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Table 1 Detail behind the JLAPUP top priority

From: Exploring the challenge of health research priority setting in partnership: reflections on the methodology used by the James Lind Alliance Pressure Ulcer Priority Setting Partnership

How effective is repositioning in the prevention of pressure ulcers?

Population

People of all ages at risk of pressure ulcers in bed.

People of all ages at risk of developing a pressure ulcer who have limited mobility and are largely seated.

Sub groups

Those with contracted limbs, dementia, heel pressure ulcers, incontinence, stroke, spinal injury, multiple sclerosis, bariatric, cachexic, in hospitals and institutions including surgical patients and those nursed in bed and those cared for at home.

Wheelchair users, with for example co-morbidities such as multiple sclerosis and spinal cord injury.

Interventions and comparisons

The optimum frequency for turning e.g., two hourly turning vs. four hourly turning in relation to the type of mattress or surface being used.

The optimum frequency and techniques for changing position or posture by self or others.

The relative effectiveness of methods of repositioning broader than turning e.g., the Trendelenburg system of positioning vs. the knee break system or the effectiveness of 30 degree tilt in conjunction with pressure relieving mattress.

Comparisons of techniques and tools for limiting damage when transferring between surfaces and lifting off cushions.

Outcomes

Prevention of pressure ulceration.

Prevention of pressure ulceration.

Impacts on quality of life of patient, carer and partners over 24 hour period, including sleep disruption and the impacts on those who would usually bed share.

Impacts on quality of life of patients and carers including the ability to undertake usual domestic, social and work/education activities. Limiting damage caused when transferring between surfaces.