On March 23, 2011, Tom Defloor, Professor of Nursing Science, passed away in Bruges, Belgium. He was one of the world's most distinguished pressure ulcer prevention researchers and a dear friend of many colleagues around the world. After 1 year of illness, he peacefully died at home, in the presence of his beloved family. He was an extraordinary man with numerous qualities. We will remember Tom as a high-achieving researcher, a supportive supervisor, and a caring person. He was inspiring and creative as well as a visionary. His contributions to our nursing profession in general and to pressure ulcer management in particular are invaluable. This contribution has been prepared on behalf of all his colleagues at the Nursing Science Unit (Ghent University, Belgium), by people who knew Tom personally and through his work, his former PhD students (Katrien Vanderwee: 2006, Sofie Verhaeghe: 2007, Ann Van Hecke: 2010, Dimitri Beeckman: 2011) and his own PhD supervisor (Mieke Grypdonck).
Born February 27, 1958, in Ostend, Belgium, Tom was awarded a BSc in nursing (1979), an MSc in medical-social sciences (1984), an Academic Teaching Degree in social-health sciences (1984), a BSc in informatics (1993), and a PhD in social health sciences (2000). His groundbreaking PhD thesis was titled "Pressure Reduction and Repositioning for the Prevention of Pressure Ulcers" and led to a significant improvement in our understanding of the importance of repositioning to prevent pressure ulcers.
Tom dedicated most of his professional life to the prevention of pressure ulcers. He developed an internationally leading research group at Ghent University in Belgium. His research staff will remember him as very energetic, approachable, inventive, creative, and supportive. He designed, performed, and supervised numerous studies related to pressure ulcer prevention. He loved to think, discuss, and rethink about different research designs to evaluate the effectiveness of interventions, materials, and methods to prevent pressure ulcers. Tom's creativity and workforce resulted in innovative and large clinical trials others believed to be impossible. He valued the scientific debate and was not fearful to initiate controversial ideas to generate new research. Implications for clinical practice were always in his mind. For Tom, research and sharing these results were inevitably linked with each other. He traveled all over Belgium, Europe, Asia, and the United States to present his research results at numerous conferences and meetings. Many researchers and clinicians will remember his unique presentation style: charming, with a lot of humor and generosity, but nevertheless always with a clear, concise, and thoughtful message.
His research legacy is massive and cannot be summarized in this brief contribution. Major groundbreaking insights were generated in the field of repositioning, the use of support surfaces, risk assessment, the classification of pressure ulcers, and the differentiation between pressure ulcers and incontinence-associated dermatitis. In 2005, he was the lead author of the statement of the European Pressure Ulcer Advisory Panel (EPUAP) on the differentiation between pressure ulcers and incontinence-associated dermatitis, published in this Journal. Through his research, he triggered many researchers, practitioners, and the wound care industry to continuously rethink interventions and methods with only 1 aim: the improvement of pressure ulcer prevention.
Between 2005 and 2007, he was the president of the EPUAP. Between 2007 and 2009, he was one of the leading figures during the development of the joint EPUAP and NPUAP guidelines on pressure ulcer prevention and treatment. He pioneered this collaborative piece of high-quality research and forged links between basic and clinical researchers in different disciplines, across many different countries.
As a supervisor, he intensively focused together with his PhD students on non blanchable erythema as an indicator for pressure ulcer risk, the development of a standardized method for pressure ulcer prevalence studies, the effectiveness of alternating mattresses, the interobserver reliability of pressure ulcer classification, the prevention and treatment of incontinence-associated dermatitis, knowledge and attitudes of nurses toward pressure ulcer prevention, and the development of implementation strategies. He also developed and tested the e-learning PUCLAS education tool (http://www.puclas.ugent.be/puclas/), a worldwide-used tool to learn and teach about pressure ulcer classification and IAD differentiation, translated into many languages.
In sum, Tom's work ranks among the highest achievements in this field. Anyone who wants to understand the principles of pressure ulcer prevention cannot bypass his work. He has left a guidebook for practitioners, researchers, and students, a long-lasting and profound contribution. The importance and quality of his work was recognized in 2010 when he was awarded the EPUAP Experienced Investigator Award by the EPUAP.
Since 1996, Tom was the Head of the Nursing Science Unit, Department of Public Health, at Ghent University in Belgium. For many years, he worked hard and enthusiastically with his team of 20 researchers, educators, and supportive staff to develop both high-quality academic research in the field of nursing and an academic master's program for nurses and midwifes in Flanders, Belgium. During his impressive career, he educated more than 3500 student nurses, from BSc, over MSc up to doctoral degree. Next to his pressure ulcer research, he conducted and published multiple studies related to malnutrition, patient education, therapy adherence in venous leg ulcer patients, advanced practice, geriatrics, family care, and nursing competences. He encouraged his staff to use quantitative, qualitative, and mixed-method designs. His basic mission was to improve the quality of nursing care for patients and their family through evidence-based research. In total, he published more than 100 articles in national and international peer-reviewed scientific journals.
Of course, there is much more to being a professor in nursing science than being a successful researcher, and in that wider field of activity, Tom also set high standards. He was an inspirational teacher who enjoyed a special affinity with students. He encouraged them and treated them with unfailing fairness and respect. Yet, he never compromised in his requirement that they endeavor to meet the highest standards of scholarship. If he was in his office, he would likely be sitting at his desk, next to the window, advising students. His door would remain open until the last student had left, no matter how long that took.
Perhaps the most remarkable thing for those who knew him well, however, was Tom's encyclopedic knowledge of so many things. He was an intellectual, voracious, and critical reader on a wide variety of subjects. His office in Ghent offered clues to this. His bookcases were filled with scientific books and texts, and when he needed a reference, he would unfailingly reach for the right one and open it at the correct page. He did this so routinely; it was clear that he had read every one of them.
The scientific community has lost an outstanding personality, but he leaves us a considerable legacy. Tom's scientific legacy is secure. It will continue to be a resource and an inspiration for many nursing researchers in general and pressure ulcer researchers in particular for many years to come. And his personal legacy-the memory of his enthusiasm and is creativity, his empathy, and modesty-will continue to enrich the lives of his family, friends, colleagues, and students.
Tom, your team at Ghent University is proud of you and will miss you as a colleague, a supervisor, a teacher, and a friend. We will never forget you.
On behalf of the Nursing Science Unit, Department of Public Health
Ghent University, Ghent, Belgium.
-Dimitri Beeckman, PhD, RN
Ghent University, Department of Public Health
Nursing Science, Ghent, Belgium; and King's College London
Florence Nightingale School of Nursing & Midwifery
London, United Kingdom
-Sofie Verhaeghe, RN, PhD
Professor in Nursing Science, Ghent University, Nursing Science Unit
Department of Public Health, Ghent, Belgium