Pressure Ulcer Multi-disciplinary Teams Via Telemedicine (PUMTT): A Trial in Long Term Care (PUMTT)
The purpose of this study is to evaluate the effectiveness of 'enhanced' multi-disciplinary wound care teams (MDTs) vs. 'usual' care teams in Long Term Care (LTC) facilities in Ontario for the treatment of pressure ulcers. LTC facilities with more than 100 beds that are within a 100 km distance from St. Mikes and have a problem with pressure ulcers will be asked to participate. A total of 10 LTC facilities will be randomly selected (i.e. selected by chance) from those that agree to participate.
The 'enhanced' MDT will be an Advance Practice Nurse(APN) with expertise in wound care who has direct access to the wound care team at St. Mikes. This APN will develop treatment plans in consultation with facility staff, providing targeted pressure ulcer treatment education on an ongoing, case by case basis. Care is supported by telemedicine with the use of digital photography and online communication between members of the care team.
This study is a stepped wedge randomized trial, meaning LTC facilities are assigned to a start date for this study totally by chance. Changes in healing rates, wound related pain, cost, number of new pressure ulcers, and number of wounds healed will be measured before, and after the APN is introduced to facilities. In order to gain more insight into how people felt about this model of care, interviews will be held with individuals and groups of staff at 5 randomly selected facilities before, during, and after the study has been completed.
|Pressure Ulcers Multi-disciplinary Wound Care Teams Remote Support Digital Wound Photography||Other: Exposure to multi-disciplinary wound care team||Phase 3|
|Study Design:||Allocation: Randomized
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
|Official Title:||Pressure Ulcer Multi-disciplinary Teams Via Telemedicine (PUMTT): A Cluster Pragmatic Randomised Controlled Trial in Long Term Care|
- Rate of reduction in wound surface area (cm2/days) [ Time Frame: 6 mths ]
- Percentage of wounds healed [ Time Frame: 6 mths ]
|Study Start Date:||October 2010|
|Study Completion Date:||March 2012|
|Primary Completion Date:||March 2012 (Final data collection date for primary outcome measure)|
Experimental: Multi-disciplinary wound care team
Stepped wedge study design i.e. start date of exposure is randomized.
Other: Exposure to multi-disciplinary wound care team
Phase 1: In Person Support (3 mths)
Advance Practice Nurses (APNs) affiliated with Enhanced Multi-Disciplinary visit LTC facilities on a weekly basis. The APN may communicate with other members of an EMDT via telephone or online.EMDTs will collectively teach and mentor LTC facility wound care teams throughout the study.
Phase 2: Remote Support (2-11 mths) In the second phase, EMDTs will support LTC facility staff remotely via telephone and online communication, visiting the facilities on an as needed basis only.
All PU treatment will be based on RNAO evidence-based guidelines (updated in 2007)contextualized to the LTC setting.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01232764
|12 Long Term Care Facilities|
|Toronto, Ontario, Canada|