Development, dissemination and evaluation of a smartphone-based app for pressure ulcer/injury prevention and treatment for use at the bedside
After launching the 2019 International Pressure Ulcer/Injury Guideline, the National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) collaborated with Sensorydata Corp., US, to develop a guideline app (InterPIP App). The app was designed to: present evidence-based guideline recommendations; incorporate search capacities and functionality to facilitate easy access to clinical guidance; provide accessibility in multiple languages; and to be available worldwide at a reasonable price, including opportunities for free access in low-resource countries. This paper describes the development, dissemination and formative evaluation of a mobile app providing evidence-based recommendations for pressure injury prevention, assessment/classification, and treatment at the point of care.
An evaluation tool was designed based on a framework developed by Nouri et al. and made available to all app subscribers.
The InterPIP App is currently available in 11 languages and had been downloaded 3616 times by February 2022 in 78 countries. A total of 62 individuals responded to the survey of end-users. In this formal evaluation of user experiences, the app was rated positively on criteria of: information/content; usability; design; functionality; ethics; and security/privacy (median=4 on a 1–5 Likert scale). Overall perceived value was ranked lower with a median of three. Users provided suggestions for ongoing app enhancement.
The InterPIP App offers a unique opportunity to bring evidence-based guidance to the point of care. Formal evaluation of end-user experiences identified opportunities for quality improvement, and informed plans for future development and evaluation.
A pressure injury (PI) is defined as localised damage to skin and/or underlying tissue, as a result of pressure or pressure in combination with shear.1 In Europe, the term pressure ulcer is preferred.1 PIs impact negatively on health-related quality of life (HRQoL) and are expensive to treat, with estimates suggesting that PIs consume a significant proportion of global healthcare budgets.2,3,4 In contemporary practice PIs remain an important safety concern, for example, Wood et al.5 reported that in the UK, PIs accounted for 19% of all patient safety incidents. This is echoed across the US,6 Canada7 and Australia.8 Despite the availability of International Pressure Ulcer/Injury Clinical Practice Guidelines1,9,10 and a plethora of global prevention initiatives, systematic reviews still report unacceptably high international incidence and prevalence rates across clinical settings in multiple countries11,12,13,14,15 (Table 1). This realisation prompted the International Guideline Consortium (consisting of the European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP) and the Pan Pacific Pressure Injury Alliance (PPPIA)) to reevaluate guideline dissemination and implementation strategies to more effectively improve patient outcomes throughout the world. This paper reports on evaluation of a guideline smartphone app, designed to support dissemination of the 2019 guidelines1 and evidence-based practice, in the early phases of development and dissemination.
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