Evaluation of the effectiveness of the convoluted foam overlay in preventing pressure ulcers

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Evaluation of the effectiveness of the convoluted foam overlay in preventing pressure ulcers


Author: Chung, Mei-chung
Title: Evaluation of the effectiveness of the convoluted foam overlay in preventing pressure ulcers
Degree: M.Sc.
Year: 2004
Subject: Hong Kong Polytechnic University -- Dissertations
Bedsores -- Prevention
Bedsores -- Treatment
Department: School of Nursing
Pages: vii, 107, 1 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1772713
URI: http://theses.lib.polyu.edu.hk/handle/200/4277
Abstract: Significance of the study The use of pressure relieving devices is widespread both in institutions and home care setting. These products available in the market vary in cost and design. In fact, there is little evidence in terms of clinical effectiveness or cost effectiveness to enable health care workers to select equipment at all. The aim of the study is to evaluate the effectiveness of a relatively cheap pressure-relieving device, a convoluted foam overlay, as compared to standard hospital mattress. Background The convoluted foam overlay is widely used in X hospital as a pressure ulcer treatment measure. It is believed that the specialized foam overlay relieves the pressure by providing a conforming support surface to distribute the body weight over a large area. Different support surfaces cost vary greatly. Some of the products just cost over HK$1,000 and some cost over HK$20,000. The convoluted foam overlay used in X hospital is different from the alternating-pressure device as no machine is required. Therefore, the problem of power failure will not occur. In addition, the cost of electricity will not be added into the cost of treating pressure such as repositioning,wound dressing and dressing materials. Despite that the convoluted foam overlay is widely used and well accepted in X hospital, its effectiveness in preventing pressure ulcer was not clear. Method Design The study was a randomized controlled trial with one experimental and one control group. The randomly selected rehabilitation patients, who satisfied the inclusion criteria, were recruited. The subjects were randomly assigned either to the experimental group (convoluted foam overlay) or the control group (standard hospital mattress). Two nurses working in infirmary unit were responsible for data collection. Baseline data was obtained within 24 hours after admission. The baseline data include the skin inspection, Norton Score, demographic data, body mass index (BMI), length of stay, serum albumin level and haemoglobin level. Afterwards, the two same nurses would perform skin inspection three times weekly and recorded down the location of newly developed pressure ulcers. Result There were 18 subjects out of 257 developed a total of 23 pressure ulcers. Among all subjects, there were 14 subjects (12%) in the control group (n=119) and 4 subjects (3%) in the experimental group (n=138). The number of subjects developing pressure ulcers in the control group was about three-fold of the experimental group. Hence, the convoluted foam overlay could significant prevent pressure ulcer development when compared with standard hospital mattress (x2=6.411, p=0.007). Conclusion The finding in this study confirmed that the convoluted foam overlay was effective in preventing pressure ulcers. In view of the limited resources available and cost containment in hospital, the convoluted foam overlay offered another cost-effective option in preventing pressure ulcers to health care professional, carer and clients.

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