An RCT to Determine the Effect of a Heel Elevation Device in Pressure Ulcer Prevention Post-hip Fracture
J. Donnelly, PhD., BSc (Hons) Health Studies, MCGI, RGN, ONC
A study (J. Donnelly, PhD., BSc (Hons) Health Studies, MCGI, RGN, ONC) published in the Journal of Wound Care (Vol 20, NO 7, July 2011) sets out to compare the differences between complete offloading and “standard care” in the prevention of heel pressure ulcers in post-hip fracture patients. The randomized control trial (RCT) was conducted in the fracture trauma unit of a major tertiary referral center in Belfast, Ireland.
Isabel Bales, RN/BSN/CWOCN
This experimental study compared the effectiveness of an intravenous bag with the Heelift Suspension Boot in preventing heel pressure ulcers. The study is the first to examine the effectiveness of intravenous bags in the prevention of heel ulcers.
By Theda Bordner, MSN, RN
Hip fracture patients are particularly vulnerable to sacral and heel pressure ulcers because of a lack of mobility. In this study, hip fracture patients who were given Heelift Suspension Boot to offload the heel did not develop any heel pressure ulcers.
H. Joanna Jiang, PhD., C. Allison Russo, M.P.H., Marguerite L. Barrett, M.S.
The Agency for Healthcare Research and Quality (AHRQ) H•Cup project (Healthcare Cost and Utilization) published a study in 2009 indicating that one out of every $10 hospitals spent in 2006 was spent on a preventable condition. The study notes that better ambulatory care, improved access to effective treatment, and more cooperation on the part of patients could have improved these statistics. The article emphasizes the importance of prevention especially in contrast to the costs of treatment.
Joan A. McInerney, MSN, RN, BC, CWOCN and Sandra K. Wheeler, BSN, RN, CWOCN | NCH Healthcare System, Naples, FL
This post illustrates the reduction of heel pressure ulcer prevalence at the NCH Healthcare System in Naples, Florida. The two-hospital system created a multi-disciplinary team that focused on assessment, consultation, and heel pressure ulcer prevention. Use of Heelift Suspension Boot was a key part of the new pressure ulcer protocol.
Nicole L. Sender RN, DNS, University Place Care Center, Tacoma, WA and Linda Manning PT, CWS, Physiotherapy Associates, Lakewood, WA
The purpose of this study was to see if amputation could be prevented by using more conservative treatment methods. A multi-disciplinary team used several tools, including Heelift® Suspension Boot, to help prevent amputation of limbs injured by pressure ulcers.
Barbara Delmore, Sarah Lebovits, Philip Baldock, Barbara Suggs, and Elizabeth Ayello describe their efforts to reduce heel pressure ulcers in their facility, which resulted in a decrease in heel pressure ulcer prevalence from 7.3% to 1.3% in 3 years.
With the increased focus on patient safety, healthcare costs, and quality care, it is critical that all medical facilities have processes in place that address pressure injury prevention. This webinar will focus on evidence-based interventions and strategies for the prevention of heel pressure ulcers. Identification of at risk patients, the relationship of anti-embolic stockings and heel injuries, legal concerns, and many other prevention and management issues will be addressed. Join us for this important presentation that will assist you and your facility in “Your Journey Towards Zero Prevalence of Heel Pressure Ulcers”, presented by Carolyn Cuttino, RN, BS, CWOCN.
A presentation by Dr. Diane Langemo, in association with Position Health, called Heel Pressure Ulcers: A to Z. This presentation includes important information about how heel pressure ulcers form, how they can be prevented, and why Heelift® boots effectively help prevent heel pressure ulcers.
serves as the authoritative voice for improved patient outcomes in pressure injury prevention and treatment through public policy, education and research. As longtime NPUAP Corporate Board Members, Position Health also recommends these webinars.
an Call, MS, CSM; Denis B. Drennan, MD; Sandra Dudziak, RN, BScN, MSc, FNP
This study used the North Carolina State University sweating foot manikin system to determine how different styles of heel offloading boots performed in terms of heat and water retention. Visit our white paper page to download the white paper titled, “Why Open Cell Foam is the Best Material for a Heel Offloading Boot” to learn more about the results of that study as it relates to pressure ulcer prevention.
Rose Raizeman, RN-EC, MSc, CETNc; Sandra Dudziak, RN, BScN, MSc, FNP
This purpose of this poster is to determine how effectively Heelift Glide and Heelift Classic boots help create a cooler, drier microclimate for improved pressure ulcer prevention. Two different third-party research groups tested these boots.
Sandra Dudziak, BScN, MS, NP, Revera LTC; Lisa McEwan, RN, Revera LTC; Grace Campo, DOC; Kennedy Lodge, Revera LTC; Evangeline Dara Uy, ADOC/WCC; Kennedy Lodge, Revera LTC
The first published (CAWC, ’14) clinical trial of its kind ever done in long term care. 30 residents across several homes were targeted with new standardized assessment tools as being at high risk for pressure injury. Heelift boots were introduced as a prevention intervention. In 6 months, no diabetic heel/foot ulcers developed and improvements of existing ulcers were observed.
Denis B. Drennan, MD
In this article, Dr. Denis B. Drennan, DM Systems founder, establishes a formula for figuring a facility’s heel pressure ulcer costs. Dr. Drennan also makes the case that investing in heel pressure ulcer prevention is more economical than treating heel pressure ulcers.
Denis B. Drennan, MD and Joseph W. Drennan, MIB
This poster offers an overview of the epidemiology, prevention, treatment, and costs of heel pressure ulcers.
Institute for Clinical Systems Improvement (ICSI). Pressure ulcer treatment. Health care protocol. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Jan. 28 p. [36 references]
Heel Pressure Ulcer Guidelines for treatment from the National Guideline Clearinghouse, the US Department of Health & Human Services, and the Agency for Healthcare Research and Quality (AHRQ). The emphasis in these guidelines is on education for patients, caregivers, and family members because education is a key component of prevention. Significantly, the guidelines also focus on the importance of pressure ulcer prevention plans and protocols.
Position Health surveyed wound care professionals at several different trade shows and conferences. Most notably, the respondents preferred heel offloading devices 6-1 over pillows.
This document summarizes years of Heelift Boot evaluations from wound care professionals who carefully trialed the product.
Evonne Fowler, RN,CNS, CWOCN; Suzy Scott-Williams, MSN, RN, CWOCN; and James B. McGuire, DPM, PT, CPed, CWS, FAPWC
This detailed article by Evonne Fowler, et. al., details why pressure relief or offloading is the most significant key to preventing heel pressure ulcers, including the difference between heel protectors versus heel offloading devices. The article also analyzes the “total patient” approach to preventing heel ulcers.
Desmond Bell, DPM | Podiatry Today
Diabetic heel ulcers pose particular challenges in the way of treatment because so many factors can impact the patient and the patient’s healing process. With those challenges in mind, this article details wound bed preparation, key considerations like offloading, and how peripheral arterial disease may affect a patient’s ability to heal.
Microclimate is becoming an increasingly important consideration in the prevention and treatment of heel pressure ulcers. This white paper begins with a clear definition of micrclimate and then goes on to explain why heat and moisture can contribute to skin breakdown in patients at risk for heel pressure ulcers. The ramifications of incorporating microclimate factors into a heel pressure ulcer prevention regiment are discussed last, including a summary of recent test results proving that heel offloading devices like Heelift Glide, with an open cell foam design, are better at releasing heat and moisture than other types of professional offloading devices.
In a recent study by the North Carolina State University College of Textiles, heel offloading boots made of different kinds of materials were tested for microclimate performance. In the study, open cell foam like that used in Heelift Brand Boots performed the best.
In 2008, heel pressure ulcers were categorized as “never events.” More recent search indicates, however, that facilities ultimately may have little control over the prevalence of heel pressure ulcers. While due diligence is non-negotiable, co-morbidities, microclimate, and end-of-life skin failure can all lead to heel pressure ulcers that will develop no matter what the facility does to prevent them. In this white paper, we explore why the categorization of heel pressure ulcers as “never” events may be unfair and how facilities can strive for seldom and hope for never.”
In far too many cases, a patient with a Stage III or IV heel pressure ulcer is left with no other option apart from amputation. This white paper describes how an integrated, multidisciplinary approach, together with Heelift Suspension Boot, prevented lower limb amputation in one patient who had a severe heel pressure ulcer.
This white paper outlines the different facets that a heel pressure ulcer protocol incorporates. Included is information on assessment of skin for patients who have or who are at risk for heel pressure ulcers, heel pressure ulcer prevention, and how to choose the proper heel offloading device.
The National Quality Forum, together with the Center for Medicare and Medicaid Services, categorized Heel Pressure Ulcers (HPUs) as “never events” in 2008. Five years later, a “perfect storm” of obstacles has evolved that makes preventing hospital-acquired pressure ulcers more difficult. These obstacles include documented nurse shortages, newly discovered complexities about why patients develop pressure ulcers, and a rising number of elderly patients who are at risk for developing heel pressure ulcers.
In the face of these challenges, how can heel pressure ulcer prevalence decrease?
This white paper summarizes the challenges that facilities are facing in regards to lowering heel pressure ulcer prevalence. It also details how a multidisciplinary approach (together with an effective heel offloading device) can come together to beat the “perfect storm” of obstacles that currently hinder efforts to prevent heel pressure ulcers.
The prevalence of heel pressure ulcers and costs for health care facilities to treat this preventable condition continue to be high. Ineffective protocols, coupled with the use of ineffective offloading devices, such as the patient pillow, are major contributing factors to the costly care and common occurrence of HPUs.
A solution to the issues of prevalence and cost to facilities in treating HPUs is explored in this WoundSource white paper. The use of a professional offloading device, combined with an integrated multidisciplinary team approach and defined heel pressure ulcer protocol are offered as a facility plan to lower HPU occurrence and cost to treat and discharge patients.
A mathematical approach to determining the savings impact of a professional offloading device being used in your facility is presented.
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