LITERATURE REVIEW AND CRITICAL APPRAISAL WK 7

Joyce Nwakor

I stopped reading your analyses after number 3 because I did not see that you were doing a complete analysis like described below. Your summary was OK but need to talk about the gaps.

· Title the first section on page one: Introduction –

· Restate the CON approved list of subjects

· Restate your PICOT question

· Then you MUST give a one to two paragraph discussion of the key terms you used to guide the search for the evidence and the search engines you used to obtain the articles you will discuss. ok

· Title the next section Critical Analysis of Five Research Articles: all articles have to be within the last 5 years of publication

· then present summaries of five (5) of the research studies you used to support your project and use the appraisal criteria below to do this part of the paper.

· Title of the article and the journal ok

· Author and Date of publication - has to be within the past 5 years to be used as evidence ok

· Type of article published: systematic review, meta-analysis, random clinical trials, cohort studies, etc need to specify in the beginning of each analysis what type of study or review it was

· EBP pyramid level of evidence (Ranks are levels I – VII) make sure your level is correct

· Include what was the purpose, process, and outcomes of that research you did this on some but not all

· Was the study appropriate and valuable to improve health need to discuss this

· Who were the participants, how many, was a power analysis done to determine if statistical analysis should be performed need to discuss

· Was randomization or volunteer, or specific sample selection used need to discuss this

· If a systematic review or meta-analysis, how did the authors determine what articles to choose to review? Need to discuss how the articles for systematic review were selected

· What was the intervention? Did this on some but not all

· Were the instruments used to analyze the data valid and reliable need to address this

· What were the results? This includes the stats findings need a more info as to the actual results and were they legitimate

· What were the strengths and weaknesses of the published article? Need to do this discussion with each article

· This includes the EBP pyramid, the instruments reliability/validity, sample size, type of analysis done, results, limitations, etc

· Did the strengths or weaknesses predominate and should the article be used to support your project and practice change? Need to state this

· Just because it is a level 1 on the EBP pyramid does not mean that it is a quality paper

 Title the next section: Summary of What is Known

·

· In this section discuss what is known from the evidence you presented and identify any gaps in knowledge from the research evidence you discussed. Need to actually discuss what the gaps are

· Give a closing statement

References – Cite a minimum of five scholarly references in APA 6th ed format. (7th edition is OK if that is what you have been using). This MUST be in proper APA format. See formatting errors on reference page

Introduction

Improvement in the healing process of pressure ulcers among elderly patients

This is not from the CON approved list of subjects so go to that list and state this properly The successful implementation of the negative pressure wound therapy is helpful in the improvement of the healing process of the pressure ulcers of the elderly patient during hospitalization.

PICOT Question:

The key terms used and the search engines

The search for the articles used for this discussion was guided by key terms such as pressure ulcer, medical device-related, pressure injury, the wound dressings, cost, flap, negative pressure, reconstruction, and pressure healing. The search engines used were Pubmed, CINHAL, Cochrane, ProQuest Nursing, and ScienceDirect. The selection criteria employed was that the selected articles were to be within the last five years of publication.

Critical Analysis of the Five Research Articles

Papp, A. A. (2019). Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction. International Wound Journal, 16(2), 394-400. https:// 10.1111/iwj.13045

This is a prospective non-randomized trial with a historic control aimed at reducing the postoperative wound healing complications using the incisional negative pressure wound therapy as an intervention (iNPWT). This study belongs to the level of evidence III since it is a non-randomized with participants assigned to the control and the treatment group. The study included surgically treated pressure ulcer patients who were receiving iNPWT as the treatment group and a historic patient cohort of all the consecutive surgically treated pressure ulcer patients during the 2 two years before the initiation of the iNPWT as the control group. There were a total of 24 patients in the control group and 37 patients in the treatment groups. Data were analyzed using the percentage of the in-hospital complications in the treatment group, length of stay, and the presence of open wounds. The outcome of the study reveals revealed that incision negative pressure wound therapy is was helping helpful in shortening the hospital stay, reduction ireduced n the postoperative complications, and the number of recurrent open wounds at 3 three months following the reconstructive negative pressure ulcer surgery.

What are the strengths and weaknesses of the study? And why should it be considered (the pyramid level, the quality of the study, what?) The study is important for the proposed project since it reveals the importance of incisional negative pressure wound therapy in dealing with the issue of pressure ulcers (Papp, 2019).

Bauer, K., Rock, K., Nazzal, M., Jones, O., & Qu, W. (2016). Pressure Ulcers ulcers in the United States' inpatient population from 2008 to 2012: Results of a retrospective nationwide study. Ostomy/wound Wound managementManagement, 62(11), 30-38.

The authors of the article are were focused on the assessment of the short-term effects associated with pressure ulcers on the short-term within the inpatient population in the United States. This is a retrospective study aimed at identifying the features of the patients that associates them with one or more pressure ulcers and this, therefore, makes the study belong to the level of evidence VI. The data presented in the article were collected through analysis of the US Nationwide Inpatient Sample (NIS) database. The analysis was performed using the screening tools of International Classification of the Disease and the Clinical Modification diagnosis codes. The data used were on the inpatient pressure ulcers that were recorded from 2008 to 2012. The patient demographics, primary outcomes of the length of stay, total hospital discharge, the in-hospital deaths, and the discharge dispositions were extracted.

The analysis of the data was performed using a t-test or the Anova ANOVA test. The continuous non-normal distributed variables like the length of stay (LOS) and the total hospital discharge (TC) were presented using the median. The chi-square test was used to compare categorical data in various groups. The outcome of the study shows showed that the prevention initiatives are were important in reducing the negative effects associated with pressure ulcers on the patient outcomes as well as the cost of healthcare. What were the short term effects and what did the data actually find (include stats)

OK about the strengths. Given the age of the data, I think you might want to have this work repeated with an actual clinical trial before considering to use it. This article is important to the project since it reveals some of the problems encountered by elderly individuals for example increase in healthcare costs and a longer hospital stay. It is also important to the healthcare facilities since it reveals the importance of adopting negative pressure ulcer control as one of the prevention strategies to this problem. The weakness of the study is that despite giving more information about the problems faced as a result of lack of intervention, it does not provide one of the effective preventive interventions that can be relied on the help in dealing with the issue of pressure ulcers among the elderly population (Bauer et al., 2016).

Lima RVK, Coltro PS, Farina JR JA (2017). LIMA, R. V. K. S., COLTRO, P. S., & FARINA JÚNIOR, J. A. (2017). Negative pressure therapy for the treatment of complex wounds. Revista do Colégio Brasileiro de Cirurgiões, 44(1), 81-93. https://doi. 10.1590/0100-69912017001001

This article is a systematic review of studies conducted from 1997 to 2016. The focus of this article review is was to assess the effectiveness of negative pressure therapy (NPT) in treating complex wounds. The focus of the intervention i.e. the negative pressure therapy is on the mechanism of action and primary therapeutic indicators(this is taken from the abstract so cite it and get it correct) . The data were collected by searching the PubMed and the Medline databases for the articles that are published from 1997 to 2016 met the inclusion criteria of ???. The study belongs to the level of evidence V I since it involves a systematic review of the qualitative multiple research studies. Need to thoroughly discuss these studies; how many articles reviewed; sample size, instruments used to assess effect, etc.

Go back to the instructions I pasted on the title page of this paper and be sure you answer ALL aspects of the analysis

Based on the outcome of the studyreviews, it appears the negative pressure therapy is working through causing causes physical effects like the increase in perfusion, controlling controls edema and exudate, reducing reduces the wound dimensions and the bacterial clearance, and the biological effects for examplesuch as the process of stimulating the granulation of the tissue formation, micro-deformations, and the reduction of the inflammatory responses (Lima et al., 2017).

Strengths, weaknesses, etc? The outcome of this study reveals its role in clinical practice. This article supports the projects that are focused on negative therapy to help in the reduction of pressure ulcers in patients with spinal cord injury. The study is important since it further reveals other roles played by the negative pressure therapy like helping in solving complications like traumatic wounds, operative wound dehiscences, burns, necrotizing wounds, venous ulcers, diabetic wounds, skin grafts, open abdomen, and the prevention of the complications in closed incisions (Lima et al., 2017).

Redo this based on the instruction on title page Atkinson, R. A., & Cullum, N. A. (2018). Interventions for pressure ulcers: a summary of evidence for prevention and treatment. Spinal Cord, 56(3), 186. https://doi. 10.1038/s41393-017-0054-y

This is a systematic review or the narrative review that gives a summary of the evidence about the intervention aimed at preventing and treating pressure ulcers. This study is a synthesis of the evidence from all the relevant randomized controlled trials, therefore it belongs to the level of evidence I. The study is also aimed at highlighting the degree to which individuals suffering from spinal cord injury have been included in the randomized controlled studies in the Cochrane reviews (Atkinson & Cullum, 2018).

Through searching the articles using the Cochrane Library and PubMed for systematic reviews, a total of 38 published systematic reviews were used and they revealed the presence of an array of the interventions. The outcome of this study reveals that there are several interventions for clinical use, nevertheless, few have been assessed enough among individuals with spinal cord injury (Atkinson & Cullum, 2018).

This study is important in clinical practice since it reveals the existence of numerous interventions that can be adopted after adequate assessment to help in addressing the problems faced by patients with spinal cord injury. This gap can be addressed by ensuring that there are high-quality randomized trials, for example, the interventions for spinal cord injury. It is also important for the capstone project that is focused on the prevention and treatment of pressure ulcers (Atkinson & Cullum, 2018). However, the study does not give specific interventions that can be relied on to achieve such specific goals in caring for patients with spinal cord injury.

Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018). Review of the current management of pressure ulcers. Advances in Wound Care, 7(2), 57-67. https://doi. 10.1089/wound.2016.0697

This study is focused on reviewing the present management of pressure ulcers. According to this study, there are several dressings as well as treatment methods that have been developed over recent years to help in the management of pressure ulcers. Therefore, the focus of this systematic review is to give highlight the benefits and the drawbacks to assists healthcare providers to appropriately select their tools. The level of evidence of this study is V since it involves the description of the qualitative studies.

The study is important for the capstone project since it shows the important efforts that are needed to ensure that there is a successful process of managing pressure ulcers. Nevertheless, the article fails to give a direct intervention that can be specifically relied on to help in the improvement in the process of managing pressure ulcers. The authors simply discuss the increase in the number of therapies in the market without even mentioning the most successful and effective intervention that clinics or hospitals can rely on in managing the pressure ulcers of elderly patients. The authors fail to provide the approach undertaken in analyzing the data drawn from the articles. The authors also fail to provide information about specific search machines used in reviewing the articles used (Boyko et al., 2018).

Summary of what is known and how the gap is being addressed

Summary of what is known and how the gGaps in the Literature is being addressed

The complications associated with pressure ulcer reconstructions are common and this means that there are higher chances of wound recurrence. Some of the complications include burns, necrotizing wounds, diabetic ulcers, and increased wound dehiscences among others. There are several interventions for clinical use, nevertheless, few interventions have been assessed to help in addressing the problems faced by the patient with spinal cord injury. There has been an increase in the number of therapies in the market, nevertheless, none has shown clear benefit over each other, and therefore, this means that pressure ulcers remain a frustrating and time-consuming issue. Even though different efforts have been made to address this issue, little attention has been given to the intervention involving the use of incisional pressure wound therapy. Negative pressure wound therapy has proven to be effective in addressing the issue of pressure ulcers among elderly patients. Should more research be done and on what subject matters specifically

Concluding remarks

The process of dealing with pressure ulcer issues among elderly individuals is presenting a huge challenge. Numerous interventions are available and some are being implemented while others are not. Negative pressure wound therapy has been considered an effective approach in dealing with pressure ulcers amongst this population. Nevertheless, this intervention is receiving little attention from healthcare professionals. Therefore, healthcare providers and hospital organizations must work as a team towards ensuring that there is an effective implementation of this intervention.

References