АNNОTАTЕD BIBLIОGRАРHY 3 Essay Example

  • Category:
    Nursing
  • Document type:
    Research Paper
  • Level:
    Undergraduate
  • Page:
    3
  • Words:
    2110

АNNОTАTЕD BIBLIОGRАРHY: A TOOL FOR ASSESSING AND PREVENTING PRESSURE ULCERS

Antonio, T & Conrad, K 2013, Clinical and economic improvements in pressure injury care at Ballarat Health Services, Wound Practice and Research, vol. 21, no. 1, pp. 4-10.

Antonia and Conrad (2013) implemented Wound Care Improvement (WCI) program with an aim of assessing injury prevalence and attaining improved patient as well as the economic outcome. The program was implement at Ballarat Health services, inpatient, outpatient and community health service in Victoria, Australia. Before the implementation of the program, there was a lack of training and education among the care providers in dealing with wound etiology as well as lack of confidence in caring for the wound. Also, the costs and pressure ulcers prevalence had become a liability for the hospitals and caregivers. The component of the program consisted of planning, leadership, measurement and monitoring, best practice clinical protocols, education and training, product formulation, reporting and communications and engagement of patients and families. The program was implement between 2009 and 2012 on 648 patients with different gender, age, diabetic condition, and pressure risk. There was a significant decline in pressure injury prevalence from 11% to 3.7% after the implementation of the program.

The study presents the conceptual basis for the Braden scale for predicting pressure injury risk in hospital outpatient, inpatient and nursing home residents. The study revealed that pressure ulcer are most frequently around bony prominences, regions where pressure interface are high. Common pressure injuries were found in the gluteal and sacral areas, notably around the sacrum, coccyx, and ischial tuberosity. The stages of these pressure injuries ranged from suspected ulcers and early soreness to necrosis and full thickness tissue loss. Despite the presented number of stages, the improvement and healing of the pressure injury did not necessarily pass successively from one phase to the next. Although the program presented an improved pressure injuries in Ballarat Health services, the variables in Antonia and Conrad’s study lacked statistical analysis to determine whether the variable explored had any statistical significance. Therefore, the study of the program variables is unreliable hence not dependable. However, the study can be used in providing significant components in developing a tool for pressure ulcer risk evaluation and preventive interventions.

Barker, A Kamar, J Tyndall, T White, L Hutchinson, A Klopfer, N & Weller, C 2013,
Implementation of pressure ulcer prevention best practice recommendations in acute care:
an observational study, International Wound Journal, vol. 10, pp. 313-320.

In this article, Barker and colleagues performed a study to investigate the significance of evidence-based ulcer prevention programs in reducing pressure ulcer prevalence in hospitals and find out if the recommended best practice strategies were incorporated in patient’s daily care. The research took place at The Northern Hospital in Melbourne Australia. The main focus of the study was to examine the care provider’s compliance with pressure injury assessment and intervention tool, the correctness of the pressure risk assessment measurement and the available prevention approaches. To accomplish this objective, Barker and colleagues performed three practice metrics. The first metric examined pressure injury prevalence; 1045 mature patients admitted in critical care, emergency department, and general wards were evaluated. The second metrics investigate the compliance of nurses to best practice documents by examined medical records from 4368 patients. Finally, the third metrics investigated the accuracy of pressure ulcer assessment tool by retrieving data from 270 surgical and medically admitted a patient in a period of three weeks. The retrieved data were analyzed using STATA and descriptive statics were performed to calculate pressure ulcer prevalence, compliance with the documentation, demographic statics, and prevention strategy. The results from the study suggested a significant reduction of pressure prevalence after implementation of the program from 12.6% to 2.6%. The study also observed a high compliance with pressure ulcer prevention documents among the nurses.

The nine years study real world study substantially investigated the changes linked to the implementation of evidence-based prevention program in dealing with pressure ulcers. Although the study was affected by factors such as changes in the environment, population, and policy, it was statically dependable and reliable. The acquired data were statistically analyzed using STATA and Cohen’s Kappa statistic applied to measure the reliability of two or more score. Besides, the study maintained its ethical consideration by acquiring approval from the Hospital’s administration and keeping the names of the patients discrete. The study reported the most used strategies for preventing pressure ulcer included continence aids and air mattress. However, the study did not investigate why some approaches where underutilized while other were highly preferred. This study presents a gap to examine further effects of nurse beliefs, knowledge and attitude on pressure ulcer prevention practice change.

Donnelly, J Winder, J Kernohan, W & Stevenson, M 2011, An RCT to determine the effect of
A heel elevation device in pressure ulcer prevention post-hip fracture. Journal of Wound Care, vol. 20, no. 7, pp. 309-318.

In this article, Donnelly and colleagues performed both a qualitative and a quantitive investigation to determine which heel suspension device is most effective in preventing pressure ulcers in older patients as well as evaluating patient’s opinion on an offloading devices. The study included elderly adult, above 65 years, with a hip fracture within two days of admission to the hospital. The patients who signed an informed consent were grouped into the intervention group and control group. Using Braden risk assessment tool, Malnutrition Universal screening tool, a mental health score, and pre-injury Barthel activities scores, the data was collected within two days of admission. Different types of mattress ranging from Alphx mattress to all standard pressure redistribution surfaces were select by nurses according to the perceived need. The data was then coded, and variables screened for reliability. Two sided hypothesis, and an acceptance power of 87.5% was performed to determine the significance difference in a number of pressure ulcers between patients in the intervention group and control group. SPSS tool was applied to analyze central tendency and dispersion, chi-square test, and independent sample t-test.119 patients were grouped into the control group while 120 were recruited into the intervention group. According to their finding, pressure injuries occurred in both groups. However, the incidence of pressure injuries were less in the patients subjected to intervention (7%) compared to the patients subjected to control group (26%). Most of the control group developed pressure injuries around their feet or heels and ankles, whereas the intervention group did not present such developments. The results found a significant correlation of hip fracture among older adults with pressure ulcers around their heels.

Although the research presented opinion from elderly adults, it was subjected to observation bias. However, the study substantially presents arguments on how to manage elderly patients with a hip fracture that can be used to determine the effectiveness of pressure injury assessment tools. The findings from this study will be incorporated when designing a pressure injury assessment tool. It is significant for the heels of the elderly adults to be elevated off the support surface.

Latimer, S Chaboyer, W & Gillespie, B 2014, Patient participation in pressure injury
prevention: giving patients a voice, Scandinavian Journal of Caring Sciences, vol. 28, no. 4,
pp. 648-654.

Latimer and colleagues performed a qualitative study to raise awareness among nurses on the opinion of patients regarding pressure injury prevention. This study was aimed to present and describe patients’ perception of their pressure injury prevention. To achieve this objective, the researchers used semi-structured interview to gather patients are feeling, and opinion concerning pressure injuries. The nurse in charge recruited 20 patients over 18 years with more than three days of admission from two hospitals in Australia. These participants had different medical condition and age. A ten to fifteen minutes interview consisting of ten questions were admitted to the patients. All the interviews were digitally recorded. Trustworthiness of the study was maintained through audibility, credibility, and dependability. The data was then coded into three classes: experiencing pressure injury; participating in pressure injury prevention, and resourcing pressure injury prevention and treatment. The experiencing pressure injury represented those patients expressing their emotional dimensions such as frustration, anger, pain and their efforts to relieve physical pressure that increased their risks to pressure injuries. Also, this category included patients with past pressure injury memory. The participating in pressure injury prevention category included a patient who were involved in care decisions and had an understanding of pressure injuries. Finally, the resourcing pressure injury prevention and treatment category encompassed the economic impact of pressure injury prevention care, access to information concerning pressure injury prevention, and time required to heal a pressure injury. The patients in the study provided an extensive description of their pressure injury experience and gained first-hand information from others.

This study support the relationship between patient outcome and nurse effectiveness in preventing pressure injuries. Beyond the patient’s severity of illness, patients’ involvement in pressure injury interventions has shown to improve the quality of care and reduce risk of patients. The study indicates that psychological factors may improve the quality of care, reduce the risk of patients to pressure injuries and increase the care givers’ job satisfaction. Most significantly, the study provides insights into understanding the effects of work place environment on nursing and patient outcome in preventing pressure injuries. The limitation to the design of this study is connected to convenience sampling, the size of the sample, common method variance and variation of data collection process. The common method variance occurred from using a single source and method of collecting data. This exposes the data to bias arising from patients’ opinions. This study presents relevant variables for designing assessment tool to better understand human health resource issues beyond nurses in preventing pressure injuries.

McInnes, E Jammali-Blasi, A Cullum, N Bell-Syer, S & Dumville, J 2013, Support surfaces for treating pressure injury: a Cochrane systematic review, International Journal of Nursing Studies, vol. 50, pp. 419-430.

In this article, MClnnes and colleagues applied a meta-analysis of written literature to investigate the effectiveness of pressure relieving surface in healing pressure injuries as well as the most effectively used pressure relieving surface. The researchers used multiple methods to obtain data and written research from medical databases using keywords related to pressure injury. The extracted data was then coded according to the description of the intervention, follow-up periods, and participants, and outcome assessed. Out of the 195 relevant articles, only 31 articles were found significant. Their study favored the use of sheepskin overlay to standard hospital mattress in reducing redness and heeling pressure ulcers. Also, their study reported a rate of 9% of wound closure for patients using non-power mattress compared with 5% of the patients with low air loss mattress. Besides, there was no statistical difference between those patients who used high technology pressure support surface and other high-tech alternating mattress and overlay.

This article provides improvements, shortfalls and advantages of different measurement tools for preventing pressure injuries. Authors of this article mainly used descriptive studies in humans, experimental studies and pressure injury preventive intervention identified by national and international experts’ review as published in various databases. Although the research was successful, it had a limitation in publication bias. This is because the research favored significant publication while rarely using the non-significant publication. Besides, the technology assessed in the research may be outdated since most of the technology analyzed were used more than decades ago. Also, the study did not recommend the best support surface for the treatment of pressure ulcers. The meta-analysis suggests a lack of existence of published research establishing a definitive cause-effect relationship between recognized risk factors and pressure injuries. Therefore, the researcher will utilize this gap to determine the relationship from a preponderance of the lower level evidence.

Reference

Antonio, T & Conrad, K 2013, Clinical and economic improvements in pressure injury care at Ballarat Health Services, Wound Practice and Research, vol. 21, no. 1, pp. 4-10.

Barker, A Kamar, J Tyndall, T White, L Hutchinson, A Klopfer, N & Weller, C 2013,
Implementation of pressure ulcer prevention best practice recommendations in acute care:
an observational study, International Wound Journal, vol. 10, pp. 313-320.

Donnelly, J Winder, J Kernohan, W & Stevenson, M 2011, An RCT to determine the effect of
A heel elevation device in pressure ulcer prevention post-hip fracture. Journal of Wound Care, vol. 20, no. 7, pp. 309-318.

Latimer, S Chaboyer, W & Gillespie, B 2014, Patient participation in pressure injury
prevention: giving patients a voice, Scandinavian Journal of Caring Sciences, vol. 28, no. 4,
pp. 648-654.

Latimer, S Chaboyer, W & Gillespie, B 2014, Patient participation in pressure injury
prevention: giving patients a voice, Scandinavian Journal of Caring Sciences, vol. 28, no. 4,
pp. 648-654.

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