RCT on preventing pressure ulcers with seat cushions

使用座垫预防压疮的随机对照试验

• 批准号: 7460045
• 负责人: David Michael Brienza
• 金额: $ 6.23万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-25 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7460045
• 关键词: Caring; Cessation of life; Clinical; Clinical Trials Data Monitoring Committees; Decubitus ulcer; Elderly; End Point; Equipment; Equipment and supply inventories; Evaluation; Failure; Funding; Health Care Costs; Healthcare; Incidence; Intervention; Investigation; Level of Evidence; Long-Term Care; Long-Term Care for Elderly; Manuals; Measures; Medicare; Monitor; Numbers; Operative Surgical Procedures; Participant; Patient Monitoring; Patients; Phase; Pilot Projects; Population; Populations at Risk; Positioning Attribute; Prevalence; Prevention; Preventive; Protocol Compliance; Protocols documentation; Publishing; Quality of life; Randomized; Range; Rate; Recruitment Activity; Research; Research Personnel; Research Training; Risk; Sample Size; Specialist; Standards of Weights and Measures; Surveys; Testing; Time; United States; United States Centers for Medicare and Medicaid Services; Wheelchair fitting; Wheelchairs; Work; Writing; beneficiary; clinical research site; cost; design; improved; loss of function; medically necessary care; patient safety; prescription document; prescription procedure; pressure; prevent

Pressure ulcers (PU) are a significant healthcare problem for the growing number of United States (US) elderly long-term care (LTC) residents. PU diminish quality of life, exact a devastating loss of function, increase the risk of death in geriatric populations and raise healthcare costs. Despite Federal preventive mandates for the long-term care (LTC) setting, widespread non-compliance occurs. The last three Centers for Medicare and Medicaid Services (CMS) LTC surveys showed a cumulative increase of 21% in the number of citations issued for failure to provide proper intervention to prevent or treat pressure ulcers. Costs for the management of PU in the US likely exceed $6.4 billion annually, with a prevalence of approximately 28% in the LTC population. Estimates of the prevalence of sitting-acquired PU in the elderly, at-risk population range from 36-50%. Several studies, including our own pilot investigation, support these estimates and have suggested that the use of wheelchair cushions designed to reduce interface pressure will reduce the incidence of sitting-acquired PU. Despite this evidence, eldedy wheelchair users are not routinely evaluated for seating and positioning needs bacause definitive studies have not been completed to justify funding for such seating interventions. Consequently, elderly Medicare beneficiaries are being denied access to medically necessary and clinically appropriate interventions. Instead, they are most frequently provided with convoluted or segmented-foam cushions that are not designed for pressure ulcer prevention. The primary aim of the proposed multi-center, randomized pressure-reducing wheelchair cushion trial (PRWC-II) is to determine the efficacy of pressure-reducing cushions in preventing sitting-acquired pressure ulcers in the elderly, LTC population. Positive results of the proposed trial will provide the level of evidence needed to change the standard of care to include the routine evaluation of at-risk residents for seating and positioning needs and the provision of a pressure-reducing cushion as a preventive measure against sitting- acquired pressure ulcers. If our hypothesis is correct, such an intervention should result in a decrease in the incidence and prevalence of sitting-acquired pressure ulcers, reduced healthcare costs, and improved quality of life.

对于越来越多的美国人来说，压疮（PU）是一个重要的医疗保健问题。