For all long-term care residents, pressure reduction foam mattresses were cost-effective 82% of the time compared to standard mattresses, with average savings of $115 per resident, the researchers showed. Foam cleansers for incontinence care would be cost-effective 94% of the time compared to soap and water, saving an average of $179 per resident.
The clinical benefits of foam cleansers for bedsores, or "pressure ulcers," however, require confirmation through more research, the team noted.
"These results provide specific evidence to support practice guidelines, which recommend reducing risk factors and improving skin health to prevent pressure ulcers," said Ba' Pham, lead author on the study and a senior research associate with the Toronto Health Economics and Technology Assessment (THETA) Collaborative. "We encourage all providers of long-term care to consider these changes," said Pham, who is completing his doctorate at U of T's Department of Health Policy, Management and Evaluation.
The Archives of Internal Medicine published the study in its current online edition.
In Ontario, there are approximately 72,000 long-term care residents in 89 facilities. As part of their study, the researchers conducted a phone survey with directors of care at 26 of those facilities, and found that only half their beds have pressure reduction foam mattresses. As well, roughly half of incontinence-care cleanings were performed with soap and water rather than foam cleansers.
This slow uptake of quality improvements in pressure ulcer care in Ontario may be connected to the condition's low profile relative to other diseases. "It's one of those diseases that's kind of silent," said Prof. Murray Krahn, principal investigator on the study who is a Professor in the Department of Medicine and the Faculty of Pharmacy at U of T, and Director of THETA.
"Unlike HIV or breast cancer, there are no advocacy groups marching for pressu
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