Research                    

Research

Pressure Ulcer Research

There has been a growing interest in undertaking research into Pressure Ulcer (PU) prevention and treatment. Indeed in 2013 the James Lind Alliance Pressure Ulcer Partnership (JLAPUP) James Lind Alliance Pressure Ulcer Partnership involving patients, carers and health care professionals agreed research priorities for this. This was welcomed by the Tissue Viability Society (TVS) http://tvs.org.uk/ who aim to promote research and increase awareness for PU prevention and treatment.

An internationally recognised research team based at Leeds Institute of Clinical Trials Research, University of Leeds are committed to undertaking research to improve patient care in this area. The team, led by Professor Jane Nixon have a comprehensive portfolio of research relating to risk factors and risk assessment, the role of pain in PU development, severe PUs, quality of life, cost-utility, support surfaces and PU monitoring

As well as seeking funding for future studies, the team have most recently completed the Pressure UlceR Programme Of ReSEarch (PURPOSE), a 5 year research programme funded by the National Institute for Health Research (NIHR) and an audit of PU monitoring systems across NHS in-patient facilities in England, funded by TVS. The team are currently undertaking the Pressure RElieving Support SUrfaces: a Randomised Evaluation 2 (PRESSURE 2) Trial funded by the NIHR Health Technology Assessment (HTA) Programme. More details of this work and related publications are detailed below.


PURPOSE Programme
The PURPOSE programme aimed to reduce the impact of pressure ulcers (PUs) on patients through:

  1. Early identification of patients at risk of developing PUs and improved identification and investigation of patients at risk of progression to severe PUs
  2. The development of methods to capture patient-reported health-related quality of life (HRQoL) and health utilities for routine clinical use and in clinical trials.

Further information regarding the PURPOSE programme can be found at:
http://medhealth.leeds.ac.uk/info/423/skin/1740/purpose and related publications are detailed below.


Pressure ulcer and Wounds Reporting in NHS Hospitals in England
The project aimed to assess the accuracy of current PU monitoring systems, against a ‘gold standard’ Pressure Ulcer/Wound Audit (PUWA). The project comprised two related pieces of work 1) a PU/Wound Audit and 2) a survey of PU monitoring systems. Related publications are detailed below.


PRESSURE 2
PRESSURE 2 aims to determine the clinical and cost effectiveness of High Specification Foam and Alternating Pressure Mattresses for the prevention of Category 2 (and above) PUs when used in conjunction with an electric profiling bed frame for patients with evidence of acute illness in secondary and community in-patient facilities

Further information regarding PRESSURE 2 can be found at:
http://medhealth.leeds.ac.uk/info/423/skin/1717/pressure_2


Publications Relating to the PURPOSE Programme of Research

  • Overall Programme
    Pressure UlceR Programme Of reSEarch (PURPOSE): using mixed methods (systematic reviews, prospective cohort, case study, consensus and psychometrics) to identify patient and organisational risk, develop a risk assessment tool and patient-reported outcome Quality of Life and Health Utility measures” has now published in the Programme Grants for Applied Research journal on the NIHR Journals Library website: http://www.journalslibrary.nihr.ac.uk/pgfar/volume-3/issue-6

    Nixon J, Wilson LM, Coleman S, Gorecki C, Muir D, Pinkney L, Keen J, Briggs M, McGinnis E, Stubbs N, Dealey C, Nelson A. Pressure ulcer programme of research – PURPOSE. European Wounds Management Association Journal 2012; 12(1):21-24.

  • Pain studies
    McGinnis, E, Briggs M, Collinson M, Wilson L, Dealey C, Brown J, Coleman S, Stubbs N, Stevenson R, Nelson EA, Nixon J. Pressure ulcer related pain in community populations: a prevalence survey. BMC Nursing 2014; 13(16) URL: http://www.biomedcentral.com/1472-6955/13/16

    Briggs M, Collinson M, Wilson L, Rivers C, McGinnis E, Dealey C, Brown J, Coleman S, Stubbs N, Stevenson R, Nelson EA, Nixon J. The prevalence of pain at pressure areas and pressure ulcers in hospitalised patients. BMC Nursing 2013; 12:19 doe: 10.1186/1472-6955-12-19. http://www.biomedcentral.com/1472-6955/12/19

    Stevenson R, Collinson M, Henderson V, Wilson L, Dealey C, McGinnis E, Briggs M, Nelson EA, Stubbs N, Coleman S, Nixon J. The prevalence of pressure ulcers in community settings: an observational study. International Journal of Nursing Studies 2013; 50(11): 1550–1557. http://www.sciencedirect.com/science/article/pii/S0020748913001004

  • Severe pressure ulcers
    Pinkney L, Nixon J, Wilson L, McGinnis E, Stubbs N, Dealey C, Nelson A, Coleman S, Patterson M, Keen J. Why do patients develop severe pressure ulcers? A retrospective case study. BMJ Open 2014; 4(1) DOI:10.1136/bmjopen-2013-004303 http://bmjopen.bmj.com/content/4/1/e004303.full

    Keen J. Normal accidents: learning how to learn about safety. In: Exworthy M, Powell M, Peckham S, Hann A (editors). Shaping health policy: case study methods and analysis. Bristol: Policy Press; 2011.

  • Risk assessment

    Coleman S, Muir D, Rawson B and Rawson Y. Patient involvement in risk tool development. Nursing Times; 2015; 111: 25, 17-19.

    Coleman, S., Nelson, E.A., Keen, J., Wilson, L., McGinnis, E., Dealey, C., Stubbs, N., Muir, D., Farrin, A., Dowding, D., Schols, J.M.G.A., Cuddigan, J., Berlowitz, D., Jude, E., Vowden, P., Bader, D.L., Gefen, A., Oomens, C.W.J., Schoonhoven, L. & Nixon, J. (2014a) Developing a pressure ulcer risk factor minimum data set and risk assessment framework. Journal of Advanced Nursing, 70(10), 2339-2352. http://onlinelibrary.wiley.com/doi/10.1111/jan.12444/abstract

    Coleman, S., Nixon, J., Keen, J., Wilson, L., McGinnis, E., Dealey, C., Stubbs, N., Farrin, A., Dowding, D., Schols, J.M.G.A., Cuddigan, J., Berlowitz, D., Jude, E., Vowden, P., Schoonhoven, L., Bader, D.L., Gefen, A., Oomens, C.W.J. & Nelson, E.A. (2014b) A new pressure ulcer conceptual framework. Journal of Advanced Nursing, 70(10), 2222-2234. http://onlinelibrary.wiley.com/doi/10.1111/jan.12405/abstract

  • Coleman S, Gorecki C, Nelson EA, Closs J, Defloor T, Halfens R, Farrin A, Brown JM, Schoonhoven L, Nixon J. Patient risk factors for pressure ulcer development: A systematic review. International Journal of Nursing 2013; 50(7): 974-1003. http://www.sciencedirect.com/science/article/pii/S002074891200421X

  • Health-related quality of life

    Rutherford C, Nixon J, Brown JM, Lamping DL, Cano SJ Using mixed methods to select optimal mode of administration for a patient-reported outcome instrument for people with pressure ulcers BMC Medical Research Methodology 2014; 14:22 DOI:10.1186/1471-2288-14-22. http://www.biomedcentral.com/1471-2288/14/22

    Gorecki C, Brown J, Cano S, Lamping D, Briggs M, Coleman S, Dealey C, McGinnis E, Nelson EA, Stubbs N, Wilson L, Nixon J. Development and validation of a new patient-reported outcome measure for patients with pressure ulcers: the PU-QOL instrument. Health and Quality of Life Outcomes 2013; 11:95 doi: 10.1186/1477-7525-11-95 http://hqlo.biomedcentral.com/articles/10.1186/1477-7525-11-95

    Gorecki C, Lamping D, Alvari Y, Brown J, Nixon J. Patient-reported outcome measures for chronic wounds with particular reference to pressure ulcer research: a systematic review. International Journal of Nursing Studies 2013; 51(1) 157-165 http://www.sciencedirect.com/science/article/pii/S0020748913000722

    Gorecki C, Lamping D, Nixon J, Brown J, Cano S. Applying mixed methods to pre-test the Pressure Ulcer Quality of Life (PU-QOL) instrument. Quality of Life Research Journal 2012; 21(3): 441-451. http://link.springer.com/article/10.1007%2Fs11136-011-9980-x

    Gorecki C, Nixon J, Madill A, Firth J, Brown J. What influences the impact of pressure ulcers on health-related quality of life? A qualitative patient-focused exploration of contributory factors. Journal of Tissue Viability 2012; 21(1): 3-12. http://www.sciencedirect.com/science/article/pii/S0965206X11000520

    Gorecki C, Closs J, Nixon J, Briggs M. Patient-reported pressure ulcer pain: a mixed methods systematic review. Journal of Pain and Symptom Management 2011; 42(3): 443-59. http://www.sciencedirect.com/science/article/pii/S0885392411000601

    Gorecki CA, Lamping DL, Brown JM, Madill A, Firth J, Nixon J. Development of a conceptual framework of health-related quality of life in pressure ulcers: a patient focused approach. International Journal of Nursing Studies 2010; 47(12): 1525-1534. http://www.sciencedirect.com/science/article/pii/S0020748910001987

    Gorecki, CA, Brown, JM., Briggs, M., Nixon, J. The evaluation of 5 search strategies in retrieving qualitative patient-reported electronic data of the impact of pressure ulcers on quality of life. Journal of Advanced Nursing 2010; 66(3):645-652. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2009.05192.x/full

  • PPI

    Coleman S, Muir D, Rawson B and Rawson Y. Patient involvement in risk tool development. Nursing Times; 2015; 111: 25, 17-19.

    Muir D. Patient and public involvement in pressure ulcer research. Journal of Tissue Viability 2011; 20(4): 132- 133. http://www.sciencedirect.com/science/article/pii/S0965206X11000374

    Muir D. The pressure ulcer research service user network UK (PURSUN UK). European Wounds Management Association Journal 2011; 11(3): 26.

  • Research Nurses

    Hemingway B, Storey C. The experience of two registered nurses adapting to the role of a clinical research nurse. Nursing Standard 2013; 27(4): 62-68.

    Choo J, Blundell S and McGinnis E. Ethical issues and challenges in pressure ulcer research – The research nurses' perspective. Journal of Tissue Viability 2012; 21(4), 105-108. http://www.sciencedirect.com/science/article/pii/S0965206X1200037X


Publications Relating to Pressure ulcer and Wounds Reporting in NHS Hospitals in England
Smith, I. L., J. Nixon, S. Brown, L. Wilson and S. Coleman (In pres). Pressure Ulcer and Wounds Reporting in NHS Hospitals in England Part 1: Audit of Monitoring Systems. Journal of Tissue Viability.

Coleman, S., I. L. Smith, J. Nixon, L. Wilson and S. Brown (In pres). Pressure Ulcer and Wounds Reporting in NHS Hospitals in England Part 2: Survey of Monitoring Systems. Journal of Tissue Viability.