Pressure Ulcer Multi-disciplinary Teams Via Telemedicine (PUMTT): A Trial in Long Term Care

• Sponsor: University of Toronto (Other)
• Overall Status: Completed
• CT.gov ID: NCT01232764
• Collaborator: Ontario Ministry of Health and Long Term Care (Other), Canadian Patient Safety Institute (Other), Central Community Care Access Center (Other)
• Enrollment: 137
• Location: 1
• Arm: 1
• Duration (Months): 17
• Patients Per Site Per Month: 8.1

Study Details

Study Description

Brief Summary

The purpose of this study is to evaluate the effectiveness of 'enhanced' multi-disciplinary wound care teams (MDTs) vs. 'usual' care teams in Long Term Care (LTC) facilities in Ontario for the treatment of pressure ulcers. LTC facilities with more than 100 beds that are within a 100 km distance from St. Mikes and have a problem with pressure ulcers will be asked to participate. A total of 10 LTC facilities will be randomly selected (i.e. selected by chance) from those that agree to participate.

The 'enhanced' MDT will be an Advance Practice Nurse(APN) with expertise in wound care who has direct access to the wound care team at St. Mikes. This APN will develop treatment plans in consultation with facility staff, providing targeted pressure ulcer treatment education on an ongoing, case by case basis. Care is supported by telemedicine with the use of digital photography and online communication between members of the care team.

This study is a stepped wedge randomized trial, meaning LTC facilities are assigned to a start date for this study totally by chance. Changes in healing rates, wound related pain, cost, number of new pressure ulcers, and number of wounds healed will be measured before, and after the APN is introduced to facilities. In order to gain more insight into how people felt about this model of care, interviews will be held with individuals and groups of staff at 5 randomly selected facilities before, during, and after the study has been completed.

Condition or Disease	Intervention/Treatment	Phase
Pressure Ulcers; Multi-disciplinary Wound Care Teams; Remote Support; Digital Wound Photography	Other: Exposure to multi-disciplinary wound care team	Phase 3

Study Design

• Study Type: Interventional
• Actual Enrollment: 137 participants
• Allocation: Randomized
• Masking: Single (Outcomes Assessor)
• Primary Purpose: Health Services Research
• Official Title: Pressure Ulcer Multi-disciplinary Teams Via Telemedicine (PUMTT): A Cluster Pragmatic Randomised Controlled Trial in Long Term Care
• Study Start Date: Oct 1, 2010
• Actual Primary Completion Date: Mar 1, 2012
• Actual Study Completion Date: Mar 1, 2012

Arms and Interventions

Arm

Intervention/Treatment

Experimental: Multi-disciplinary wound care team Stepped wedge study design i.e. start date of exposure is randomized.

Other: Exposure to multi-disciplinary wound care team; Phase 1: In Person Support (3 mths) Advance Practice Nurses (APNs) affiliated with Enhanced Multi-Disciplinary visit LTC facilities on a weekly basis. The APN may communicate with other members of an EMDT via telephone or online.EMDTs will collectively teach and mentor LTC facility wound care teams throughout the study. Phase 2: Remote Support (2-11 mths) In the second phase, EMDTs will support LTC facility staff remotely via telephone and online communication, visiting the facilities on an as needed basis only. All PU treatment will be based on RNAO evidence-based guidelines (updated in 2007)contextualized to the LTC setting.

Outcome Measures

Primary Outcome Measures

1. Rate of reduction in wound surface area (cm2/days) [6 mths]

Secondary Outcome Measures

1. Percentage of wounds healed [6 mths]

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• LTC facility must be located within the Toronto Central or Central LHIN geographic boundaries.

• LTC facility must be <100 km from the St. Michael's Hospital wound care team.

• LTC facility must be entering data into MDS.

• LTC facility administrator must consent to participate.

• LTC facility must report a PU prevalence rate >5.5% in the 4th quarter 2009 MDS. [This is the average pressure ulcer prevalence rate for Ontario LTC facilities as reported by the Canadian Institute of Health Information (CIHI) in the 4th quarter 2009.]

• Individual with PU (or Substitute Decision Maker (SDM)) must provide informed consent.

Exclusion Criteria:

• LTC facility <100 beds.

• LTC facility >100 km from the St. Michael's Hospital wound care team

• LTC facility reporting a PU prevalence rate < 5.5% in the 4th quarter 2009 MDS.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	12 Long Term Care Facilities	Toronto	Ontario	Canada

Sponsors and Collaborators

• University of Toronto
• Ontario Ministry of Health and Long Term Care
• Canadian Patient Safety Institute
• Central Community Care Access Center

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Additional Information:

• Toronto Health Economic Technology Assessment collaborative

Publications

None provided.

• Responsible Party: Anita Stern, Researcher, University of Toronto
• ClinicalTrials.gov Identifier: NCT01232764
• Other Study ID Numbers: 25048
• First Posted: Nov 2, 2010
• Last Update Posted: Sep 28, 2012
• Last Verified: Sep 1, 2012

• Additional relevant MeSH terms: Pressure Ulcer; Ulcer; Wounds and Injuries

Study Results

No Results Posted as of Sep 28, 2012