Realist Evaluation of PU-RAIs in Clinical Practice: THEORY TESTING
Research type
Research Study
Full title
Realist Evaluation of Pressure Ulcer Risk Assessment Instruments in Clinical Practice: Theory Testing
IRAS ID
258489
Contact name
Susanne Coleman
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
0 years, 8 months, 1 days
Research summary
Background\nPressure ulcers (PUs) range in seriousness from slight skin damage to deep wounds. They occur in immobile patients and cause pain, reduce people’s quality of life, can lead to mortality and are estimated to cost 4% of the annual NHS budget. PU Risk Assessment forms help nurses to identify patients ‘at risk’ toprompt preventative measures (e.g. nursing care, mattresses). Due to limitations of standard forma a new form – the Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) was robustly developed/evaluated and has since been implemented in several NHS acute hospitals.\n\nA realist evaluation will be undertaken to understand how different contexts influence particular nursing team responses and give rise to different outcomes when using PURPOSE-T and standard forms. The realist evaluation incorporates 4 steps: theory development; theory prioritisation; theory testing; guidance development. This application is concerned with theory testing and guidance development.\n\nAim\nTo explain how PU risk assessment forms are used in different contexts in clinical practice to support clinical judgement, communication and decision making about care planning and delivery. \n\nDesign\nA realist process evaluation using mixed methods will be undertaken incorporating:\n-Organisational documentary review\n-Ethnographic observation of PU-RAI use and associated care planning and delivery \n-Patient record review \n-Semi-structured interviews with patients and carers \n-Semi-structured interviews with key members of staff \n-Semi-structured interviews with staff from other hospitals (not involved in the above) to support generalizability of the findings.\n-Service-user focus group with an established University of Leeds group, the Pressure Ulcer Research Service User Network (PURSUN) \n- Key stakeholder focus group to refine programme theories and develop user guidance for PU-RAI use.\n\nExpected Outcomes\nThe study will improve our understanding of how risk assessment forms are used in clinical practice. This will inform guidance development to better target their use in different circumstances and ongoing research evaluation methods.\n
REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
19/YH/0033
Date of REC Opinion
15 Apr 2019
REC opinion
Further Information Favourable Opinion