A Randomised Controlled Trial of Medical Devices for Pressure Ulcers

Tissue Viability Nurse Specialists care for patients with any type of wound, with a focus on wound prevention, especially pressure ulcer prevention. I soon recognised the limited evidence-base behind our clinical practice, evoking my interest in research that is relevant to nursing practice.
There are numerous different devices marketed as heel pressure ulcer prevention devices, with evidence about the biomechanics and how they should prevent pressure ulcers, but a limited evidence base about their clinical utility and effectiveness in practice. In theory, specialist boots that offload the heel should prevent heel pressure ulcers if there is an absence of pressure directly being applied to that area of skin, but in practice patients still get pressure ulcers whilst using them. My PhD consisted of three work packages: a systematic review of the existing evidence base, interviews with Tissue Viability Nurses about how they utilise the devices in clinical practice and ethnographic observations of clinical practice. I will discuss the findings of my research, and how this informed a HTA funded multi-centre three-armed RCT: WHiTE14-PRESSURE3 (currently open to recruitment, 1000/3106 patients recruited to date).