Comparing Patient Adherence: Heel Keeper versus Traditional Heel Elevating Off-Loading Boot for Pressure Injury Prevention/Treatment
Purpose
A study was performed to measure and compare the level of patient adherence for patients who were prescribed traditional heel elevating off-loading boots and the Heel Keeper, a new heel elevating off-loading device. The goal of the study was to determine which off-loading device provides the best level of patient adherence and to determine if there was a significant difference in patient adherence between the two off-loading devices.
Materials and Methods
Convenience samples were obtained at a skilled nursing facility and an outpatient wound clinic. A verbally administered questionnaire was used as the survey tool. Data acquisition was performed by senior nursing staff at the nursing facility and the principal investigator at the wound clinic. There were no exclusion criteria. Primary data obtained included the estimated duration the device was worn in a 24- hour period and the patient’s preference regarding the Heel Keeper versus traditional off-loading. Patients are still being enrolled and these results are preliminary.
Comparison Findings:
Average Duration Worn in 24-Hours
Reported Duration Worn in 24-Hours
Patients Who Have Worn Both Prefer
Conclusions:
- Patients wore the Heel Keeper 63% (5.3 hours) longer per day than the traditional heel off-loading boots.
- 13.7 hours versus 8.4 hours per 24 hours (p-value = 0.008)
- The “Never Wear” rate for the Heel Keeper was significantly better than the traditional heel off-loading boots. The Heel Keeper reduces the number of patients who refuse to wear an off-loading device by 70%!
- 12% versus 40% (p value of 0.008)
- Of patients who have worn both devices, the Heel Keeper is preferred and more likely to be worn.
- 80% versus 7% (p value of 0.0001)
Despite the preliminary nature of the data, statistical significance was achieved in all measured outcomes. Based on these findings, the Heel Keeper provides a better level of patient adherence than traditional heel off-loading boots.