Pressure Injury、Caregiver、Knowledge Translation

Pressure Ulcer Clinical Trial

Official title:

Evaluate Knowledge Translation Care Plan on Knowledge, Attitude, and Practice of Caregivers and Care Effects of Patients With Pressure Injury

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06128005
• Other study ID #: pressureinjury853121
• Status: Recruiting
• Phase: N/A
• Start date: October 1, 2020
• Est. completion date: June 2, 2024

Study information

• Verified date: March 2024
• Source: National Defense Medical Center, Taiwan
• Contact: Yi-Syuan Lai
• Phone: 886-0925810218
• Email: family8531[@]hotmail.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Background and importance:

In 2003, a pressure injury is listed as one of the indicators of care quality in clinical setting by Taiwan joint commission on hospital accreditation. That reflects that a pressure injury is a significant heath care issue. Nowadays, it still constantly happens at hospitals, home, and nursing homes: Pressure injuries cause pain, and increase length of hospital stay, rehospitalization rate, and death rate. In current clinical practice, standardized guidelines and basic principles are followed for pressure injury management, and it is found that most of the caregivers are unsure about what are the consequences of having pressure injuries and how to manage and prevent them. Therefore, the caregivers are more passive, and feel nervous and confused. In literature, there are guidelines for pressure injury prevention and management. However, they are primarily designed for heath professionals. As a result, to achieve evidence-based practice and knowledge translation, I hope to make individual management plans for each patient, provide caring support, and follow up with patients. And caregivers can benefit from knowledge, attitude, practice, and caring effect.

Description:

Goals:

The study aims to achieve knowledge translation in nursing for pressure injury care. The caregivers of patients with pressure injuries and their family can benefit from translating of knowledge, attitude, and practice, and they can have more knowledge related to pressure injuries, and learn how to react to and care for patients. In this way, it will be possible to promote wound healing and prevent recurrence of pressure injuries.

Method:

This study is a randomized controlled trial. There are seventy participants. The experimental group receives care plans in which knowledge translation is applied, and the control group receives usual care. Generalized estimating equations, GEE, is used to assess the effectiveness of care plans with knowledge translation for patients and family with pressure injuries.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 70
• Est. completion date: June 2, 2024
• Est. primary completion date: March 2, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 0 Years to 100 Years

Eligibility

Inclusion Criteria:

1. Grade 1-3 pressure injury diagnosed by medical staff.

2. The patient needs to have a caregiver.

3. The patient and the caregiver need to be older than 20 years old, (4) The informed consent of this study.

(5) The caregiver Those who understand the content of health education (MMSE>24 points)

Exclusion Criteria:

1. The patient has >3 disease diagnoses,

2. The patient is diagnosed by a doctor as a terminally ill patient or the life expectancy is less than 3 months,

3. There is a life-threatening acute problem (active bleeding site, acute myocardial infarction, acute bronchitis, etc. ),

4. pressure injury caused by invasive pipeline placement,

5. need to wear non-invasive positive pressure respirator, (6) need to stay in intensive care center for a long time (>10 days),

6. need a long time For surgical patients, each operation takes > 5 hours,

7. the caregiver has dementia,

8. the caregiver has mental illness or alcohol and drug addiction,

9. no caregiver.

Related Conditions & MeSH terms

• Crush Injuries
• Pressure Injury
• Pressure Ulcer
• Wounds and Injuries

Intervention

Behavioral:
• knowledge translation in nursing for pressure injury care
Pressure injury's knowledge and healing of wound.

Locations

Country	Name	City	State
Taiwan	Vivian	Keelung	Zhongzheng District

Sponsors (1)

Lead Sponsor	Collaborator
Yi-Syuan Lai

Country where clinical trial is conducted

Taiwan, 

References & Publications (8)

Cuddigan J, Haesler E, Moore Z, Carville K, Kottner J. Development, dissemination and evaluation of a smartphone-based app for pressure ulcer/injury prevention and treatment for use at the bedside. J Wound Care. 2022 Dec 1;31(Sup12):S29-S39. doi: 10.12968/jowc.2022.31.Sup12.S29. — View Citation

Haesler E, Pittman J, Cuddigan J, Law S, Chang YY, Balzer K, Berlowitz D, Carville K, Kottner J, Litchford M, Moore Z, Mitchell P, Sigaudo-Roussel D. An exploration of the perspectives of individuals and their caregivers on pressure ulcer/injury prevention and management to inform the development of a clinical guideline. J Tissue Viability. 2022 Feb;31(1):1-10. doi: 10.1016/j.jtv.2021.10.008. Epub 2021 Oct 30. — View Citation

Jeyathevan G, Cameron JI, Craven BC, Jaglal SB. Identifying Required Skills to Enhance Family Caregiver Competency in Caring for Individuals With Spinal Cord Injury Living in the Community. Top Spinal Cord Inj Rehabil. 2019 Fall;25(4):290-302. doi: 10.1310/sci2504-290. — View Citation

Lin F, Wu Z, Song B, Coyer F, Chaboyer W. The effectiveness of multicomponent pressure injury prevention programs in adult intensive care patients: A systematic review. Int J Nurs Stud. 2020 Feb;102:103483. doi: 10.1016/j.ijnurstu.2019.103483. Epub 2019 Nov 21. — View Citation

Mervis JS, Phillips TJ. Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019 Oct;81(4):881-890. doi: 10.1016/j.jaad.2018.12.069. Epub 2019 Jan 18. — View Citation

Munoz N, Posthauer ME, Cereda E, Schols JMGA, Haesler E. The Role of Nutrition for Pressure Injury Prevention and Healing: The 2019 International Clinical Practice Guideline Recommendations. Adv Skin Wound Care. 2020 Mar;33(3):123-136. doi: 10.1097/01.ASW.0000653144.90739.ad. — View Citation

Santamaria N, Gerdtz M, Sage S, McCann J, Freeman A, Vassiliou T, De Vincentis S, Ng AW, Manias E, Liu W, Knott J. A randomised controlled trial of the effectiveness of soft silicone multi-layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: the border trial. Int Wound J. 2015 Jun;12(3):302-8. doi: 10.1111/iwj.12101. Epub 2013 May 27. — View Citation

Tescher A, Deppisch M, Munro C, Jorgensen V, Cuddigan J. Perioperative pressure injury prevention: National Pressure Injury Advisory Panel root cause analysis toolkit 3.0. J Wound Care. 2022 Dec 1;31(Sup12):S4-S9. doi: 10.12968/jowc.2022.31.Sup12.S4. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	wound healing	PUSH tool. Measure Length x Width, Exudate Amount and Tissue Type in pressure injury.	6 weeks and 12 weeks
Primary	caregiver's knowledge	Using a self-made questionnaire, the informal caregivers' knowledge of pressure injuries, such as: how does a pressure injury form, what are the care methods for a pressure injury, what should be prepared for wound care, methods to prevent a pressure injury, etc.	6 weeks and 12 weeks
Primary	caregiver's attitude	Use the self-made questionnaire to understand the caregivers' attitudes towards pressure injuries, such as whether they have motivation to care for them, whether they think it is important to prevent pressure injuries, whether they are confident that they can take good care of them, etc.	6 weeks and 12 weeks
Primary	caregiver's practice	Using a self-made questionnaire, the caregiver actually evaluates the situation of caring for the crush injury, such as: body positioning, repositioning, nutritional supply status, wound dressing change, wound grading assessment, body cleanliness, whether the protrusion of the bone is paid attention to, reducing Pressure equipment, etc.	6 weeks and 12 weeks
Secondary	The recurrence rate of pressure injury three months after intervention	Patients with reoccurrence of pressure injury/Total number of experimental group or control group*100%	12 weeks
Secondary	The rehospitalization rate	Number of patients re-admitted for pressure injuries /Total number of experimental group or control group *100%	12 weeks
Secondary	The mortality rate	The number of Patient deaths/Total number of experimental group or control group *100%	12 weeks