Research Review Essay

Research Review Essay

N320 Research Review Part 1

This is the first assignment to introduce your PICO(T) , scope and nature of the problem, background information of the problem, details regarding your research review, and the EBP approach you have taken for your research. This is a “building assignment” as part 1 and part 2 will build to complete the Final Assignment in which you will have a comprehensive Research Review.You do not need to worry about self-plagiarism when continuing to part 2 and so on. You will have a minimum of seven articles or more for the final Research Review. Research Review Essay

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Assignment Part 1-75 possible points. – should include significant detail and synthesis of your research as it relates to your PICO.  See Assignment Part 1 Rubric and Example papers.

Instructions:Follow APA 7^th ed. format and follow Assignment Part 1 Rubric (refer to example paper part 1)

1. Use APA 7^th ed. Manual or recommend APA templatesites listed in content section to set up paper (Chapter 2, APA manual 7^th ed.)
2. Write in 12 font Times New Roman
3. DO NOT write in first person. No I statements. This is a research reviewnot a study so refer to it as such in your work.
4. Write about your topic in paragraph format
5. Include a Tittle page (see APA 7^th ed power point) (Do not use Assignment 1… as your title) The title should not be your entire PICO but should allow the reader to understand what your Research is about * see example papers in the course

You do not need to use a running head for your paper but include page # appropriately placed per APA (refer to Chapter 2 and Section 2.3 2.4.  Figure 2.2).

Example title: Comparison of pressure reduction boots versus repositioning to reduce pressure ulcers in the elderly

7. Follow instructions for headings. Use the rubric headings for the headings in each section of your assignmentexcept “Introduction” the heading for the introduction.  In 7^th ed. APA this is the restatement of your paper title( see APA 7^th ed. Section 2.7)
8. 8. Include data search table as a table labeled and referenced appropriately in your paper. (APA 7^th Chapter 7, see example table 7.1)
9. Include research model worksheet in paragraph format to describe your EBP model in your paper and include your simple diagram as a figure referenced appropriately in APA 7^th ed. format in your paper.
10. Include completed and corrected literature review tables as an Appendix labeled Appendix A and follow APA 7^th ed. Instructions for correct placement of an appendix in your work ( after Reference section)
11. References on a separate page following APA 7^th ed format, Chapter 9-10.

 

Comparison of Silicone Foam Dressings Versus Pressure Reduction Techniques

Pressure injuries can have significant negative consequences for patients including infection, reduced quality of life, disability and even death (Campbell, et al., 2020). Pressure injuries are also very costly for patients and healthcare systems, estimated to average between $37,000-$70,000 per patient (Walker, et al. 2015). In patients who were both immobile and incontinent, Gray &Guiliano found the “prevalence of facility-acquired pressure injury in the sacral area remained statistically significant” compared to patients who were continent (2018, p. 65). Placing a silicone foam dressing over the sacrum is a commonpreventative practice in patients with stage 1 pressure injuries, but does research support this intervention when incontinence is involved? It is important to utilize evidence-based research to determine if this is the best practice to prevent skin breakdown in this population, as they have increased vulnerability to pressure injuries. Research Review Essay

Background

The first step toward preventing pressure injuries is thorough assessment. The Agency for Healthcare Research and Quality (AHRQ) recommends inspecting skin for the following: temperature, color, moisture, turgor and integrity. They advise utilization of assessment tools such as the Braden Scale to standardize skin assessments and determine patient risk for skin breakdown (Berlowitz, et al., 2014). There are two main types of skin breakdown in the pelvic area, pressure injuries and incontinence-associated dermatitis. Pressure injury is defined by Campbell et al., as “localized damage to the skin and/or underlying tissue, usually over a bony prominence” (2020, p. 30). When a patient is determined to be at risk for developing pressure injury through a Braden score or other scale, pressure reduction techniques are utilized to prevent breakdown. Pressure reduction techniques vary by hospital but typically include turning and repositioning, placing pillows to cushion bony prominences, and utilizing pressure-reducing mattresses. In contrast, incontinence-associated dermatitis (IAD) is defined by Gray &Guiliano as “erythema and edema of the surface of the skin, sometimes accompanied by serous exudate, erosion or secondary cutaneous infection” specifically found in patients who are incontinent of bowel and/or bladder (2018, p. 63). Though these two conditions are separate, incontinence is found to worsen the risk of developing pressure injuries. In their multivariate analysis on immobility, incontinence and pressure injury, Gray &Guiliano found that the presence of IAD significantly increased the likelihood of developing a pressure injury (2018.) Some of the prevention strategies overlap between these conditions, such as preventing moisture and pressure reduction techniques. Research Review Essay

Research Problem Statement

            With this known link between IAD and pressure injury, it is important for clinicians to determine the best interventions to prevent skin breakdown in populations where both are present. This paper is comparing the use of silicone foam dressings in this population, versus pressure reduction techniques alone.

Research Purpose

The purpose of this paper is to determine whether silicone foam dressings prevent skin breakdown more effectively than pressure reduction techniques alone, in hospitalized patients who have stage 1 pressure injuries and incontinence.

Research Question

            In individuals with both incontinence and stage 1 pressure injuries, how does a silicone foam dressing compared to pressure reduction techniques affect skin integrity within a hospital stay?

Research Utilization Model

The Johns Hopkins Nursing Evidenced-Based Practice Model (JHNEBP) is an appropriate research model to use for this research focus as it was developed to make incorporating evidence more manageable for nurses during clinical practice. This makes it well suited to research and implementation within a hospital system. Melnyk and Fineout-Overholt (2019) describe the three main steps: Practice Question, Evidence, and Translation. First, the question is developed and refined, a leader is determined, and an interdisciplinary team is formed. Then, evidence is screened, rated, and summarized. This phase ends with specific recommendations determined by the strength of the research. Recommendations can be one of four options such as changing the practice immediately because the evidence is strong, considering a pilot or research study, or if there is little evidence, continuing research or ending the project. Finally, the results of the study are integrated into practice (Melnyk & Fineout-Overholt, 2019, pp. 413-414). Research Review Essay

While utilizing this model, the interdisciplinary team should be composed of bedside nurses, managers, WOC nurses and hospitalists. The research obtained will guide the interdisciplinary team in answering the research question and determining the best way to disseminate this research into clinical practice in the hospital setting. Figure 1 visually depicts the JHNEBP model utilized in this research project.

 

 

 

 

 

 

Figure 1

The Johns Hopkins Nursing Evidence-Based Practice Model

 

Search Criteria and Results

The research for this study was completed utilizing CINAHL, PubMed, Medline, and Cochrane, including 313 articles from 2015 to present. Table one notes the keywords used in these searches.

Table 1

Data Research Table

Keyword	CINAHL	PubMed	Medline	PsychInfo	Cochrane
Pressure injury AND prevention AND incontinence Full Text 2015-2020	15	35			0
Pressure injury AND prevention AND silicone foam dressing Full Text 2015-2020	16	16
Pressure injury AND silicone foam dressing Full Text 2015-2020	19	17	28		2
Incontinence AND silicone foam dressing Full Text 2015-2020	5	1
Pressure injury AND prevention AND case study Full Text 2015-2020		159

 

11 research articles were included in this research project: two systematic reviews, two randomized-controlled trials, one non-randomized controlled trial, one case study, one case study analysis, one follow-up analysis, one non-experimental analysis, and two clinical guides. Figure 2 illustrates the strength of evidence of this research visually with the Strength-of-evidencerating pyramid which was found in Melnyk & Fineout-Overholt (2019, p. 116, Figure 4.2).

Figure 2

Strength-of evidence rating pyramid.