• Subject Name : Nursing

Methodological Framework for The Research Question

Introduction to Preventing Pressure Injury in Residents

Pressure injuries are also known as pressure sores or pressure ulcers (Alderden, 2017). They are mainly caused due to progressive damage to the skin and tissues underneath the surface. The main mechanism and the root cause of development of the same can be attributed to the increased friction and constant pressure on the bony surfaces. People with advancing age have more fragile skin and thus, are more prone to the development of pressure injuries (Alderden, 2017). These pressure injuries can add to the suffering of individuals suffering from the same. However, with early detection and intervention management, the condition can be controlled from extending and impacting the neighboring tissues. It is a common phenomenon observed in aged care facilities, where older people are being managed for. Due to the lack of mobility and multiple comorbidities, the healing process of the patient might be lowering and thus, adding to the discomfort of the patient (Kayser, 2019). Multiple intervention strategies can be followed by the nurses to manage and prevent the formation of pressure injuries in patients residing in aged care facilities. The study design and methodology will help in pondering the role of nurses in the process of prevention of pressure injury and the intervention strategies in terms of their impact on the healing of pressure injuries in patients residing in aged care facilities. 

Research question

What is the nurse's perception regarding the prevention of pressure injuries in aged care facilities?

Aims

  1. To identify the positive nurse’s perceptions for preventing pressure injuries in aged care facilities
  2. To identify the negative nurse’s perception for preventing pressure injuries in aged care facilities
  3. To examine the best possible healthcare intervention strategy planning for preventing pressure injuries in aged care facilities.

Significance

The condition of pressure ulcers is preventable but it can also be an alarming situation for the patient to suffer from (Palfreyman, 2016). Preventing this condition is not only vital to protect the patients from the underlying harm, but also to considerably reduce the cost of treatment aligned with the same. Pressure ulcers can also result in morbidity and can lead to more severe impairments. This can lead to the patient developing an underlying infection, delayed healing, and longer stays in healthcare settings (Russell, 2020). The nurses are the vital team members that work with the patient, to enable care providers to them. The perception of the nurses is, therefore, crucial to acknowledge to understand the barriers and limitations faced by them during the care provision of the patient. This will help define advanced healthcare solutions to prevent the life-threatening impact of pressure ulcers in older patients (Lichterfeld, 2020).

Background

The prevalence of pressure ulcers is observed on an increasing trend in older patients. There are multiple implications on health along with the advancing age. Pressure injuries can deteriorate the overall health status of the patient, leading to declining healthcare outcomes (Beeckman, 2019). The main objective of the study will be to review the evidence present on the perception of the nurses aligned in the patient care for individuals, who are more vulnerable to developing pressure injuries. This will help focus on developing more constructive and conceptualized programs, which will help promote patient safety and address to the other multiple factors aligned with the prevention of pressure injuries. It will also help in drawing a conclusive approach for a single component and effective initiatives to prevent the pressure injuries from further spreading and impacting the clinical status of the patient.

Methodology

The main aim of the research methodology of the study is to define a path for the researcher to conduct the study in an orderly manner (Cecez, 2020). This also formulates the path for developing problems and objectives and presenting them in a schematic result obtained during the period in which the study is conducted. The study design on the other hand provides a directive framework for the study (Bajzik, 2020). There is an imperative need for selecting the best suitable study design, to be synchronized in regards to the research approach. This is also modulated by the interrelated study decisions. This study will be based on a qualitative study design. As the qualitative study design helps in defining the non-numerical data, it will be the best option to analyze the results of perceptions and experiences of the nurses (Moalusi, 2020). It will also help define a newer and advanced approach for generating ideas that can be used for future inferences. It will also help analyze the pattern of perception of the nurses in preventing pressure injuries and thus, helping in formulating future interventions and management techniques. The study will also follow the inductive research paradigm (Huang, 2019). As this will be a new topic to be pondered upon, the indictive method of research paradigm will help obtain sound results. This type of research paradigm will also enable the researcher to develop a new theory, based on collecting the observations and analyzing the pattern of these observations attained from the study. 

Methods

The main participants for the study will be healthcare nurses aligned inpatient care in aged care facilities. Both male and female nurses will be recruited for the study purpose. The recruitment of these nurses will be based on their years of experience in aged care settings and should be above the age of 30 years. They should also be working in providing care to the patients who are either vulnerable to developing pressure injuries or are currently being provided care and management for pressure injuries. For the study 100 residential care facilities will be targeted. the study will be based on the survey method for data collection. The survey will help collect the nurse's perception as per their ease. The survey method can be best suited both in qualitative as well as quantitative study. However, for this study as the data is to be collected on a primary basis, the survey method will be the best option. It will help reflect upon the attitude of the nurses, which will help set a future purpose for the study. The method of the survey will also enable comfort for the participants, to answer the questions asked as per their perception. This will help collect more dynamic data post collection of reflection of the same (Lowry, 2016). It will also be fruitful in defining a characteristic for the population. It will also enable the researcher to establish a testing hypothesis about the nature of the relationship within the participant population, chosen to be evaluated. The survey will be in a questionnaire format and will be delivered to the nurses by the means of Email. This will help gather vast information, within a shorter duration of timeframe (Zhou, 2018). It will also be cheaper and the data collected on the primary basis through the survey method will be easier to be analyzed. The recruitment of the participants will be carried out through stratified random sampling. This method gives an equal chance of selection to all participants. It also helps in data analysis, with less risk of an error occurring while interpreting the data (Ning, 2020). As for the study purpose, nurses above the age of 40 years will be included, therefore, this type of sampling will be the best possible method to select the participants (Etikan, 2017). Within a subgroup, the researcher will be able to stratify a good sample to collect the data from.

Data Analysis

The method for data analysis chosen for this study will be thematic analysis. This is one of the best possible methods as our study is based on qualitative study design (Marshall, 2017). This analysis method can help cover multiple aspects of a study and addressing the multiple questions arising from the same study design. This method is also best suitable to identify a particular pattern to focus upon, from the given dataset. It also provides an access to identify an umbrella of approaches through which various theoretical models proposed for the study can be identified. As our study is based on focusing on nurse's perception of prevention of pressure injuries in aged care facilities, the use of thematic analysis can provide us with a wide range of possible outcomes from the derivatives attained. As the method of thematic analysis goes beyond just counting the phrases and words written across in text, it will help explore both explicit and implicit meanings of the data set (Roberts, 2019). It will also help connect the derivative and how it will impact the overall well-being and transition of care provided to the patients. This analysis will also help define the positive and negative impact of the nurse's perception, deemed as the best possible solution for the prevention of pressure injuries in aged care facilities. 

Ethics

Following ethical consideration will be kept in mind while conducting this research:

  • Informed consent- Each participant will be fully informed about the details of the evaluation to be carried out. The participants will be made aware of the aims and purpose of the research study to be conducted. They will also be duly informed on the potential harms and benefits, that might be inflicted upon them during the research study. An informed decision will be taken from each of the participants, before enrolling them to be evaluated for the study purpose (Prusaczyk, 2017). The participants will be provided with a right to leave the study in between if they do not feel confident or secure enough to participate in the study any further.
  • Voluntary participation- Each of the enrolled people will be provided with the ease to participate as they please. They will be free to withdraw from the study, at any point in time, without negatively impacting the study. There will be no pressure or force on any participant to continue or enroll in the study.
  • Ensuring no harm- Any participant will be made sure of protection from any physical or psychological harm. They will not be subjected to any form of stress, anxiety pr pain during the process of conduction of the study, till the time of study being concluded (Petillion, 2017). There will be n invasion of privacy done for any participant, throughout the research study.
  • Confidentiality- Any information which may be identifiable, will be kept undisclosed from being published in the reports. All of the necessary information will be withheld with the program coordinator only. The participant's names and details will be kept undercover and their original names will not be included in the study (Hudson, 2020).
  • Anonymity- The details of the identity of the participants will be kept hidden from the research team. The details will only be made aware of the program coordinator.
  • Assessment of relevant information- Only the details which are useful for the study will be conducted. The evaluations will be kept as simple as possible (Leonelli, 2016). It will also remain in sync with the main intention and focus of the evaluation to collect the required data for conducting the study.

Conclusion on Preventing Pressure Injury in Residents

The role of nurses can be deemed as pivotal in managing and preventing pressure injuries in aged patients. The nurses possess the required knowledge of the best possible intervention strategies to be used to help patients with pressure injuries. Early identification and management are required in preventing pressure injuries, as it might add to the misery of the patient. pressure injuries can also prolong the stay in the hospital, adding to the medical burden on health as well as on expenses born by the patients. The nurse's perception of managing and preventing pressure injuries also plays a vital role. This is also helpful in defining positive healthcare outcomes from the patients, post-implementation of treatment solutions to the patient.

References for Preventing Pressure Injury in Residents

Alderden, J., Rondinelli, J., Pepper, G., Cummins, M., & Whitney, J. (2017). Risk factors for pressure injuries among critical care patients: A systematic review. International Journal of Nursing Studies71, 97-114. https://doi.org/10.1016/j.ijnurstu.2017.03.012

Bajzik, J., Havranek, T., Irsova, Z., & Schwarz, J. (2020). Estimating the Armington elasticity: The importance of study design and publication bias. Journal of International Economics127, 103383. https://doi.org/10.1016/j.jinteco.2020.103383

Beeckman, D., Serraes, B., Anrys, C., Van Tiggelen, H., Van Hecke, A., & Verhaeghe, S. (2019). A multicentre prospective randomized 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 Studies97, 105-113. https://doi.org/10.1016/j.ijnurstu.2019.05.015

Cecez-Kecmanovic, D., Davison, R. M., Fernandez, W., Finnegan, P., Pan, S. L., & Sarker, S. (2020). Advancing qualitative IS research methodologies: Expanding horizons and seeking new paths. Journal of the Association for Information Systems21(1), 1. https://doi.org/10.17705/1jais.00599

Etikan, I., & Bala, K. (2017). Sampling and sampling methods. Biometrics & Biostatistics International Journal5(6), 00149. http://dx.doi.org/10.15406/bbij.2017.05.00149

Huang, L., Wu, C., & Wang, B. (2019). Challenges, opportunities, and paradigm of applying big data to production safety management: From a theoretical perspective. Journal of Cleaner Production231, 592-599. https://doi.org/10.1016/j.jclepro.2019.05.245

Hudson, N., Law, C., Culley, L., Mitchell, H., Denny, E., & Raine-Fenning, N. (2020). Conducting dyadic, relational research about endometriosis: A reflexive account of methods, ethics, and data analysis. Health24(1), 79-93. https://doi.org/10.1177%2F1363459318786539

Kayser, S. A., VanGilder, C. A., & Lachenbruch, C. (2019). Predictors of superficial and severe hospital-acquired pressure injuries: A cross-sectional study using the International Pressure Ulcer Prevalence™ survey. International Journal of Nursing Studies89, 46-52. https://doi.org/10.1016/j.ijnurstu.2018.09.003

Leonelli, S. (2016). Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems. Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences374(2083), 20160122. https://doi.org/10.1098/rsta.2016.0122

Lichterfeld-Kottner, A., El Genedy, M., Lahmann, N., Blume-Peytavi, U., Büscher, A., & Kottner, J. (2020). Maintaining skin integrity in the aged: A systematic review. International Journal of Nursing Studies103, 103-109. https://doi.org/10.1016/j.ijnurstu.2019.103509

Lowry, P. B., D'Arcy, J., Hammer, B., & Moody, G. D. (2016). "Cargo Cult" science in a traditional organization and information systems survey research: A case for using nontraditional methods of data collection, including Mechanical Turk and online panels. The Journal of Strategic Information Systems25(3), 232-240. https://doi.org/10.1016/j.jsis.2016.06.002

Marshall, Z., Welch, V., Thomas, J., Brunger, F., Swab, M., Shemilt, I., & Kaposy, C. (2017). Documenting research with transgender and gender diverse people: protocol for an evidence map and thematic analysis. Systematic reviews6(1), 1-6. https://doi.org/10.1186/s13643-017-0427-5

Moalusi, K. (2020). Numbers conceal the intricacies in categorizing qualitative research in organizational studies: What lies beneath the surface?. SA Journal of Industrial Psychology46, 12. https://doi.org/10.4102/sajip.v46i0.1692

Ning, J., & Tao, H. (2020). Randomized quasi-random sampling/importance resampling. Communications in Statistics-Simulation and Computation, 1-13. https://doi.org/10.1080/03610918.2018.1547398

Palfreyman, S. (2016). Patients at risk of pressure ulcers and moisture-related skin damage. British Journal of Nursing25(12), 24-28. https://doi.org/10.12968/bjon.2016.25.12.S24

Petillion, W., Melrose, S., Moore, S. L., & Nuttgens, S. (2017). Graduate students’ experiences with research ethics in conducting health research. Research Ethics13(3-4), 139-154. https://doi.org/10.1177%2F1747016116677635

Prusaczyk, B., Cherney, S. M., Carpenter, C. R., & DuBois, J. M. (2017). Informed consent to research with cognitively impaired adults: Transdisciplinary challenges and opportunities. Clinical Gerontologist40(1), 63-73. https://doi.org/10.1080/07317115.2016.1201714

Roberts, K., Dowell, A., & Nie, J. B. (2019). Attempting rigor and replicability in the thematic analysis of qualitative research data; a case study of codebook development. BMC Medical Research Methodology19(1), 66. https://doi.org/10.1186/s12874-019-0707-y

Russell, C. D., Tsang, S. T. J., Simpson, A. H. R., & Sutherland, R. K. (2020). Outcomes, microbiology, and antimicrobial usage in pressure ulcer-related pelvic osteomyelitis: messages for clinical practice. Journal of Bone and Joint Infection5(2), 67. https://dx.doi.org/10.7150%2Fjbji.41779

Zhou, D., Yan, Z., Fu, Y., & Yao, Z. (2018). A survey on network data collection. Journal of Network and Computer Applications116, 9-23. https://doi.org/10.1016/j.jnca.2018.05.004

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