Discussion
SECONDARY
Our RCT evaluating CBPM technology followed earlier published studies on the same technology.Prior CBPM studies typically focused on either clinicalNotwithstanding the lack of statistical significance on measures of central tendency (Taken as a whole, the findings of this clinical trial are mixed. The primary outcomes do not differ significantly between groups. For the primary end point, it is indeed unfortunate that data loss resulted in the study being underpowered to detect a statistically significant 15% relative reduction in the pressure measures (particularly because the relative difference in the study was 16% for the primary outcome). Alongside this, one of the secondary outcomes (skin changes at new locations) was reduced in the intervention group. Lastly, the ICU vs non-ICU subgroup analysis, which importantly was not a prespecified subgroup analysis, raises the possibility (which should only be viewed as a hypothesis-generating possibility) that the CBPM intervention may be most beneficial in care settings where there is less nurse staffing and lower nursing care intensity.Our study findings must be interpreted in the context of existing literature on CBPM systems. Collectively, studies do suggest that CBPM may be a useful component of multifaceted efforts to decrease new PIs among those at the highest risk. Our findings are consistent with previous resultsWe anticipate that CBPM systems will be most effective if incorporated as part of a multicomponent intervention including staff training on PI prevention and the use of pressure-reducing mattresses, which was also considered in the study by Gunningberg et al.