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A descriptive study of heel pressure ulcers : a pilot feasibility study Topolnicky, Ruth Lillian

Abstract

Using a descriptive research design, a pilot feasibility study was designed to assess the feasibility of conducting a study of the norms of healing of pressure ulcers that occur on the heels of older adults. Such a study was considered necessary because it was the perception of this writer that the number of cases of heel pressure ulcers among older adults in residential care had risen to unprecedented levels. However, there was little data to support this impression as the actual prevalence of heel pressure ulcers in British Columbia and the Lower Mainland had not been reported in the research literature. An apparent increase in the prevalence of pressure ulcers at the heel is a significant clinical problem because little is known about the norms of their healing. This is problematic because healing outcomes could be optimized if clinical decision-making could be based on knowledge of the norms of pressure ulcer healing. Since pressure ulcer research is expensive and the number of older adults with heel pressure ulcers was unknown, it was necessary to assess the costs of conducting such a study and the number subjects who could be identified. Also assessed was the utility of a novel Image Digitization Program "Mouseyes" in measuring pressure ulcer healing. The study was conducted in the Simon Fraser Health Region between mid June and November 6 of 1998. A total of 23 subjects were identified and referred to the researcher. Fourteen were ineligible and a convenience sample of nine subjects were enrolled in the study. Two subjects were followed for a four month period in order that heel pressure ulcer healing could be described. Seven subjects were seen on a one time basis in order that the utility of the Mouseyes Program could be assessed. For all visits, the time required to assess pressure ulcer healing was described in order that estimates the personnel costs and logistics of conducting a larger study could be assessed. Study results suggest that "Mouseyes" is an acceptable instrument for measuring healing in heel pressure ulcers and that a larger study of the norms of heel pressure ulcer healing is feasible if sufficient funds are available to support personnel costs. Analysis of logistical problems encountered during the study suggest that a larger study is feasible if two full time research facilitators can be hired to recruit subjects and conduct the wound healing assessments. To obtain a large enough sample, the study would need to run over a 12 to 18 month period.

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