The TaP Trial A Randomised Controlled Trial of a Turning and Positioning System for the Prevention of Pressure Injuries in the Intensive Care Unit. Study Protocol

Lead Presenter

Supporting Presenters

Gerdtz, M.
Gefen, A.
Padual, W.V.
Alves, P.
Trvellini, C.
Ghosh, A.
Shea, A.
Cross, A.
Santamaria, N.

Presented At

Abstract

Introduction:
Practice guidelines recommend turning and positioning of the body to prevent pressure related skin damage,1 however evidence of the effectiveness of turning and positioning systems for preventing pressure injuries is lacking. The aim of the study is to determine the clinical effectiveness of a system for turning and positioning ICU patients, when compared to usual care turning and positioning devices, for preventing pressure injuries.

Methods:
The study is an investigator initiated, prospective, multi centre, two group, non-blinded, randomised controlled trial. The study setting is a large ICU in Australia. The primary outcome is the incidence of pressure injuries in both intervention and control groups during the study period. Study participants will be >18 years of age, admitted to the ICU, and at high risk of pressure injury development. Participants will be randomised to the intervention group (to receive care with a turning and positioning system) or the control group (to receive care with the usual care slide sheet and pillows) for the duration of their ICU stay. The sample size is n=215 per group (n=430 total). Data collection includes demographics, ICU stay characteristics, diagnosis and treatment, adherence to treatment, and pressure injury development. The analysis will be based on intention to treat protocol.

Results:
This presentation will consider the background to the research, the current evidence for turning and positioning systems, and the study protocol of this prospectively registered clinical trial.

Discussion:
This study is the first identified randomised controlled trial to determine the clinical effectiveness of a system for turning and positioning ICU patients, when compared to usual care turning and positioning devices, for preventing pressure injuries. The results will inform the evidence base for best practice in pressure injury prevention in the ICU setting.

References:
1. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance, Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. 2014, Cambridge Media: Osborne Park, Australia.
Maintenance of the 30-degree side lying lateral tilt position in bed: An observational study.

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