Effectiveness of two cushions in the prevention of heel pressure ulcers.
OBJECTIVE
The aim of the study was to determine the effectiveness of two cushions in the prevention of heel pressure ulcers in a geriatric population.


BACKGROUND
Heel pressure ulcers are a major problem in nursing practice. Several measures for the prevention of heel pressure ulcers are discussed in the literature, but the effectiveness of the different types of cushions in the prevention of heel pressure ulcers is poorly studied.


METHODS
In this comparative study, two different cushions to prevent heel pressure ulcers were investigated: a wedge-shaped, bedwide, viscoelastic foam cushion and an ordinary pillow. All patients were lying on a viscoelastic foam mattress and were repositioned every 4 hours.


METHODS
One hundred sixty-two patients over 75 years of age.


RESULTS
The incidence of heel pressure ulcers grades 2-4 was 1.9% in the wedge-shaped cushion group and was 10.2% in the pillow group. The patients in the wedge-shaped cushion group developed significantly fewer heel pressure ulcers (p = 0.03). Patients with a wedge-shaped cushion under the lower legs had an 85% less chance in developing a heel pressure ulcer (p = 0.02). The median time to develop a heel pressure ulcer was 4.0 days (IQR = 3.0-5.0) in the wedge-shaped cushion group and 3.5 days (IQR = 1.0-5.8) in the pillow group (p = 0.61). The probability to remain pressure ulcer-free at the heels was significantly higher in the wedge-shaped cushion group (p = 0.008).


CONCLUSIONS
The study provides evidence that a wedge-shaped, bedwide, viscoelastic foam cushion decreases the risk of developing a heel pressure ulcer compared with the use of a pillow.
Department of Nursing Science, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. alexander.heyneman@ugent.be
Alexander
A
Heyneman
Katrien
K
Vanderwee
Mieke
M
Grypdonck
Tom
T
Defloor
D000368:Aged; D000369:Aged, 80 and over; D001513:Beds; D004548:Elasticity; D055318:Evidence-Based Nursing; D005260:Female; D005851:Geriatric Nursing / Q000379:methods*; D006365:Heel; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D011312:Pressure; D003668:Pressure Ulcer / Q000453:epidemiology / Q000451:nursing* / Q000517:prevention & control*