Pressure Ulcer Prevention: a Turn and Positioning System Combined With Incontinence Care and Tailored/Standard Repositioning

NCT ID: NCT02690753

Last Updated: 2018-03-09

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

NA

Total Enrollment

227 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-29

Study Completion Date

2017-12-31

Brief Summary

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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.

Detailed Description

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Conditions

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Pressure Ulcers Incontinence-associated Dermatitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Tailored repositioning + Standardised incontinence care + TAP

A protocol tailored to individual risk factors will be applied to patients at risk.Comfort Shield® barrier cream cloths will be used for incontinence care every morning and after each episode of incontinence. The Prevalon® Turn and Position System 2.0, SAGE will be used for turning and positioning patients at risk when laying in bed.

Group Type EXPERIMENTAL

A protocol tailored to individual risk factors

Intervention Type PROCEDURE

The Prevalon® Turn and Position System 2.0

Intervention Type DEVICE

Comfort Shield® barrier cream cloths

Intervention Type DEVICE

Standard repositioning + Standardised incontinence care + TAP

Instead of developing and using a tailored pressure ulcer prevention protocol, patients will receive standard care.Comfort Shield® barrier cream cloths will be used for incontinence care every morning and after each episode of incontinence. The Prevalon® Turn and Position System 2.0, SAGE will be used for turning and positioning patients at risk when laying in bed.

Group Type EXPERIMENTAL

The Prevalon® Turn and Position System 2.0

Intervention Type DEVICE

Comfort Shield® barrier cream cloths

Intervention Type DEVICE

Usual care

Instead of developing and using a tailored pressure ulcer prevention protocol, patients will receive standard care. Instead of using comfort Shield® barrier cream cloths, incontinence care will be given to patients using the standard procedure on the ward. Instead of using the turn and position system, patients will be turned according to the standard procedure on the ward.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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A protocol tailored to individual risk factors

Intervention Type PROCEDURE

The Prevalon® Turn and Position System 2.0

Intervention Type DEVICE

Comfort Shield® barrier cream cloths

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* At risk of developing pressure ulcers (Braden score \< 17)
* Maximum 24hours admitted on the ward at the time of inclusion
* Expected lenght of stay: 8 days
* Free of pressure ulcers category II, II, IV and incontinence-associated dermatitis (IAD) category 2 at the start of the study

Exclusion Criteria

\- Patients with no active or supportive therapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Sage Products, LLC

INDUSTRY

Sponsor Role collaborator

University Ghent

OTHER

Sponsor Role lead

Responsible Party

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UCVV

University Centre for Nursing and Midwifery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dimitri Beeckman, PhD

Role: PRINCIPAL_INVESTIGATOR

University Ghent

Locations

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AZ St. Maarten

Duffel, Antwerpen, Belgium

Site Status

AZ St. Dimpna

Geel, Antwerpen, Belgium

Site Status

AZ Nikolaas campus Beveren

Beveren, Oost-Vlaanderen, Belgium

Site Status

UZ Gent

Ghent, Oost-Vlaanderen, Belgium

Site Status

AZ Oudenaarde

Oudenaarde, Oost-Vlaanderen, Belgium

Site Status

ASZ Aalst

Aalst, , Belgium

Site Status

AZ Monica

Antwerp, , Belgium

Site Status

ZNA Hoge Beuken

Antwerp, , Belgium

Site Status

ZNA St. Elisabeth

Antwerp, , Belgium

Site Status

Imelda Ziekenhuis

Bonheiden, , Belgium

Site Status

AZ St. Jan Brugge

Bruges, , Belgium

Site Status

ASZ Geraardsbergen

Geraardsbergen, , Belgium

Site Status

AZ Delta Menen

Menen, , Belgium

Site Status

AZ St. Jan Oostende

Ostend, , Belgium

Site Status

AZ Delta Roeselare

Roeselare, , Belgium

Site Status

Countries

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Belgium

References

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Beeckman D, Van Damme N, Schoonhoven L, Van Lancker A, Kottner J, Beele H, Gray M, Woodward S, Fader M, Van den Bussche K, Van Hecke A, De Meyer D, Verhaeghe S. Interventions for preventing and treating incontinence-associated dermatitis in adults. Cochrane Database Syst Rev. 2016 Nov 10;11(11):CD011627. doi: 10.1002/14651858.CD011627.pub2.

Reference Type BACKGROUND
PMID: 27841440 (View on PubMed)

Beeckman D, Van Lancker A, Van Hecke A, Verhaeghe S. A systematic review and meta-analysis of incontinence-associated dermatitis, incontinence, and moisture as risk factors for pressure ulcer development. Res Nurs Health. 2014 Jun;37(3):204-18. doi: 10.1002/nur.21593. Epub 2014 Apr 3.

Reference Type BACKGROUND
PMID: 24700170 (View on PubMed)

De Meyer D, Van Hecke A, Verhaeghe S, Beeckman D. PROTECT - Trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning to increase repositioning compliance. J Adv Nurs. 2019 May;75(5):1085-1098. doi: 10.1111/jan.13932. Epub 2019 Jan 25.

Reference Type DERIVED
PMID: 30549321 (View on PubMed)

Related Links

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http://www.ucvvgent.be

Website of the research group

Other Identifiers

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PA2015/041

Identifier Type: -

Identifier Source: org_study_id

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