Evidence Based Research: Pressure Ulcers
What are the applicable clinical approaches that may be adopted in the reduction of the occurrence of pressure ulcers among long term care patients? Pressure ulcers are caused by excessive rest on a particular posture without a change in position. The application of pressure on these areas results to these ulcers, and thus the need for solutions. Such cases are usually common in hospitals among patients on long term care. Nurses can offer solution to these illnesses by constantly changing the position of the patient, as well as usage of materials with minimal stress on the patient’s body. According to research, the materials used in form of bedding in a hospital has significant impacts on the pressure enacted on the patient’s body, resulting to a prevalence of pressure ulcers among long term patients (Edlichet al., 2004, p 28).
According to analysis of PICO, the problem is the pressure on the prevalence of ulcers among patients on long term hospital care. The intervening measure is the consistent change in the patient position to reduce pressure application on the body of the patient. Another approach is the use of materials that enact minimal pressure on the patient’s body, eliminating ulcer occurrence. For comparison, there are no previously adopted approaches aimed at minimizing the prevalence of pressure ulcers, despite the existence of various forms of medication. The results of the process are minimization in the prevalence of pressure ulcers among patients on long term medical care (Newhouseet al., 2007, p. 68).
References
Edlich, R., et al. (2004). Pressure ulcer prevention. Journal of long-term effects of medical implants, 14(4).
Newhouse, R. P. et al. (2007). Johns Hopkins nursing evidence-based practice model and guidelines. Sigma Theta Tau International Honor Society of Nursing.
| PICO Worksheet | |||
| The PICO Question
What are the applicable clinical approaches that may be adopted in the reduction of the occurrence of pressure ulcers among long term care patients? Patient and Problem The patients are majorly people with long term illnesses that have been admitted in the hospitals. The problem is the absence of materials which are good and consistent change in positioning as a way of easing the body pressure of the patient. Intervention The intervention to be applied on the patient is to constantly change the positioning of the patient on the bed, and also use materials that prevent stress and pressure on their body. Comparison with Other Medication There has been no previous prevention approach of pressure ulcers, but there exists several medications to treat the suffering patients. Outcomes The outcome of the adoption of the depicted strategies is a resultant reduction in occurrence and prevalence of pressure ulcers among long term patients. |
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| What is the practice issue/problem?
The practice issue under study is the prevention of pressure ulcers among long term patients, through the provision of alternative materials and approaches |
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| What is the practice area?
✓Clinical ___ Education |
___ Administration ___ Other |
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| How was the practice issue identified? (check all that apply)
✓Safety/risk management concerns ✓Unsatisfactory patient outcomes ✓Wide variations in practice ___ Significant financial concerns |
___ Difference between hospital and community practice ✓ Clinical practice issue is a concern ___ Procedure or process is a time waster ___ Clinical practice issue has no scientific base ___ Other: |
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| What evidence must be gathered? (check all that apply) | |||
| ✓ Literature search
✓ Guidelines ___ Expert Opinion ___ Patient Preferences |
✓Clinical Expertise
___ Financial Analysis ✓Standards (Regulatory, professional, community) ___ Other |
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| Search terms:
Pressure Ulcers, Long Term Patients, Bedding materials in hospitals, |
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| Databases to search:
Ø Cochrane database for evidenced-based medicine Ø Medline Ø PubMed Ø Embase Ø ERIC Ø PsycInfo |
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| Search Strategies:
Comparison of reputable sources of information Focusing on expert opinion from scholars and doctors Use of a variety of data sources for research conduction |
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| Evidence Appraisal Worksheet | ||||
| PICO Question: What are the applicable clinical approaches that may be adopted in the reduction of the occurrence of pressure ulcers among long term care patients? | ||||
| APA Reference for Article | Type of Source | Strength of Research | Brief Description of Research | |
| 1 | Demarré, L., Verhaeghe, S., Van Hecke, A., Grypdonck, M., Clays, E., Vanderwee, K., & Beeckman, D. (2013). The effectiveness of three types of alternating pressure air mattresses in the prevention of pressure ulcers in Belgian hospitals. Research in nursing & health, 36(5), 439-452.
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Case Study | The provided information is of high credibility and would be significant in conducting the research. It however does not cover crucial aspects in the research work. This enables the strength of the research to be Satisfactory. | The case study effectively depicts materials necessary for the prevention of pressure ulcers. It focuses on pressure mattresses, which are effective in the protection of the patients, with a focus on Belgian hospitals. The source of information recommends the use of three types of discussed mattresses, for eradicating the prevalence of ulcer’s pressure. |
| 2 | Reddy, M., Gill, S. S., & Rochon, P. A. (2006). Preventing pressure ulcers: a systematic review. Jama, 296(8), 974-984.
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Peer Reviewed Article | The research journal provides significant information regardarding ulcer prevention. It is at a level which is Good. | The journal is in the review form of preventive measures proposed for pressure ulcers. The author focuses on prevalent medical interventions, and their success in eradicating these ulcers. It gives a recommendation for the use of materials reducing pressure and stress for patients on long term hospital care. |
| 3 | Moore, Z. E., & Cowman, S. (2014). Risk assessment tools for the prevention of pressure ulcers. The Cochrane Library. | Expert Opinion | The opinionated article provides vital information regarding necessary tools for the risk assessment of vital tools, as well as the prevention of pressure ulcers. It is a Strong source for the research. | The author elucidates vital tools that should be adopted to minimize the risk occurrence of pressure ulcers, advising on the use of pressure mattresses, as well as other materials that protect the patient from pressure. He also advocates for constant change in positions, to minimize stress. |
| 4 | McInnes, E., Chaboyer, W., Allen, T., Murray, E., & Webber, L. (2013). Acute care patient mobility patterns and documented pressure injury prevention-an observational study and survey. Wound Practice & Research: Journal of the Australian Wound Management Association, 21(3), 116. | Case Study | It succinctly depicts the causes and prevention of injuries, making it a vital tool for the conduction of the research on pressure ulcers prevention. It is in a level which is Good. | The other explicates patterns of acute care mobility, as well as the documented principles and practices for the prevention of pressure ulcers. Through a case study, the article recommends maximization of patient care by nurses, through constant checkups and adherence to their requests and wishes. |