Little evidence, of very low to moderate quality, exists on the effects of interventions for preventing and treating IAD in adults. Soap and water performed poorly in the prevention and treatment of IAD. Application of leave-on products (moisturisers, skin protectants, or a combination) and avoiding soap seems to be more effective than withholding these products. The performance of leave-on products depends on the combination of ingredients, the overall formulation and the usage (e.g. amount applied). High quality confirmatory trials using standardised, and comparable prevention and treatment regimens in different settings/regions are required. Furthermore, to increase the comparability of trial results, we recommend the development of a core outcome set, including validated measurement tools. The evidence in this review is current up to 28 September 2016.

The development of the GLOBIAD is a major step towards a better systematic assessment of IAD in clinical practice and research worldwide. However, further validation is needed.

Funding sourcesThe Belgian Health Care Knowledge Centre (KCE) funded and sponsored the trial via the KCE Trials Programme (study ID KCE16012), a national public funding programme of noncommercial trials. No funding from the manufacturers of the study devices was received. Involvement of the sponsor included refinement of the study design and statistical analyses but they were not involved in data collection. KCE members reviewed the manuscript for statistical correctness and interpretation. The corresponding author had the final responsibility for the decision to publish.

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Aim To study the effectiveness of tailored repositioning and a turning and repositioning system on: (a) nurses’ compliance to repositioning frequencies; (b) body posture of patients after repositioning; (c) incidence of pressure ulcers and incontinence‐associated dermatitis; (d) nurses’ and patients’ preferences, comfort and acceptability; and (e) budget impact. Background Patient‐tailored systematic repositioning is key in pressure ulcer prevention. To date, a clinical decision‐making tool is lacking and compliance to pressure ulcer prevention guidelines is low. Research concerning commercially available turning and repositioning systems is lacking. Design Multicentre, cluster, three‐arm, randomized, controlled pragmatic trial. Methods Two hundred and twenty‐seven patients at risk of pressure ulcer development were recruited at 29 wards in 16 hospitals between February 2016 and December 2017. Wards were randomly assigned to two experimental groups and one control group. Results Nurses’ compliance to repositioning frequencies increased significantly in the experimental groups when patients were cared for in bed (94.6% vs. 69% and 84.9% vs. 71.4%). Applying the turning and repositioning system was associated with significantly more correctly positioned patients (30–45° tilted side‐lying position) (69.6% vs. 34.6%). Few pressure ulcers and incontinence‐associated dermatitis incidents occurred. Both patients and nurses were positive about the intervention. Higher labour costs related to repositioning in bed were found in the control group. Conclusion This was the first study investigating the effect of tailored repositioning and the use of a repositioning aid to increase nurses’ compliance to repositioning. The results were in favour of the interventions yet demonstrating the importance of follow‐up and education. Trial registration This study is registered at https://clinicaltrials.gov/NCT02690753;NCT02690753.