title: Multidimensional team-based intervention using musical cues to reduce odds of facility-acquired pressure ulcers in long-term care: a paired randomized intervention study.
abstract: OBJECTIVE
  To test the effectiveness of a pressure ulcer (PU) prevention intervention featuring musical cues to remind all long-term care (LTC) staff (nursing and ancillary) to help every resident move or reposition every 2 hours.
  
  
  METHODS
  Twelve-month paired-facility two-arm (with one-arm crossover) randomized intervention trial.
  
  
  METHODS
  Ten midwestern U.S. LTC facilities. Four treatment facilities received intervention during Months 1 to 12, four comparison facilities received intervention during Months 7 to 12, and two pseudo-control facilities received no intervention.
  
  
  METHODS
  LTC facility residents (N = 1,928).
  
  
  METHODS
  All facility staff received in-person education, video, and handouts, and visiting family members received informational pamphlets on PU prevention and an intervention featuring musical cues. Nurse-led multidisciplinary staff teams presented the cues as prompts for staff and family to reposition residents or remind them to move. Musical selections (with and without lyrics) customized to facility preferences were played daily over the facility intercom or public address system every 2 hours for the 12-hour daytime period.
  
  
  METHODS
  Primary outcome measure was the frequency of new facility-acquired PUs divided by the total number of facility Minimum Data Set (MDS) resident assessments conducted during the study period.
  
  
  RESULTS
  Odds of a new PU were lower in intervention facilities (P = .08) for MDS 2.0 assessments and were significantly lower (P = .05) for MDS 3.0. Mean odds ratios suggested intervention facility residents were 45% less likely than comparison facility residents to develop a new PU.
  
  
  CONCLUSIONS
  Customized musical cues that prompt multidisciplinary staff teams to encourage or enable movement of all residents hold promise for reducing facility-acquired PUs in LTC settings.
authors.affiliation: School of Nursing, Duke University, Durham, North Carolina; College of Nursing, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Yap
authors.forename: Susan M
authors.initials: SM
authors.lastname: Kennerly
authors.forename: Mark R
authors.initials: MR
authors.lastname: Simmons
authors.forename: Charles R
authors.initials: CR
authors.lastname: Buncher
authors.forename: Elaine
authors.initials: E
authors.lastname: Miller
authors.forename: Jay
authors.initials: J
authors.lastname: Kim
authors.forename: Winston Y
authors.initials: WY
authors.lastname: Yap
mesh_terms: D000368:Aged; D003463:Cues; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged; D006801:Humans; D015994:Incidence; D008134:Long-Term Care / Q000379:methods*; D008297:Male; D009147:Music Therapy / Q000379:methods*; D016017:Odds Ratio; D003668:Pressure Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: long-term care; multidisciplinary healthcare teams; nursing interventions; pressure ulcer prevention