong length of stay; and may prove fatal.  In the acute care setting, HAPU incidence ranges from 14% to 17%, thus more scientific interventions to decrease pressure ulcer rates are being sought. Aims of the Study: The primary aim of this randomized, controlled trial (RCT) is to determine whether prophylactic application of Mepilex® Border Sacrum dressing (intervention) will reduce the incidence of pressure ulcers (PUs) in ICU patients, by reducing (Moisture; Friction; & Shear), compared to a control group receiving usual care (SKIN BUNDLE). Primary endpoint is to demonstrate a reduction in PU incidence. Secondary aims are to examine the role of multiple explanatory variables (age, sex, condition related factors; treatment and patient related factors) as correlates to the development of HAPUs. Research Hypotheses: H1.1    The rate of pressure ulcer prevalence will be significantly lower in the intervention group compared to the control group. H2.1    There will be a reduction in medical costs and resource utilization as measured by number of days of hospitalization. Study Design: A two-group study design was used with 734 critically ill patients, who were randomized in a 1:1 ratio, either to a prophylactic application of the Mepilex® Border Sacrum dressing intervention or a control group. All patients admitted to the ICUs, with a Braden Scale Score < 13, and intact skin, were enrolled in the study. Demographic data and severity of illness was collected at baseline. Patients remain in the study during their ICU stay, and  are tracked (post-ICU discharge) through the EMR, for HAPU incidence/mortality, until hospital discharge. Intervention Group – Subjects receive Usual Care (SKIN BUNDLE) and application of the Mepilex® Border Sacrum dressing, which is changed every 3 days and prn. Each shift, skin assessment is done on all subjects, including lifting the edge of the dressing to check the sacral area beneath the dressing. We also examine the integrity of the Mepilex® Border dressing. Control Group – Usual Care including daily evidence-based care identified in the SKIN BUNDLE. The Braden score, use of SKIN bundle & skin condition is recorded daily. This RCT study is in progress. Descriptive statistics will be used to describe the sample population demographics, co-morbidities, and HAPU incidence rate. Pearson’s Correlation will be used to examine for particular risks, as correlates to the development of HAPUs. Statistical significance is p <.05. Implications for Nursing: By analyzing all HAPUs, education/ interventions can be implemented with a goal of zero HAPUs, which is part of the national Bold Safety Goals and the Institute for Healthcare Improvement’s “5 Million Lives”. Findings contribute to nursing science and also serve as a driver for evidence based changes in our current clinical practices.en_GB
dc.subjectHospital acquired pressure ulcersen_GB
dc.subjectHAPUsen_GB
dc.subjectPreventionen_GB
dc.date.available2012-02-20T12:05:03Z-
dc.date.issued2012-02-20T12:05:03Z-
dc.date.accessioned2012-02-20T12:05:03Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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