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  • Subject Name : Nursing

Person-Oriented Research Ethics

Introduction to Pressure Injuries Prevention

According to Padula, Pronovost & Makic et al. (2019), the pressure injuries are very common among the old age patients and this can lead to extreme pain if not managed properly. These pressure injuries are caused by the failure of the peripheral circulatory system. Pressure prevention injuries can be managed with the help of effective assessments and management. This can include the use of air mattresses, ointments, repositioning, and many others. If the pressure injuries are not managed effectively then it can lead to unexpected outcomes like dehydration, nutrition issues, impaired activity, and a few others. The strategies are a healthy diet, changing the position frequently, redistribution of pressure, use of pressure prevention aids like monitoring cords, tapes, pressure stockings, casts and orthotics, skincare, and few others (Barakat-Johnson, Lai &Wand, 2017). This essay will discuss the methodology of the conduction of experiments related to the research question.

Background

The research question is the prevention of pressure injuries in residents of aged care. The PICO framework is used for the research and the population is residents of aged care, intervention is air mattress and pressure prevention ointments, the comparison is repositioning, and the outcome is the prevention of pressure injuries. The research design includes the use of quantitative randomized control trials (RCT). According to Fulbrook, Lawrence & Miles (2019), 2.7 % to 29 % of hospitalized patients suffer from pressure injuries, a patient of critical care is at high risk of pressure injuries with a very high range - 41% prevalence and 33% incidence.  

Methodology

Eligibility criteria for study selection

Only those articles that were in the English language and were recent like in the range of 2015-2016 were selected, others were rejected. Those articles that were able to satisfy the condition of the PICO question were selected while others were rejected. The use of recent articles helps in provides the latest insights about the topics and guides the researcher in the right direction (Peighambari, Sattari & Kordestani et al., 2016)

Information sources

The articles were selected from highly valued and credible sites or journals like CINAHL, PubMed, and MEDLINE.

Search

The keywords were used with the help of Boolean characters for finding articles like pressure prevention OR old patients, pressure injury AND aged care, pressure prevention AND aged care, and few other combinations. The commonly used Boolean operators in methodology are NOT, OR, AND (Pazhaniraja, Sountharrajan & Kumar, 2020). The use of a combination of key terms with Boolean operators helps in generating search results for the required topic.

Data Collection Process and Data Items

According to Sovacool, Axsen, & Sorrell (2018), quantitative research in health care is very fruitful as it includes the use of mathematics and statistical methods for the analysis of the data collected and results. This helps as the data included are conditions, behavior, people, and many others. This method also offers advantages like large sample sizes, research duplications, quick collection of data, and a few more. The use of randomized control trials (RCT) offers chances to measure or compare the effectiveness of the treatments or interventions. This minimizes the chances of biases in the research study as well; thereby increasing the validity and credibility of the results. Large sample sizes are helpful in providing smaller errors, accurate and reliable results, and conduction of research that yields significant information (Khalilzadeh & Tasci, 2017).

A randomized control trial was conducted for this study in which two groups of large sample size were made; the first group received the interventions like air mattress and pressure prevention ointments. According to Baghdadi, Rafiei & Rashvand et al. (2020), the use of ointments on aged care patients showed better results, the authors conducted a randomized control trial on different groups. The ointment used was aloe vera gel that not only showed effective results in cases of pressure injuries but also showed satisfactory results for skin like a laxative effect, antiseptic effect, anti-aging effect, moisturizing, and anti-inflammatory action. According to Li, Ma & Yang (2017), using randomized control trial it was found that the use of pressure prevention ointment decreased damage to the skin, effective healing, maintaining a moist environment for wound healing, antimicrobial effects, and analgesic effects. The participants require frequent monitoring and evaluation of their effects and health status. 

Whereas, the second group was made for comparative results and they received repositioning as a pressure prevention strategy. According to Beeckman, Serraes & Anrys et al. (2019), the air mattress helps in the redistribution of pressure and reduces the pressure damage to soft tissues, improves blood circulation, alternating air pressure mattress are less effective than a static air mattress. 

The participants were informed about the research and written consent was taken to ensure the maintenance of ethical aspects during the research. The privacy and confidentiality of the participants were maintained throughout the research and it was also ensured that the participants did not get any harm or injuries during the research study data collection (Cascio & Racine, 2017). It was also ensured that the participants are well-aware of the effects of the study and the outcomes as well. The analysis of each group was conducted independently.

Table showing the search results:

Search number

Query

Limiters/Expenders

Results

S1

pressure injury and aged care

Open access, under recent 5 years of publication, Search modes - Boolean/Phrase

1113

S2

pressure injury or aged care

Open access, under recent 5 years of publication, Search modes - Boolean/Phrase

15812

S3

pressure prevention OR old patients

Open access, under recent 5 years of publication, Search modes - Boolean/Phrase

23530

S4

pressure prevention and old patients

Open access, under recent 5 years of publication, Search modes - Boolean/Phrase

1917

Conclusion on Pressure Injuries Prevention

It is found that in aged care centers or hospitals having aged patients often face the issues of pressure injuries. However, these can be prevented with the help of air mattresses, ointments, repositioning, sliding sheets, and many others. The complications of pressure injuries like dehydration issues, skin texture issues, swelling, inflammation, and others can be prevented with the use of pressure prevention strategies. For this, the research can use a quantitative study with randomized control trials. Moreover, ethical considerations should also be maintained. The quantitative study can be conducted with the use of Boolean operates and use specifics key terms that satisfy the requirement as per the research question. The air mattresses offer various advantages like improved blood circulation and comfortable movement of patients for its pressure redistribution. The nursing interventions should be frequently monitored and the results should be evaluated as well for better and effective results. This frequent monitoring ensures the safety and improved results of pressure injury prevention in aged care facilities.

References for Pressure Injuries Prevention

Baghdadi M, Rafiei H, Rashvand F, Oveisi S. (2020). Effect of aloe vera gel, calendula officinalis ointment, and simple prophylactic sacral dressings for pressure injury development. Chronic Wound Care Management and Research, 7, 19-26
DOI:10.2147/CWCMR.S256537

Barakat-Johnson, M., Lai, M., Wand, T., & White, K. (2019). A qualitative study of the thoughts and experiences of hospital nurses providing pressure injury prevention and management. Collegian, 26(1), 95-102.DOI: 10.1016/j.colegn.2018.04.005

Beeckman, D., Serraes, B., Anrys, C., Van Tiggelen, H., Van Hecke, A., & Verhaeghe, S. (2019). A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing home residents. International Journal of Nursing Studies, 97, 105-113. DOI: 10.1016/j.ijnurstu.2019.05.015

Cascio, M. A., & Racine, E. (2018). Person-oriented research ethics: Integrating relational and everyday ethics in research. Accountability in Research, 25(3), 170-197. DOI: 10.1080/08989621.2018.1442218

Fulbrook, P., Lawrence, P., & Miles, S. (2019). Australian nurses' knowledge of pressure injury prevention and management: A cross-sectional survey. Journal of Wound, Ostomy, and Continence Nursing, 46(2), 106.DOI: 10.1097/WON.0000000000000508

Khalilzadeh, J., & Tasci, A. D. (2017). Large sample size, significance level, and the effect size: Solutions to perils of using big data for academic research. Tourism Management, 62, 89-96.DOI: 10.1016/j.tourman.2017.03.026

Li, W., Ma, Y., Yang, Q., Pan, Y., & Meng, Q. (2017). Moist exposed burn ointment for treating pressure ulcers: A multicenter randomized controlled trial. Medicine, 96(29), e7582. DOI:10.1097/MD.0000000000007582

Padula, W. V., Pronovost, P. J., Makic, M. B. F., Wald, H. L., Moran, D., Mishra, M. K., & Meltzer, D. O. (2019). Value of hospital resources for effective pressure injury prevention: A cost-effectiveness analysis. BMJ Quality & Safety, 28(2), 132-141.DOI: 10.1136/bmjqs-2017-007505

Pazhaniraja, N., Sountharrajan, S., & Kumar, B. S. (2020). High utility itemset mining: A Boolean operators-based modified grey wolf optimization algorithm. Soft Computing, 1-14.DOI: 10.1007/s00500-020-05123-z

Peighambari, K., Sattari, S., Kordestani, A., & Oghazi, P. (2016). Consumer behavior research: A synthesis of the recent literature. Sage Open, 6(2), 2158244016645638. DOI: 10.1177/2158244016645638

Sovacool, B. K., Axsen, J., & Sorrell, S. (2018). Promoting novelty, rigor, and style in energy social science: Towards codes of practice for appropriate methods and research design. Energy Research & Social Science, 45, 12-42.DOI: 10.1016/j.erss.2018.07.007

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