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Learning Objective 1: Describe the role of mobility in pressure ulcer prevention.
Learning Objective 2: Discuss strategies for cueing and engaging multidisciplinary staff teams in implementing a pressure ulcer prevention program.
Methods: A 12-month paired-facility randomized clinical trial was conducted in 10 LTC facilities from one nursing home chain in Midwestern U.S.A. Four facilities received intervention throughout trial; four comparison facilities received intervention during months 7-12 only; two facilities received no intervention. During the intervention, every 2 hours during each 12 daytime hours, musical selections (with/without lyrics) tailored to each facility’s preferences were used via the intercom/public address system to cue all LTC staff (nursing, dietary, maintenance, administration, housekeeping) to assist all residents (n=1,928) in moving. Primary outcome measure was institutional rate of facility-acquired PUs, defined as the number of resident facility-acquired PUs divided by the total number of facility resident Minimum Data Set (MDS) assessments conducted during the study period. The facilities changed from MDS 2.0 to 3.0 during the study period and thus results for both are presented.
Results: Protective effect of the intervention approached significance (p=.08) for MDS 2.0 assessments, and was significant (p<.05) for MDS 3.0. Based on an average of odds ratio (OR) means, intervention facility residents were 45% less likely to develop a new PU. Implementation varied across facilities.
Conclusion: Using tailored musical prompts to cue multidisciplinary staff teams to encourage or enable movement of all residents (not just those at high risk for PU development) holds promise for reducing facility-acquired PUs in LTC settings. The occupational subculture of nursing may affect implementation.