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The Effectiveness of Two Heel Pressure Reduction Devices for Heel Pressure Ulcer Prevention
Anne Aquila MSN, RN, CS / Deborah Ferretti MS, RN, CS
Abstract
A descriptive study design using a convenience sample of thirty-four acute care patients was conducted to comparatively evaluate the effectiveness of the EHOB Foot WAFFLE® Air Cushion and the Stryker® Air-Shu Boot at relieving tissue interface pressure at the heel. Subjects were studied for a maximum period of seven days, with tissue interface pressure readings taken on day one, three, and seven. During the study, subjects wore the Foot WAFFLE® Air Cushion on the right foot and the Stryker® Air-Shu Boot on the left foot. General skin condition, product application, and subjective data were collected. Analysis of the data using the one-tailed T-test demonstrated that the EHOB Foot WAFFLE® Air Cushion was more effective at relieving heel interface pressure with the subject positioned both supine (p=.00005) and supine with 30 degrees of head elevation (p=.00005). There was no significant difference between the two products at reducing pressure at the achilles or calf. Subjective responses from subjects demonstrated a preference for the Foot WAFFLE® Air Cushion.
Purpose
The purpose of this study was to compare the effectiveness of the Stryker® Air-Shu Boot and the Foot WAFFLE® Air Cushion in reducing tissue interface pressures at the heel and in the prevention of heel pressure ulcers. The redistribution of pressure to other surfaces of the leg was also examined.
Results
The results demonstrated superior pressure relief at the heel with the Foot WAFFLE® Air Cushion (p=.00005) on day one in both positions, and day three in the elevated position. There was no evidence of superior pressure relief at the achilles or the calf. While subjects and nurses identified concerns with both products, responses to the Foot WAFFLE® Air Cushion were more favorable.
Cost Analysis
When calculating the cost of the products, one must consider the savings realized if pressure ulcers are prevented that may have otherwise occurred. the average cost to treat a pressure ulcer ranges from $5,000 to $40,000. Nursing care costs can increase as much as 50% for patients with pressure ulcers. The cost of the Foot WAFFLE® Air Cushion was comparable to the cost of the Stryker® Air-Shu Boot (shell with liner.) In settings which clean and reuse the Air-Shu shell, the product cost would be lower. However, the study showed more effective pressure relief and more positive patient responses to the Foot WAFFLE® Air Cushion which could lead to better prevention of pressure ulcers on the heel.
Conclusions
The EHOB Foot WAFFLE® Air Cushion was more effective at reducing tissue interface pressure on the heel on day one of the study with the subjects supine (p=.00005), and with 30 degree of head elevation (p=.00005). The EHOB Foot WAFFLE® Air Cushion was more effective at reducing tissue interface pressure on the heel on day three only with the subjects supine with 30 degrees of head elevation. No significant difference was found between the products on day seven in either position. There was no significant difference between the products at reducing tissue interface pressure at the achilles or the calf. Subjective responses of the subjects and staff demonstrated a preference for the EHOB Foot WAFFLE® Air Cushion.
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Products Applicable to this Study:
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