Risk factors of pressure ulcer

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Risk factors of pressure ulcer

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

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To Prepare:

  • Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high-level evidence) you selected in Module 3.
  • Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
  • Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project) Risk factors of pressure ulcer

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer-reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

Clinical issue of interest

Issue of interest- Pressure Ulcer

Pressure ulcers also known as pressure injuries, pressure sores, decubitus ulcers and bed sores are localized injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction (Shi et al., 2021) Risk factors of pressure ulcer

Risk factors of pressure ulcer include limited mobility, poor nutrition, comorbidities, weak, dry, thin skin due to aging, pressure, friction, shear, and moisture.

70% of cases involving pressure ulcers are among individuals over 65 years of age

Injuries to the skin and underlying tissue, known as pressure ulcers (also known as pressure sores or bedsores), are most commonly caused by sustained pressure applied to the skin’s surface. Those who are confined to bed or who spend extended periods of time in a chair or wheelchair are more susceptible to developing these conditions than others. Pressure ulcers affect around 70% of adults over the age of 65, and they are seen in 9-22 percent of nursing home residents and 5-32 percent of hospitalized patients. Pressure ulcers are frequently caused by sitting or laying in the same posture for an extended period of time. Pressure ulcers are more prone to occur if the skin becomes thin, dry, or weak as a result of ageing or disease, among other factors. Pressure ulcers are more common in older persons in general, and they are particularly common in people who have trouble moving.

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Clinical issue of interest Continue

Negative pressure wound therapy (NPWT) uses suction, tubing, and wound dressing to promotes wound healing through optimization of blood flow, decreasing local tissue edema and remove excess exudate and any infectious material that may be present in the wound (Dumville, et al., 2015)

Standard moist wound therapy is the practice of keeping a wound in an optimally moist environment to promote faster healing and prevent the development of scab, promote keratinocytes cell function, facilitate autolytic debridement and stimulate collagen synthesis (Shi et al., 2021) Risk factors of pressure ulcer

PICOT

P- Patient with immobility and elderly patients 60 years and above

I- Negative pressure wound therapy

C- Standard moist wound therapy

O- Improve the therapeutic process of pressure ulcer

T- two months

For elderly patients above 60 years with pressure ulcers (P), will negative pressure wound therapy (I) as opposed to standard moist wound therapy (C) improve the therapeutic process of the pressure ulcer (O) during their two-week stay at the hospital (T)?

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Description of the PICOT Question

Population/ Patient Problem: Identifies the people or patients with the clinical issue (pressure ulcer) which are patients with immobility and elderly 65 years and above.

Intervention: Represents the treatment plans to resolve the clinical issue which is the use of negative pressure wound therapy.

Comparison: Represents the alternatives to my plan, eg. different type of treatment like standard moist wound therapy

Outcome: Represents the desired/expected result of the treatment that improve the therapeutic process of pressure ulcer

Time:  The period that the treatment is expected to last which is within two month

Description of the PICOT Question Continue

My PICOT questions correspond to the question type “Intervention or Therapy,” which can be used to assess which

treatment will produce the best outcomes.

the comparison illustrates the difference between negative pressure wound therapy and standard moist wound therapy.

These questions can assist me in educating and advising my patients about their ulcer injuries, treatment options, and

success rates.

Research database

Pubmed

Scopus

Google scholar

Medline

 

Level of evidence

Article- “Preventive interventions for pressure ulcers in long-term older people care facilities: A systematic review”

Level of evidence- level I

Systemic evidence is still lacking from randomized trials conducted on interventions for preventing pressure ulcers

No single effective way identified for preventing pressure ulcers

Only a 1/3 of the preventive interventions used were effective (Mäki-Turja-Rostedt et al., 2019)

Article- “Initial Experience Using a Novel Reticulated Open Cell Foam Dressing with Through Holes during Negative Pressure Wound Therapy with Instillation for Management of Pressure Ulcers”

Level of evidence- level IV

The case study involved 5 patents

The evidence from the study is weak due to small sample size used, lack of control group and selection bias (Fernandez et al., 2017) Risk factors of pressure ulcer

Patients suffer from pressure ulcers, which also place a significant financial strain on their families. Despite the fact that most PUs could be avoided, the number of PUs has remained high. Effective PU prevention is essential in order to avoid undue suffering and expenditures. There are numerous approaches of preventing PUs in LOPC facilities; however, there is no single approach that is effective in all situations. Prevention measures in LOPC facilities were shown to be beneficial in one-third of the cases. Systematic evidence from randomized trials on preventative interventions for PUs in LOPC settings, on the other hand, is currently missing in this area. The findings can be applied in practice for the selection of PUs in LOPC facilities, and in research for the development of efficient preventive treatments for PUs in LOPC settings.