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PROTECT - Trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning to increase repositioning compliance
Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.ORCID iD: 0000-0003-3080-8716
2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 5, p. 1085-1098Article in journal (Refereed) Published
Abstract [en]

AIM: To study the effectiveness of tailored repositioning and a turning and repositioning system on: (1) nurses' compliance to repositioning frequencies; (2) body posture of patients after repositioning; (3) incidence of pressure ulcers and incontinence-associated dermatitis; (4) nurses' and patients' preferences, comfort and acceptability; and (5) budget impact.

BACKGROUND: Patient-tailored systematic repositioning is key in pressure ulcer prevention. To date, a clinical decision-making tool is lacking and compliance to pressure ulcer prevention guidelines is low. Research concerning commercially available turning and repositioning systems is lacking.

DESIGN: Multicentre, cluster, three-arm, randomised, controlled pragmatic trial.

METHODS: Two hundred twenty-seven patients at risk of pressure ulcer development were recruited at 29 wards in 16 hospitals between February 2016 - December 2017. Wards were randomly assigned to two experimental groups and one control group.

RESULTS: Nurses' compliance to repositioning frequencies increased significantly in the experimental groups when patients were cared for in bed (94.6% versus 69% and 84.9% versus 71.4%). Applying the turning and repositioning system was associated with significantly more correctly positioned patients (30-45° tilted side-lying position) (69.6% versus 34.6%). Few pressure ulcers and incontinence-associated dermatitis incidents occurred. Both patients and nurses were positive about the intervention. Higher labour costs related to repositioning in bed were found in the control group.

CONCLUSION: This was the first study investigating the effect of tailored repositioning and the use of a repositioning aid to increase nurses' compliance to repositioning. The results were in favour of the interventions yet demonstrating the importance of follow-up and education.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019. Vol. 75, no 5, p. 1085-1098
Keywords [en]
Cluster randomised trial, compliance, medical device, nursing, pressure ulcer, prevention, repositioning, tailored
National Category
Surgery Nursing
Identifiers
URN: urn:nbn:se:oru:diva-70800DOI: 10.1111/jan.13932ISI: 000465107000017PubMedID: 30549321Scopus ID: 2-s2.0-85060575209OAI: oai:DiVA.org:oru-70800DiVA, id: diva2:1271924
Note

Funding Agency:

Sage Products LLC Cary Illinois USA 

Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2019-06-18Bibliographically approved

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Beeckman, Dimitri

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