Maintaining and improving skin health are major goals in acute and long-term care. Patients at the extremes of age, the critically ill, medically compromised and those with immobility are at risk for developing several skin disorders, with pressure ulcers (PUs) as one of the most common and mostly preventable ones. Prevalence figures of PUs vary between 6.4% and 31.4%. PUs are described as localised injuries to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure combined with shear. Prevention of PUs is internationally seen to be a key quality indicator of care. To prevent PUs, reducing both the amount and the duration of pressure and shear at the pressure points of the body is strongly recommended. One of the interventions to achieving this, is the use of pressure-reducing devices (mattresses, cushions, etc.). Studies that compare the (cost-) effectiveness of different pressure-reducing devices are needed. The primary aim of this study is to compare the (cost-) effectiveness of pressure ulcer prevention in high risk patients using static air support devices (Repose®) versus alternating-pressure devices. The second aim is to get insight in patients' experiences and perceptions of comfort using static air support devices and alternating-pressure devices. The third aim is to get insight in caretakers' perceptions of barriers and facilitators of the use of static air support devices and alternating-pressure devices and to reveal how these perceptions influence the readiness to use the products in clinical practice. This randomized controlled trial will be performed in ca. 25 nursing homes in a random sample of 306 residents who are at high risk of developing pressure ulcers. Residents will be included in the study for a period of 14 days. Skin assessment and risk factor registration will be done on a daily basis by the nurses. Reliability checks and time measurements will be completed by the researcher.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
308
* Repose® Mattress * Repose® Cushion * Repose® Wedge or Foot Protectors
Woonzorgcentrum Zonnetij
Aartselaar, Antwerpen, Belgium
Woonzorgcentrum Zonnewende
Aartselaar, Antwerpen, Belgium
Woonzorgcentrum De Mick
Brasschaat, Antwerpen, Belgium
Woonzorgcentrum Sint-Maria
Brecht, Antwerpen, Belgium
Woonzorgcentrum Veilige Have
Aalter, Oost-Vlaanderen, Belgium
Woonzorgcentrum Sint-Jozef
Assenede, Oost-Vlaanderen, Belgium
Woonzorgcentrum De Vijvers
Gentbrugge, Oost-Vlaanderen, Belgium
Woonzorgcentrum Meulenbroek
Hamme, Oost-Vlaanderen, Belgium
Woonzorgcentrum Heilig Hart
Oudenaarde, Oost-Vlaanderen, Belgium
Woonzorgcentrum Egmont
Zottegem, Oost-Vlaanderen, Belgium
...and 16 more locations
Pressure ulcer incidence (Cat. II+)
Development of at least 1 pressure ulcer Cat. II+ during study period
Time frame: 14 days
Patient experiences and perceptions using a static air mattress
Patients experiences and perceptions of comfort using static air support devices and alternating-pressure mattresses. Patient acceptability \[tolerance, (sleep) comfort, pain)
Time frame: 14 days
Caretakers perceptions of barriers and facilitators to use static air mattress
Nurses acceptability \[barriers and facilitators\].
Time frame: 14 days
Incidence of incontinence-associated dermatitis (IAD)
Development of at least 1 IAD during study period
Time frame: 14 days
Cost of the intervention (Repose) versus the standard care (Alternating)
Economic measures (from an organizational and patient perspective)
Time frame: 14 days
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