Multidimensional Team-Based Intervention Using Musical Cues to Reduce Odds of Facility-Acquired Pressure Ulcers in Long-Term Care: A Paired Randomized Intervention Study

• Published in: Journal of the American Geriatrics Society (JAGS) 2013-09, Vol.61 (9), p.1552-1559
• Main Authors: Yap, Tracey L., Kennerly, Susan M., Simmons, Mark R., Buncher, Charles R., Miller, Elaine, Kim, Jay, Yap, Winston Y.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cues; Dermatology; Female; Follow-Up Studies; General aspects; Homes for the Aged; Humans; Incidence; Intervention; Long term health care; long-term care; Long-Term Care - methods; Male; Medical sciences; multidisciplinary healthcare teams; Music Therapy - methods; nursing interventions; Odds Ratio; Pressure Ulcer - epidemiology; Pressure Ulcer - prevention & control; pressure ulcer prevention; Pressure ulcers; Prevention and actions; Preventive medicine; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Severity of Illness Index; Skin involvement in other diseases. Miscellaneous. General aspects; Time Factors; Treatment Outcome; United States - epidemiology
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.12422

Objectives To test the effectiveness of a pressure ulcer (PU) prevention intervention featuring musical cues to remind all long‐term care (LTC) staff (nursing and ancillary) to help every resident move or reposition every 2 hours. Design Twelve‐month paired‐facility two‐arm (with one‐arm crossover) randomized intervention trial. Setting Ten midwestern U.S. LTC facilities. Four treatment facilities received intervention during Months 1 to 12, four comparison facilities received intervention during Months 7 to 12, and two pseudo‐control facilities received no intervention. Participants LTC facility residents (N = 1,928). Intervention All facility staff received in‐person education, video, and handouts, and visiting family members received informational pamphlets on PU prevention and an intervention featuring musical cues. Nurse‐led multidisciplinary staff teams presented the cues as prompts for staff and family to reposition residents or remind them to move. Musical selections (with and without lyrics) customized to facility preferences were played daily over the facility intercom or public address system every 2 hours for the 12‐hour daytime period. Measurements Primary outcome measure was the frequency of new facility‐acquired PUs divided by the total number of facility Minimum Data Set (MDS) resident assessments conducted during the study period. Results Odds of a new PU were lower in intervention facilities (P = .08) for MDS 2.0 assessments and were significantly lower (P = .05) for MDS 3.0. Mean odds ratios suggested intervention facility residents were 45% less likely than comparison facility residents to develop a new PU. Conclusion Customized musical cues that prompt multidisciplinary staff teams to encourage or enable movement of all residents hold promise for reducing facility‐acquired PUs in LTC settings.