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advantages for pressure ulcer prevention: they are inexpensive, easy to maintain, portable, easy to use and acceptable to patients


n 250 nurses working in the Neurosciences and Surgical units of the hospital took part in the survey. A semi-structured questionnaire, administered face-to face, was employed to generate quantitative data. It consisted of 32 items in five sections: sociodemographic characteristics, knowledge about use of water-filled gloves, use, perception and criteria for use. The nurses also took part in in-depth interviews to provide qualitative data


n Most survey participants were aged 26-30 years (28.8%) and the majority were women (97.2%). Most subjects were registered nurses or midwives; only 8.4% of nurses had a Bachelor of Nursing qualification


n The results indicated that most nurses (nearly 80%) knew about water-filled gloves for prevention of pressure ulcers, though only 37% had been taught about them during their training. Most nurses used water-filled gloves in everyday clinical practice, with nearly 30% mentioning that they used them after seeing colleagues using them. Knowledge and use were significantly associated with nurses’ years of experience. Older nurses also tended to rely more on their own knowledge and experience


n Nurses with adequate knowledge of risk factors for pressure ulcers used water-filled gloves more than those who did not have this knowledge. Three quarters of nurses felt that the use of water-filled gloves had contributed greatly to reduction in heel pressure ulcers


n Nurse perception about water-filled gloves was also significantly linked to their use


n The authors described levels of knowledge, perception and use of water-filled gloves as ‘fairly adequate’ among the nurses involved in this study, but recommended that continuing education and initiatives to encourage use and best clinical practice, by nurses themselves as well as by training bodies and hospitals, should be encouraged in order to optimise patient benefit.


Adejumo PO, Ingwu JA. Nurses’ use of water-filled gloves in preventing heel pressure ulcer in the University College Hospital, Ibadan, Nigeria. Int Wound J 2010; 7: 472–9


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Australian Medical Sheepskin aids pressure ulcer prevention


Readability Relevance to daily practice Novelty factor


n This prospective, multicenter, randomised controlled trial was designed to assess the efficacy of the Australian Medical Sheepskin in prevention of sacral


37 Wounds International Vol 2 | Issue 1 | ©Wounds International 2011 pressure ulcers in nursing home patients


n Sheepskin has been used since the 1930s and was understood to have valuable pressure-relieving and moisture-absorbing properties, and therefore to be useful in preventing pressure ulcers. The Australian Medical Sheepskin (AMS), devised in the 1990s, has been tanned and processed such that it is resistant to urine and can withstand up to 60 washes at 80ºC


n Most studies using the AMS have been performed in acute hospital patients. The current study examined effectiveness in nursing home patients, who are at increased risk of developing pressure ulcers


n All patients newly admitted to one of eight nursing homes for a primarily physical impairment were assessed for inclusion in the study. Subjects were eligible if they had an anticipated stay of more than one week, had no sacral ulceration on admission, did not have darkly pigmented skin (to avoid difficulty in diagnosing grade 1 pressure ulcer) and had no known allergy to wool


n Patients were randomised to usual care or usual care plus AMS overlaid on their mattress in the area of the buttocks, no later than 48 hours after admission


n The AMS was used until 30 days after admission (or until the patient was discharged or died if this period was shorter); use could be continued after the first 30 days if the patient requested it. The primary outcome for the study was sacral pressure ulcer incidence 30 days after admission


n N=588 patients were randomised (293 control, 295 experimental); data from 543 patients could be analyzed (272 from the control and 271 from the experimental group)


n The incidence of sacral pressure ulcers grade 1 or higher was significantly lower in the experimental group than in the control group (8.9% vs. 14.7%). Analysis on pressure ulcer incidence adjusted for Braden risk score, age, and gender showed an odds ratio of 0.53 (95% confidence interval: 0.29–0.95), confirming that AMS has a significant protective effect


n The results of a comfort questionnaire completed by patients showed that most aspects of the AMS were judged favourably, but about one third of respondents found the AMS made them too warm. Just over half would recommend it to other patients


n The AMS made bedding changes slightly more difficult and slightly less convenient, but nurses did not encounter difficulty in using it


n The authors concluded that the AMS is an effective aid for preventing pressure ulcers, and recommended that guidelines on pressure ulcer prevention be revised to reflect this finding.


Mistiaen P, Achterberg W, Ament A, Halfens R, Huizinga J, Montgomery K, Post H, Spreeuwenberg P, Francke AL. The effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home


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