Here - EWMA 2013

ORAL PRESENTATIONS
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Free Paper Session: Education
HOW MUCH EXPERIENCE AND EDUCATION IS NEEDED TO EFFECTIVELY
APPLY COMPRESSION THERAPY
Stella Amesz 1 , Annelies van Zandbergen 1 , Peter Schlejen 1,2
1 Wond Expertise Centrum en Zorg Brug (Gouda, Netherlands);
2 Department of surgery, Groene Hart Ziekenhuis (Gouda, Netherlands).
Aim: In the Netherlands, compression therapy is often applied by different types of
professionals, having differing levels of education and experience. Unfortunately,
compression therapy isn’t always executed correctly, which can – in extreme cases –
lead to amputation of a lower limb. The question is: can education level, special
courses, or the amount of experience guarantee the correct application of compression
therapy? Or do we need a different technique to administer this therapy? These are
questions we’d like to answer.
Methods: We asked fifty people of varying levels of education and experience to
administer compression therapy on the same pair of legs. The right leg was treated
with the traditional method, and on the other leg a visual indication was used to gauge
the stress level of the bandage. We judged the bandaging by measuring the pressure
on the leg.
Results: All of the participants had some experience with the traditional method, but
only a few ever used bandages with stress indicators. Neither education level nor
experience proved to be a guarantee for adequately applying compression therapy.
However, using the bandages with the stress indicators led to much better pressure
readings.
Conclusions: The visual indicator on the bandage proved to more effective than either
experience or education.
FREE PAPER SESSION: EDUCATION
42
Free Paper Session: Education
IMPACT OF STRUCTURED EDUCATIONAL INTERVENTION ON PREVENTION OF
PRESSURE ULCERS IN BEDRIDDEN ORTHOPEDIC PATIENTS-A RANDOMIZED
CONTROLLED TRIAL
Soundappan Kathirvel 1 , Amarjeet Singh 1 , Mandeep Singh Dhillon 1 , Sukhpal Kaur 1 ,
Sonu Goel 1
1 PostGraduate Institute of Medical Education and Research (Chandigarh, India).
Aim: Pressure ulcer (PU) is a common, neglected and preventable complication of
bedridden patients at hospital and at home. This randomized controlled trial
(CTRI/2011/07/001862) compares the impact of two structured educational intervention
packages on prevention of PU in bedridden orthopedic patients.
Methods: Ninety two orthopedically bedridden patients with Braden score ≤12 & stage I
PU were block randomized into two groups. One group was offered Prevention Package
1 (PP1), i.e Self Instruction Manual (SIM), one to one training and counseling on PU care
practices to patients and their care givers. Second group was given SIM only (PP2).
Patients were followed daily in hospital till discharge and fortnightly in home for 3 months
for development of PU.
Results: The cumulative incidence of PU was 8.7% in PP1 and 21.7% in PP2 for the
entire study period. Hospital acquired pressure ulcer (HAPU) incidence rate was
6.1/1000 person days in PP1 and 21.8 in PP2. Risk ratio was 2.5 (95% CI 0.89, 7.1,
p-0.07) and rate ratio was 2.77 (95% CI 0.91, 8.4, p-0.04). Kaplan Meier survival curves
for HAPU in PP1 and PP2 were significantly different (p-0.045). PP1 group also showed
significant improvement in knowledge and skills.
Conclusion: Provision of information combined with training of patients and care givers
on preventive practices reduces PU incidence both at hospital and at home. A
comprehensive approach involving administrators, health care professional, patients and
care givers warrants further research.
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