NURSING RESEARCH
cuka
part2.docxRunning Head : ARTICLE CRITIQUE
RESEARCH ARTICLE CRITIQUE 2
Quantitative Research Article Critique
Uka Anna
Grand Canyon University- NRS 433V
June 9, 2019
The Prevalence of Pressure Ulcer Using Foam or Pad dressing on Patients in Hospital and Skilled Nursing Facility.
Background
The article by Padula (2017) indicates that hospital acquired Pressure Injuries (HAPIs) are prevalent, costly, and deadly to critically ill and acute patients. Their prevalence is 2.5 million patients annually and the cost 500-150000 USD per case. There are about 60,000 deaths yearly, causing a health burden. Risk and skin assessments have become imperative with foam dressing arising as a new method of preventing pressure injuries and mitigating the problem. through prophylactic dressings loading forces on tissues between the bony prominence and support surface is mitigated causing a quality improvement in injuries among patients who undergo cardiac surgery. In this study, the focus is on evaluating the efficacy of prophylactic foam in clinical trial situations through an observational approach with the purpose of establishing how effective and valuable it is in preventing HAPI rates.
On the other hand, in a quantitative study conducted by Frain (2008), it is indicated that extended care where numerous medical regimens are afforded, there is an enhancement of rehabilitation on the patients. Heel pressure which has prevalence rates of 19-32 percent resulting from hip fractures, diabetic neuropathy, structural deformities, and cerebrovascular accidents and implicated in the study. Heel ulcers are indicated to be common and critical, hence requiring care. Since there is no information on long-term care, this study provides a study on that.
How these two articles support the nurse practice issue that I choose in relation to PICOT Question And Ethical consideration Comment by Linnette Nolte: Please delete this as this is a narrative paper. Insert a short heading in APA format
The PICOT pays attention to the population of hospital patients and skill nursing facility patient. The research is focused on reducing pressure ulcer by protecting the bony area with pad dressing, the effects is very positive as we look in to the population involved. Comment by Linnette Nolte: What is your PICO question?
The study responded to the PICOT question by offering a positive relationship between pad dressing and reduction of pressure ulcer among patients. On the other hand, the article by Frain (2008) indicates research into what impact long-term care has on decreasing heel ulcers.
Method of Study:
The study by Padula (2017) was carried out through a retrospective observational cohort study in the US acute care academic medical centers while examining the effectiveness and value of prophylactic 5-layer sacral dressings to prevent HAPI rates in the acute context. There was the acquisition of all pressure injury rates between 2010 and 2015 with the clinical database providing quarterly hospital-level administrative information on hospitalization of patients in the entire system of over 250 academic medical centers. The all-cause pressure injury rates; were merged with a quarter. lt hospital-level information which the manufacturers of foam dressings gave about the purchases on the 5-layerfoam. Comment by Linnette Nolte: This sentence loses its meaning??
There was a longitudinal data analysis to the cohort for every hospital to act as its own control due to variation of initiation on the foam usage. Counts of pressure injuries acquired from hospitals underwent the inclusion, exclusion criteria of AHRQ Patient Safety Indicator for critically ill and acute patients after which aggregate hospital data was conducted. Comment by Linnette Nolte: What study is this?
On the contrary, a study by Frain (2008) conducts a study among 40 of the 42 residents in a skilled care unit of a 470-bed, long term amenity in Royersford, Pa. Through a random selection, this population included participants observed for a year. There was the inclusion of 37 staff members and given that the study was within the nursing care standards no individual consent was required. The only permission acquired was from the administrator. The acquisition of demographic data of the patients was accessed when the program set in and Braden scales Scores were computed on a quarterly plan. The collecting, recording, and maintaining of data was by the Certified Wound and Ostomy Care Nurse. As easy-to-use heel assessment form to served with aspects such as skin assessment, orientation to the heel assessment, training, use of visual and hands-on models, proper techniques where foam blocks, foam splints, and pillows were checked. Within the three stages incidence rates, deaths, transfers, discharges were checked. There is also a literature review which indicates that Some long-term care facilities where there is professional nursing care when compared with the other care facility that had been evaluated as being at low risk using a pressure ulcer, it was discovered that hydro polymer foam dressings decreased the prevalence of heel ulcers 72% in 2 years. The study had been conducted among 52 patients compared the effectiveness of hospital pillows on the patients. Comment by Linnette Nolte: I don’t understand this sentence Comment by Linnette Nolte: What are the benefits and limitations of each study?
Results of Study
Therefore, the study by Padula (2017) uses a representative sample of 38 of over 240 academic medical centers merged with data on purchase f prophylactic 5-layer foam sacral dressings. There are observations in 912 hospitals with 631 having the prophylactic foam 5-layer where 1.03 million patients are hospitalized. In the average medical center where there are 1754 hospitalizations per quarter, there are 2586 units of prophylactic sacral dressing representing the whole number of patients for an average 7-day period. The foams were given to high-risk patients and indeed there was a decrease in the pressure injury rates. Therefore, with an increased prophylactic dressing from 2.60 USD to 20 USD per patient, there was a decline in pressure injuries from 120 USD expenditure per patient to 43 USD. The results imply that the usage of prophylactic foam dressings on patients is significant in the reduction of pressure injuries among patients for they help discover unobserved factors.
In the study by Frain (2009), completion rates for heel assessment were 79 percent for the 21 women and 19 men. At the end of the assessment, none of the patients had heel pressure ulcer because of the regular assessment, caregiver awareness, staff education, and preventive measures. It, therefore, implies that early detection, continuous assessment, the use of hydropolymer foam dressings among other preventive mechanisms reduce and can eliminate the prevalence of pressure ulcers because it helps in preventing further infections and offers the required care environment.
Outcomes Comparison
The comparative analysis of the two articles shows that the usage of diverse long-term methods in attending to patients who have ulcers has a higher impact on the elimination of the pressure ulcers as compared to the use of prophylactic 5-layer foam dressing alone. However, even the usage of the foam whether hydropolymer foam dressings or prophylactic 5-layer is still significant in the healing of a patient.
All in all the two articles indicate that it is possible to reduce or do away with pressure ulcer by protecting the bony area with pad dressing because it prevents further infections and enhances healing. Comment by Linnette Nolte: ulcers
References
Frain, R. (2008). Decreasing the incidence of heel pressure ulcers in long-term care by increasing awareness: results of a 1-year program. OstomyWound Management, 62-68. Retrieved from https://pdfs.semanticscholar.org/ad65/4a52aa235ffb05e1e51ced200db153303697.pdf
Padula, W. (2017). Effectiveness and value of prophylactic 5-layer foam sacral dressings to prevent hospital-acquired pressure injuries in acute care hospitals: an observational cohort study. Journal of Wound, Ostomy and Continence Nursing, 44(5), 413–419. doi:doi: 10.1097/WON.0000000000000358
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