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• W2743111491 abstract "Skin tears are a prevalent preventable wound among older people that can have serious consequences. There has been little research into how to reduce the likelihood of their occurrence. Moisturising the skin has been suggested as a simple strategy to reduce their incidence. A pragmatic cluster randomised controlled trial (RCT) was undertaken in 12 residential aged care facilities to test whether this was in fact the case. The present study was conducted as an important adjunct to that RCT. It was designed to identify “usual” moisturising practice pre and post-intervention in both control and intervention facilities and thus determine whether practice changed according to protocol only in the intervention facilities or whether there was evidence of contamination in the control sites. Understanding how moisturising practice changed in the facilities during the RCT was considered essential for accurate interpretation of the trial’s results. A secondary aim of this study was the identification of enablers and barriers to moisturising. Collected pre RCT intervention, this information could inform the implementation process and/or assist the researchers to understand what had contributed to any practice change found. The study included surveys of carers and interviews with site managers, both pre and post RCT intervention, across all 12 residential aged care facilities involved in the trial. Eighty five carers completed the survey pre-intervention: 44 from control facilities, group 1 and 41 from intervention facilities, group 2. Post-intervention there were 104 respondents, 59 carers from group 1 and 45 from group 2. All 12 site managers agreed to be interviewed pre and post-intervention, six from group 1 and six from group 2. Skin Tear Prevention: What Is “Usual” Skin Moisturising Practice? Page v Little evidence of there being “usual” skin moisturising practice in any of the intervention or control sites was found pre-intervention from either the survey or interviews. Post-intervention practice remained ad hoc in the control sites whereas a significant change in practice, which matched the intervention protocol, i.e. twice daily moisturising with a standardised pH neutral, perfume free moisturising lotion (Abena) was evident at the intervention sites. This provided confirmation that the intervention had been successfully implemented and that contamination of the control sites had not occurred. This was an important finding as it provided some certainty that the lower skin tear incidence found in the intervention group by the RCT researchers could be directly attributed to the implementation of the moisturising practice protocol. As regards the barriers and enablers, those identified by carers reflected the real life practicalities that impact on their ability to do their job well such as cream availability/accessibility and having a clear documentation/process/protocol. Most managers on the other hand, identified enablers more associated with management, such as providing staff with a rationale for the new practice and giving the staff an opportunity to be actively involved. Identified barriers included the absence of the aforementioned enablers plus the resident preferring not to be moisturised and there being documentation ‘not to moisturise’. Many of the identified enablers formed part of the RCT intervention protocol and were therefore seen as having contributed to its successful implementation. It is therefore recommended that these enablers be considered by any agency when attempting to translate the RCT evidence into everyday practice. Skin Tear Prevention: What Is “Usual” Skin Moisturising Practice? Page vi" @default.
• W2743111491 created "2017-08-17" @default.
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• W2743111491 date "2014-01-01" @default.
• W2743111491 modified "2023-09-22" @default.
• W2743111491 title "Skin tear prevention: what Is “usual” skin moisturising practice?" @default.
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