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Pressure Ulcer Multi-disciplinary Teams Via Telemedicine (PUMTT): A Trial in Long Term Care (PUMTT)

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ClinicalTrials.gov Identifier: NCT01232764
Recruitment Status : Completed
First Posted : November 2, 2010
Last Update Posted : September 28, 2012
Information provided by (Responsible Party):

Study Description
Brief Summary:

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.

Condition or disease Intervention/treatment Phase
Pressure Ulcers Multi-disciplinary Wound Care Teams Remote Support Digital Wound Photography Other: Exposure to multi-disciplinary wound care team Phase 3

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 137 participants
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
Study Start Date : October 2010
Primary Completion Date : March 2012
Study Completion Date : March 2012

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
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.

Outcome Measures

Primary Outcome Measures :
  1. Rate of reduction in wound surface area (cm2/days) [ Time Frame: 6 mths ]

Secondary Outcome Measures :
  1. Percentage of wounds healed [ Time Frame: 6 mths ]

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • LTC facility must be located within the Toronto Central or Central LHIN geographic boundaries.
  • LTC facility must be <100 km from the St. Michael's Hospital wound care team.
  • LTC facility must be entering data into MDS.
  • LTC facility administrator must consent to participate.
  • LTC facility must report a PU prevalence rate >5.5% in the 4th quarter 2009 MDS. [This is the average pressure ulcer prevalence rate for Ontario LTC facilities as reported by the Canadian Institute of Health Information (CIHI) in the 4th quarter 2009.]
  • Individual with PU (or Substitute Decision Maker (SDM)) must provide informed consent.

Exclusion Criteria:

  • LTC facility <100 beds.
  • LTC facility >100 km from the St. Michael's Hospital wound care team
  • LTC facility reporting a PU prevalence rate < 5.5% in the 4th quarter 2009 MDS.
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01232764

Canada, Ontario
12 Long Term Care Facilities
Toronto, Ontario, Canada
Sponsors and Collaborators
University of Toronto
Ontario Ministry of Health and Long Term Care
Canadian Patient Safety Institute
Central Community Care Access Center
More Information

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Anita Stern, Researcher, University of Toronto
ClinicalTrials.gov Identifier: NCT01232764     History of Changes
Other Study ID Numbers: 25048
First Posted: November 2, 2010    Key Record Dates
Last Update Posted: September 28, 2012
Last Verified: September 2012

Additional relevant MeSH terms:
Wounds and Injuries
Pressure Ulcer
Pathologic Processes
Skin Ulcer
Skin Diseases