response post

Problem/PICOT/Evidence Search (PPE) Worksheet

Name:

Date:

Criteria

I have been a nurse for 13 years now, I have worked in both acute and long-term facilities with mostly adult patients. My experience has exposed me to many challenges and problems but the one that is very common with all these facilities is pressure ulcers.

Pressure ulcers are also known as bedsores. They are localized damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in combination with shear or friction. Pressure ulcers may develop from stage one to four during which a great deal of pain may be inflicted on the patient.

The most common sites for pressure ulcers are the sacrum, coccyx, heels, and hips. Other sites which are not common include elbows, knees, ankles, back of shoulders, or the back of the cranium. Pressure ulcers happen as a result of continuously applied pressure to soft tissues that completely or partially obstructs blood flow to the soft tissue. Shear can also cause pressure ulcers as it pulls on blood vessels that feed the skin. Pressure ulcers are common with patients on bed rest and wheelchair bound. Pressure ulcers can be very difficult to prevent in critically ill people, frail elders, and individuals with impaired mobility.

Pressure ulcers in progression can become septic thereby becoming a life-threatening issue. Repositioning a patient every 1-2 hours using a pillow to pressure spot may assist with the prevention of pressure ulcers. When a wound developed, hydrocolloid or hydro-cellular foam dressing may be used and thus leaving the question of which one is more efficient in wound healing and progression. Other treatments like anabolic steroids, negative pressure wound therapy, phototherapy, and debridement can also be used. The importance of picking this nursing problem lies in the severity of the problem.

Clinical Nursing Practice Problem

Select and identify ONLY one quality or safety clinical priority area from the assignment guidelines practice scenario. Summarize why you believe the nursing practice problem/issue is the most important. Summarize your rationale (why) for choosing the problem.

Clinical Nursing

PICOT Question

Using the NR439 Guide for Writing PICOT Questions and Examples located in the assignment guidelines, write out your PICOT question. Include the PICOT letters in your question.

In long term care facilities, will geriatric patients who are bedridden ages sixty-five and older with pressure ulcer (P), will hydrocolloid wound dressing (I) be more effective in wound healing (O) compared to hydro-cellular foam dressing (C) over 30 days?

Define PICOT Elements

Define each of the PICOT elements from your question above.

P- (patient population/patients of interest): Long-term care geriatric patients with pressure ulcers.

I- (Intervention): Changing from hydro-cellular foam dressing to hydrocolloid dressing.

C- (Comparison): No utilization of hydrocellular dressing.

O- (Measurable outcome): Change in the size of pressure ulcer and in appearance

T- (Time frame in months): 30 days

Evidence Retrieval Process and Summary

Using only the Chamberlain College of Nursing library:

(1) Locate evidence that is relevant to your chosen nursing practice problem. Explain how you believe the evidence is relevant to your chosen nursing practice problem.

(2) Explain why you chose the evidence

(3) Provides a complete APA reference to the evidence (must include authors, year, title of the evidence, title of the resource)

(4) Evidence must be published within the last 10 years

(5) Provides the permalink

According to Cortés, Salazar-Beltrán, Rojas-Castañeda, Alvarado-Muriel, Serna-Restrepo, & Grinspun (2018), “Hydrocolloid dressing is not only efficient in pressure ulcer healing but also in the pressure ulcer prevention.” This study emphasized on the fact that hydrocolloid dressing in relation with conventional pressure ulcer care has been found to be very effective in pressure ulcer healing or prevention. I selected this study because it satisfied the criteria of the PICOT element and also satisfied or support the problem I selected substantially.

Reference

Cortés, O. L., Salazar-Beltrán, L. D., Rojas-Castañeda, Y. A., Alvarado-Muriel, P. A., Serna-Restrepo, A., & Grinspun, D. (2018). Use of Hydrocolloid Dressings in Preventing Pressure Ulcers in High-risk Patients: A Retrospective Cohort. Investigacion & Educacion En Enfermeria, 36(1), 118–129. Retrieved from: https://eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/detail/detail?vid=0&sid=c9844dd6-788b-43dc-b13a-115c9b5ee842%40sessionmgr4007&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#

Implications of the Evidence

Summarize what you learned from the evidence. Summarize why you believe the nursing evidence-based practice committee should focus their next research project on the nursing practice problem.

Pressure ulcers when left untreated may progress in stages (1-4) and even may become unstageable. In this light, the untreated pressure ulcer becomes very painful and may get infected and the patient may develop sepsis as a result. other complications from untreated pressure ulcers include cellulitis, bone/joint infections, and cancer. These are all life-threatening scenarios and thus must be taken seriously. This evidence has proven that pressure ulcers can be very common and life-threatening, in this light, more research studies should delegate more resources in order to prevent further occurrence and also unnecessary progression to sepsis.

Evidence Search Terms

Identify 4 (or more) relevant searchable terms you used for your search for evidence.

Pressure ulcer and PICOT, Nursing care & pressure ulcer, Nursing care and PICOT element, Pressure ulcer and hydrocolloid dressing, Evidence Based Practice Pressure Ulcer Prevention Strategies.

Evidence Search

Strategies

Select 4 (or more) relevant search strategies you used to narrow/limit your search for

evidence.

NR439 PICOT Worksheet 5/2019 ST

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