Pressure Ulcer Multi-disciplinary Teams Via Telemedicine (PUMTT): A Trial in Long Term Care

NCT ID: NCT01232764

Last Updated: 2012-09-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

137 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-10-31

Study Completion Date

2012-03-31

Brief Summary

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The purpose of this study is to evaluate the effectiveness of 'enhanced' multi-disciplinary wound care teams (MDTs) vs. 'usual' care teams in Long Term Care (LTC) facilities in Ontario for the treatment of pressure ulcers. LTC facilities with more than 100 beds that are within a 100 km distance from St. Mikes and have a problem with pressure ulcers will be asked to participate. A total of 10 LTC facilities will be randomly selected (i.e. selected by chance) from those that agree to participate.

The 'enhanced' MDT will be an Advance Practice Nurse(APN) with expertise in wound care who has direct access to the wound care team at St. Mikes. This APN will develop treatment plans in consultation with facility staff, providing targeted pressure ulcer treatment education on an ongoing, case by case basis. Care is supported by telemedicine with the use of digital photography and online communication between members of the care team.

This study is a stepped wedge randomized trial, meaning LTC facilities are assigned to a start date for this study totally by chance. Changes in healing rates, wound related pain, cost, number of new pressure ulcers, and number of wounds healed will be measured before, and after the APN is introduced to facilities. In order to gain more insight into how people felt about this model of care, interviews will be held with individuals and groups of staff at 5 randomly selected facilities before, during, and after the study has been completed.

Detailed Description

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Conditions

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Pressure Ulcers Multi-disciplinary Wound Care Teams Remote Support Digital Wound Photography

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Multi-disciplinary wound care team

Stepped wedge study design i.e. start date of exposure is randomized.

Group Type EXPERIMENTAL

Exposure to multi-disciplinary wound care team

Intervention Type OTHER

Phase 1: In Person Support (3 mths)

Advance Practice Nurses (APNs) affiliated with Enhanced Multi-Disciplinary visit LTC facilities on a weekly basis. The APN may communicate with other members of an EMDT via telephone or online.EMDTs will collectively teach and mentor LTC facility wound care teams throughout the study.

Phase 2: Remote Support (2-11 mths) In the second phase, EMDTs will support LTC facility staff remotely via telephone and online communication, visiting the facilities on an as needed basis only.

All PU treatment will be based on RNAO evidence-based guidelines (updated in 2007)contextualized to the LTC setting.

Interventions

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Exposure to multi-disciplinary wound care team

Phase 1: In Person Support (3 mths)

Advance Practice Nurses (APNs) affiliated with Enhanced Multi-Disciplinary visit LTC facilities on a weekly basis. The APN may communicate with other members of an EMDT via telephone or online.EMDTs will collectively teach and mentor LTC facility wound care teams throughout the study.

Phase 2: Remote Support (2-11 mths) In the second phase, EMDTs will support LTC facility staff remotely via telephone and online communication, visiting the facilities on an as needed basis only.

All PU treatment will be based on RNAO evidence-based guidelines (updated in 2007)contextualized to the LTC setting.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* LTC facility must be located within the Toronto Central or Central LHIN geographic boundaries.
* LTC facility must be \<100 km from the St. Michael's Hospital wound care team.
* LTC facility must be entering data into MDS.
* LTC facility administrator must consent to participate.
* LTC facility must report a PU prevalence rate \>5.5% in the 4th quarter 2009 MDS. \[This is the average pressure ulcer prevalence rate for Ontario LTC facilities as reported by the Canadian Institute of Health Information (CIHI) in the 4th quarter 2009.\]
* Individual with PU (or Substitute Decision Maker (SDM)) must provide informed consent.

Exclusion Criteria

* LTC facility \<100 beds.
* LTC facility \>100 km from the St. Michael's Hospital wound care team
* LTC facility reporting a PU prevalence rate \< 5.5% in the 4th quarter 2009 MDS.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ontario Ministry of Health and Long Term Care

OTHER_GOV

Sponsor Role collaborator

Canadian Patient Safety Institute

OTHER

Sponsor Role collaborator

Central Community Care Access Center

UNKNOWN

Sponsor Role collaborator

University of Toronto

OTHER

Sponsor Role lead

Responsible Party

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Anita Stern

Researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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12 Long Term Care Facilities

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Stern A, Mitsakakis N, Paulden M, Alibhai S, Wong J, Tomlinson G, Brooker AS, Krahn M, Zwarenstein M. Pressure ulcer multidisciplinary teams via telemedicine: a pragmatic cluster randomized stepped wedge trial in long term care. BMC Health Serv Res. 2014 Feb 24;14:83. doi: 10.1186/1472-6963-14-83.

Reference Type DERIVED
PMID: 24559218 (View on PubMed)

Related Links

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http://www.theta.utoronto.ca

Toronto Health Economic Technology Assessment collaborative

Other Identifiers

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25048

Identifier Type: -

Identifier Source: org_study_id