Pressure Ulcers Clinical Trial
Official title:
A Turn and Positioning System and Standardized Incontinence Care Combined With Tailored Repositioning Versus a Standard Repositioning Protocol for Pressure Ulcer Prevention: A Multicenter Prospective Randomized Controlled Clinical Trial and Health Economical Analysis in a Hospital Setting
The prevalence of pressure ulcer in hospitals is 7,3% - 23%. The primary etiological factors
are pressure or pressure combined with shear. Prevention is very important and comprises:
preventive skin care including cleansing and protecting the skin from exposure to moisture,
the systematic repositioning of the patient, the offloading of the heels from the surface of
the bed, the use of adequate bed support surfaces and an adequate nutritional status. The
development and implementation of a risk based prevention plan for individuals identified as
being at risk is strongly recommended. Limited compliance exists towards pressure ulcer
preventive interventions. 25,5% of the patients at risk receive fully adequate prevention in
bed. The reposition frequence is adequate in 55% of patients at risk. There is a lack of
rigorously performed research addressing the effectiveness of devices or risk based protocols
to improve compliance. Health care budgets are limited, priorities should be set in the
allocation of health care resources.
The primary aim of this study is to compare the effectiveness of the turn and position system
(Prevalon®Turn and Position System 2.0, SAGE) versus standard care to improve reposition
frequence in patients at risk. The second aim is to compare the effectiveness of a tailored
protocol versus standard care to improve reposition frequence in patients at risk. The third
aim is to compare the effectiveness of standardized incontinence care versus standard care to
improve the incidence of pressure ulcers and incontinence-associated dermatitis (IAD). Also a
health economic evaluation will be performed.
The study will be performed in hospital setting (university and general hospitals) in a
random sample of 226 patients aged > 18 who are at risk of developing pressure ulcers.
Patients will be recruited from three types of wards: intensive care units, geriatric wards
and rehabilitation wards. Patients will be included in the study for a period of 8 days.
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