In the U.S., 2.5 million pressure ulcers are treated each year in acute care facilities alone, estimated at a staggering cost of $11 billion. The cost of treating an individual pressure ulcer ranges from $500 to $40,000 depending on the severity of the wound. The prevalence of pressure ulcers in Canada has been found to be at least as high as in the U.S., with an average of one in four patients across healthcare settings suffering from a pressure ulcer (ref: Prevalence of pressure ulcers in Canadian healthcare settings, Ostomy Wound Management; 2004; 50 (10): 22 38).
"There seems to be a huge mismatch between the billions of dollars we're spending on treating this condition, including an incredible amount of nursing time, and the relatively little effort in determining best practices for prevention," says Dr. Paula Rochon, a geriatrician and senior scientist at Baycrest, and senior author on the study.
Using MEDLINE and other databases, the research team identified only 59 randomized control trials of pressure ulcer prevention conducted over the last 30 years, involving a total of 13,845 patients. Fifty-nine studies in 30 years, say researchers, is a surprisingly meager research effort given the magnitude of the problem. Most of the patients in the studies were in acute care hospitals (67%), 17% were in long-term care, and the rest in rehabilitation or mixed care settings. Prevention methods included use of specialized mattresses, repositioning, mixed nutritional supplements and skin lotions.
To assess the scientific rigor of the studies, investigators applied a checklist (CLEAR NPT quality-rating guidelines) for non-pharmacological interventions. The checklist included indicators such as adequate randomized selection of participants for the study, assessor and patient blinding to the intervention, and consistent follow-up schedule.
Results
Only three of the 59 studies fulfilled
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Contact: Kelly Connelly
kconnelly@baycrest.org
416-785-2432
Baycrest
22-Aug-2006