Extra steps to influence worldwide research and care

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Tod Brindle, a nurse clinician at Virginia Commonwealth University Medical Center, doesn’t have a research job.

“Most of us operate within a framework of carrots and sticks - mentors, department chairs, benchmarks, protected time, yearly checkups, ‘K’ awards, mock study sections, promotion and advancement linked to publication, tenure shimmering in the distance - an entire mechanism to try to nurture our research careers,” said Jacob Wegelin, Ph.D., assistant professor in the Department of Biostatistics, VCU School of Medicine. “Mr. Brindle, by contrast, enjoys none of these benefits.”

And with all of his comparative research disadvantages, he has achieved what many of us can only dream of.

Despite this apparent research disadvantage, Brindle and Wegelin published research in 2012 that is now being recognized as the foundation for subsequent worldwide literature and the basis for protecting patients from injury across the globe.

The article, published in the March/April 2012 issue of the Journal of Wound, Ostomy and Continence Nursing (JWOCN), received the honor as the best original, clinical research peer-reviewed article published in the journal in the past year. Titled “Prophylactic Dressing Application to Reduce Pressure Ulcer Formation in Cardiac Surgery Patients,” the article explores the use of foam dressings to prevent pressure ulcers.

This is the first time that the use of a dressing was conceptualized and implemented to prevent sacral pressure ulcers in this patient population. Specifically, cardiac surgery patients were selected because they are globally regarded in the pressure ulcer literature as the greatest at-risk group of patients.

While limitations of the study failed to achieve statistical significance, the study showed that the dressing was demonstrating a protective effect, that patients in the study who utilized the dressings did not develop pressure ulcers during their operating room case and that the skin of those utilizing the dressing may have survived longer without injury.

“The greatest outcome of this study is that it challenged the standards of practice for ‘normal preventative care’ and allowed researchers all over the world the chance to duplicate our study to further try and prove its efficacy,” Brindle said.

The worldwide response includes two randomized controlled trials utilizing this paper’s hypothesis and dressing, more than 10 peer-reviewed journal articles and more than 30 scientific posters.

In addition, an estimated 1,000 hospitals worldwide have taken the initial study results and implemented the use of this dressing into practice. More than 550 hospitals in the U.S. have duplicated a study similar to the one published by Brindle and Wegelin. Twenty hospitals in Saudi Arabia have done the same. There are 10 active studies in Canada and randomized controlled trials in Australia, South Korea, the Netherlands and England.

Brindle said the global response to the study is “due to the excellent statistical analysis provided by Dr. Wegelin, who provided a blueprint for future statistical analysis.”

“I've been collaborating on research projects for 10 years, and among the clinicians with whom I've worked, Tod Brindle stands out,” Wegelin said. “And with all of his comparative research disadvantages, he has achieved what many of us can only dream of.”


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