Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Pressure Ulcer Rate in Multidisciplinary Hospital Units After Multifactorial Intervention: A Stepped-Wedge, Cluster Randomized Controlled Trial Publisher Pubmed



Jafary M1 ; Adibi H2 ; Shayanfard K3 ; Zohdi M1 ; Godarzi Z4 ; Yaseri M5 ; Najafpour Z6, 7
Authors
Show Affiliations
Authors Affiliations
  1. 1. Shariati Hospital, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. University of Luxembourg, Luxembourg City, Luxembourg
  4. 4. Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Health Care Management, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  7. 7. Health care Management Group, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Golestan street, Ahvaz, Iran

Source: Journal of Patient Safety Published:2018


Abstract

Objectives: This study was conducted to measure the effectiveness of interventions in decreasing the rates of pressure ulcer in a general hospital setting. Methods: Sixteen units in a general hospitals in Iran participated in this stepped-wedge, cluster randomized controlled trial during a 45-week study period. This trial has a one-sided crossover design from control to intervention. The units were randomly assigned fulfilling entry criteria. After the approval by the governing board of hospital, the manipulative intervention, in addition to usual care, was implemented on patients with a Braden criterion of 14 or less. The primary outcome was ulcer specification (grade and location of ulcer), and the secondary outcome was the length of hospital stay. Results: A total of 18,900 patients were admitted during the 45-week study period in the study units, of whom approximately 20% (3846 patients) were identified as high risk according to the items of Braden scale criteria during the admission assessment by nurses. The highest rate of PUs (80%) was in grade 2, and 16% of patients had grade 3 and 4 PUs. The ulcers of the skin overlying the sacrum and hip areas were the most common sites in the patients under study. The rates of PU in the control, training, and intervention phases were 5.49 (4.72-6.34), 5.68 (3.82-8.15), and 4.62 (3.87-5.47), respectively, per 1000 patient-days. Conclusions: The multifaceted intervention proposed by the present study has succeeded in reducing rate of pressure ulcer. Multifaceted programs based on training are appropriate ways to provide essential information to patients and their caregivers, which result in improvement of their participation in therapeutic process. We recommend hospitals to use these findings as a quality improvement plan for decreasing the rate of pressure ulcer. © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Related Docs
1. Pressure Ulcer Following Circumferential Head Dressing, Orbit (London) (2020)
2. Effect of Intensive Care Unit Nurses' Empowerment Program on Ability in Visual Differential Diagnosis of Pressure Ulcer Classification, Critical Care Nursing Quarterly (2019)
3. Transdermal Wound Oxygen Therapy on Pressure Ulcer Healing: A Single-Blind Multi-Center Randomized Controlled Trial, Iranian Red Crescent Medical Journal (2015)
Experts (# of related papers)
Maryam Esmaeili (1)
Nahid Dehghan Nayeri (1)