Heel protection for pressure ulcer prevention: from prehospital patient care to discharge

Plain English summary of protocol

Background and study aims
Since 2007, patient safety issues which include pressure ulcers prevention are on top of the Swedish healthcare’s agenda. Research has shown that the incidence of hospital-acquired pressure ulcers on the sacrum (the large bone at the base of the spinal cord) has decreased, probably due to the increase of use of pressure ulcers prevention mattresses. However, the incidence of hospital-acquired pressure ulcers on the heels is still present.
Pressure ulcers cause suffering for the patient and considerable costs for health care. Pressure damage can occur quickly (within hours), depending on the individual patient's risk factors and it is important that preventive actions will start as soon as possible. That can already start in ambulances. Ambulances in Sweden are equipped with conventional stretchers (without pressure relief function) and the length of transport may vary from a few minutes and hours. No study, either international or national, has been done on the development of pressure ulcers across the continuum of care, from the ambulance to the hospital. To our knowledge, no research has so far identified the best method to prevent this kind of pressure ulcers. The aim of the study is to investigate the effects of an early treatment (Heelift – heel pressure ulcers prevention boot) on hospital-acquired heel pressure ulcers.

Who can participate?
Patients over 70 years of age, with neurological symptoms or reduced general condition, transferred by ambulance to the emergency department will be invited to participate in this study.

What does the study involve?
Patients will be randomly allocated to one of two groups: the intervention group or the control group.
Patients in the intervention group will receive a heel pressure ulcers prevention boot on both heels. This prevention boot will be used during the whole hospital stay (emergency department, ward). At the end of the hospital stay, the patients will be asked to evaluate the use of the prevention boot, regarding usefulness, comfort and acceptance. Patients in the control group will receive standard pressure ulcers prevention care. Both groups of patients will have their heels assessed for pressure ulcers regularly.

What are the possible benefits and risks of participating?
The patient's level of risk for development of pressure ulcers will be assessed. Patients will also have their heels assessed for pressure ulcers regularly during their hospital stay. These assessments will take place in the ambulance, in the emergency department and throughout the entire hospital stay.
There will no risks to the patients. Participation in this study will not delay any need of medical care.

Where is the study run from?
The study is run from the following study sites: the ambulance care in Uppsala County Council, Uppsala University Hospital, the ambulance care in County Council of Värmland and Karlstad Central Hospital (Sweden).

When is the study starting and how long is it expected to run for?
The study started in May 2011 and is expected to be finished in April 2013.

Who is funding the project?
This study is funded by Uppsala University Hospital, Karlstad University, Uppsala County Council, Varmland County Council and Uppsala-Örebro Regional Research Council (Sweden).

Who is the main contact?
Principal Investigator: Asa Muntlin Athlin, asa.muntlin@pubcare.uu.se
Research Site Manager, County Council of Värmland: Carina Baath

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• Sweden

Study participating centre

Sponsor information

Funders

Funder type

Research council

Results and Publications

Study outputs

Editorial Notes

17/12/2020: Publication reference added.