title: Prevention of heel pressure ulcers among older patients--from ambulance care to hospital discharge: A multi-centre randomized controlled trial.
abstract: The aim was to investigate the effect of an early intervention, a heel suspension device boot, on the incidence of heel pressure ulcers among older patients (aged 70+).
  
  
  BACKGROUND
  Pressure ulcers are a global healthcare issue; furthermore, the heel is an exposed location. Research indicates that preventive nursing interventions starting during the ambulance care and used across the acute care delivery chain are seldom used.
  
  
  METHODS
  A multi-centre randomized control study design was used. Five ambulance stations, two emergency departments and 16 wards at two Swedish hospitals participated. Altogether, 183 patients were transferred by ambulance to the emergency department and were thereafter admitted to one of the participating wards.
  
  
  RESULTS
  Significantly fewer patients in the intervention group (n=15 of 103; 14.6%) than the control group (n=24 of 80; 30%) developed heel pressure ulcers during their hospital stay (p=0.017).
  
  
  CONCLUSIONS
  Pressure ulcer prevention should start early in the acute care delivery chain to increase patient safety.
authors.affiliation: Faculty of Health, Sciences and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden; County Council of Värmland, Karlstad, Sweden. Electronic address: carina.baath@kau.se.
authors.forename: Carina
authors.initials: C
authors.lastname: Bååth
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Engström
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Surgery and Oncology Division, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Gunningberg
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; School of Nursing, University of Adelaide, Adelaide, Australia; Department of Emergency Care, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Muntlin Athlin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D005260:Female; D006365:Heel / Q000473:pathology*; D006801:Humans; D008297:Male; D010351:Patient Discharge; D003668:Pressure Ulcer / Q000517:prevention & control*
keywords: Acute care delivery chain; Ambulance care; Emergency department; Heel pressure ulcer; Prevention; RCT