Testing a Tool to Help Prevent Pressure Injuries in Veterans with Spinal Cord Injury at VA Clinics

What this Trial Is About

Spinal cord injury SCI is a lifelong condition that affects health, daily activities, and quality of life. People with SCI face a high risk of developing pressure injuries, which are areas of skin and tissue damage caused by pressure and shear, typically occurring over bony areas. Unlike most pressure injuries acquired in hospitals or nursing homes, those in people with SCI often develop in the community, leading to serious, costly problems. This research evaluates how well a decision support tool called the Community Acquired Pressure Injury Prevention Field Implementation Tool CAPP-FIT works in preventing community-acquired pressure injuries CAPrIs and how well it is used in clinical practice. The study involves implementing the CAPP-FIT at seven Veterans Affairs VA spinal cord injury clinics across the country in a staggered way. The tool includes a Veteran survey to identify risks and needed actions, and a Provider Report available in the electronic health record that recommends evidence-based actions. Veterans complete the survey via secure email or an iPad in the clinic. The study includes training providers, redesigning clinic workflows, and evaluating how the tool is adopted and maintained. After initial implementation, each site decides how to keep using the CAPP-FIT to support long-term use. Participants will complete the Veteran survey and attend scheduled clinic visits where providers use the Provider Report. Researchers will monitor new pressure injuries, hospitalizations related to these injuries, and satisfaction of both Veterans and providers over six months following implementation. They will also track how many providers and Veterans use the tool, how risks are managed, and barriers or facilitators to its use. The study lasts through implementation and maintenance phases, with ongoing evaluation of how the CAPP-FIT fits into regular care.

Implementing a Decision Support Tool to Prevent Community-Acquired Pressure Injury in Spinal Cord Injury (SCI) in the Spinal Cord Injury Clinic