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dc.contributor.authorGreenwood, C.
dc.contributor.authorNixon, J.
dc.contributor.authorNelson, E.A.
dc.contributor.authorMcGinnis, E.
dc.contributor.authorRandell, Rebecca
dc.date.accessioned2023-06-21T11:14:39Z
dc.date.accessioned2023-07-11T09:50:26Z
dc.date.available2023-06-21T11:14:39Z
dc.date.available2023-07-11T09:50:26Z
dc.date.issued2023-05
dc.identifier.citationGreenwood C, Nixon J, Nelson EA et al (2023) Offloading devices for the prevention of heel pressure ulcers: A realist evaluation. International Journal of Nursing Studies. 141: 104479.en_US
dc.identifier.urihttp://hdl.handle.net/10454/19497
dc.descriptionYesen_US
dc.description.abstractHeel pressure ulcers can cause pain, reduce mobility, lead to longer hospital stays and in severe cases can lead to sepsis, amputation, and death. Offloading boots are marketed as heel pressure ulcer prevention devices, working by removing pressure to the heel, yet there is little good quality evidence about their clinical effectiveness. Given that evidence is not guiding use of these devices, this study aims to explore, how, when, and why these devices are used in hospital settings. To explore how offloading devices are used to prevent heel pressure ulcers, for whom and in what circumstances. A realist evaluation was undertaken to explore the contexts, mechanisms, and outcomes that might influence how offloading devices are implemented and used in clinical practice for the prevention of heel pressure ulcers in hospitals. Eight Tissue Viability Nurse Specialists from across the UK (England, Wales, and Northern Ireland) were interviewed. Questions sought to elicit whether, and in what ways, initial theories about the use of heel pressure ulcers fitted with interviewee's experiences. Thirteen initial theories were refined into three programme theories about how offloading devices are used by nurses 'proactively' to prevent heel pressure ulcers, 'reactively' to treat and minimise deterioration of early-stage pressure ulcers, and patient factors that influence how these devices are used. Offloading devices were used in clinical practice by all the interviewees. It was viewed that they were not suitable to be used by every patient, at every point in their inpatient journey, nor was it financially viable. However, the interviewees thought that identifying suitable 'at risk' patient groups that can maintain use of the devices could lead to proactive and cost-effective use of the devices. This understanding of the contexts and mechanisms that influence the effective use of offloading devices has implications for clinical practice and design of clinical trials of offloading devices. How, for whom, and in what circumstances do offloading devices work to prevent heel pressure ulcers? Tissue viability nurses' perspectives.en_US
dc.description.sponsorshipCG conducted this review as part of her PhD at the University of Leeds which was funded by a Charitable Grant from https://leedscares.org/LeedsHospitalsCharity (https://www.leedshospitalscharity. org.uk/) and Smith and Nephew Foundation.en_US
dc.language.isoenen_US
dc.rights© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).en_US
dc.subjectDevicesen_US
dc.subjectHeel pressure ulceren_US
dc.subjectOffloadingen_US
dc.subjectPreventionen_US
dc.subjectRealist evaluationen_US
dc.subjectTissue viability nurse specialisten_US
dc.titleOffloading devices for the prevention of heel pressure ulcers: A realist evaluationen_US
dc.status.refereedYesen_US
dc.date.Accepted2023-03-06
dc.date.application2023-03-13
dc.typeArticleen_US
dc.type.versionPublished versionen_US
dc.identifier.doihttps://doi.org/10.1016/j.ijnurstu.2023.104479
dc.rights.licenseCC-BY-NC-NDen_US
dc.date.updated2023-06-21T11:14:48Z
refterms.dateFOA2023-07-11T09:51:21Z
dc.openaccess.statusopenAccessen_US


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