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Running head: PRESSURE ULCERS 1 Research Critique Part 1


Enajite M. Ejuwa


Grand Canyon University


Introduction to Nursing Research


NRS-433V September 11, 2016 PRESSURE ULCERS 2 Problem Statement


The prevalence of pressure ulcer in the United states is ranked third behind cancer and


cardiovascular disease. The Center for Disease Control (cdc) indicates the rate of occurrence in


acute care facilities is .03- 38% while in long term facilities it accounts for 3.5- 69% resulting in


healthcare cost of Pressure ulcers of $9.1-$11.6 billion per year. Individual patient care ranges


from $20,900 to 151,700 per incident of pressure ulcer. In 2007 Medicare estimated that each


pressure ulcer added $43,180 in costs to a hospital stay which has resulted in more than 17,000


lawsuits related to pressure ulcers annually The average hospital treatment cost associated with


stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers


during one hospital stay. With these rate of occurrence levels, the significance to the nursing profession as the primary caregivers cannot be ignored so the research was conducted to look at


nurses? use of critical thinking when administering care and the differences in nursing care clinical judgment as it is the ability of the nurse to make decisions that are evidence-based and also to


make judgment to act (Tanner, 2006).


Purpose of Research


The question promoting this research asked for a survey of the process of pressure ulcer


prevention and management in acute and nursing home setting so the background issues which


promote or deter compliance to the nation's policies and rules. The study brings to bare need to


make healthcare workers be aware of some areas that need further study no harm care and this


will close the space already in existence (Soban et al, 2011).


Research Question PRESSURE ULCERS 3 The research is set out to answer four main questions pose to the participant. 1, No pressure ulcer needs to occur when a patient is the hands of healthcare workers. What does this idea


mean to you? 2, Some patient does and some do not develop pressure ulcer in the clinical area,


why? 3, Is there anything that enjoins you to make prevention and management of pressure ulcer


number one in your care of patients? 4, Since being educated on pressure ulcer prevention and


management in your institution, what is your experience?


The questions set out for this research ask nurses their views and experiences the care of


patients. This study uses a qualitative approach to describe the experience of the nurses and


healthcare assistants (HCA) on procedure of the prevention and management of pressure ulcer in


acute and nursing home setting.


Literature Review


The author used an article from 'effects of education and experience on nurses' value of


pressure ulcer' this explains that the participating nurses knew little about pressure ulcers and


why it is important to prevent them even though they have been educated prior to placement during registration (Samuriwo R., (2014).


The study shows that the operation of pressure ulcer prevention and management was effective due to management and political encumbrance. The nurses and HCA were encouraging in


themselves to see the process succeed but there was not enough time allotted and their lack education, therefore further study is required to prove that not enough of time does not mean not


enough staff (Newham R, et al, 2015). Pressure ulcer continue to be a problem in healthcare,


about 1.3 million to 3 million patients have pressure ulcer and it cost about $500 to $40000 to PRESSURE ULCERS treat one at a time. The occurrence of pressure ulcer differs depending on the facility, in the hospital occurrence is about


0.4 percent to 38.0 percent while 2.2 percent to 23.9 percent in the nursing homes and O


percent to 17 percent in home care setting (Lyder C. H, 2010).


This research started with various goals in view but fell short due to poor response;


firstly, the ward managers to be educated for the intervention did not respond to repeated requests by the researchers. Secondly, the operation ran out ohime as the financial commitment


was only for one year. In this study six staff nurses and six HCA that were care givers to the patients and two acute care facilities and two primary care facility were recruited for the purpose


and three of these facilities had large number of inpatient and one was median size and all near


each other for easy access between staff and patients (Newham R, et al, 2015).


The National Patient Safety Agency (NPSA) whose purpose is to limit danger to patient


from pressure ulcer, in 2011 briefly listed the solution to this problem to be checking the skin of


patients, positioning at regular intervals including looking out for moisture-free area and checking nutritional levels of the patients (Benboe M, 2012).


Conceptual I Theoretical Framework


This research started at the beginning with the intention of having a study customized to


the UK and England on the prevention and management of pressure ulcers hence, the entire reference articles available before now were all from the USA. The researchers utilized the resources of healthcare staff, management and the patients in the local facilities and the methodology used was of the qualitative method (Newham R, et al, 2015). 4 PRESSURE ULCERS 5 Grounded theory talks of standard all-inclusive way of carrying out qualitative research


geared toward the development of a theory. Grounded theory extensive importance due to its; 1,


open systematic way of carrying out a qualitative research. 2, affords specific ways for taking


care of the phase of analyzing inquiries. 3, summarizes and brings together collected data and


analysis. 4, gives meaning to qualitative research as a scientific finding (Charmaz K, (2009).


The study developed a framework by the survey questions posed to participants and the


report of their responses verbatim. The survey questions elicited the truth of prior training of the nurses and the involvement of facility management especially due to governmental policies enforcement in terms of financial liability (Newham R, et al, 2015).


Despite limitations, the importance of pressure ulcer prevention and management cannot


be overemphasized, the cost and the adverse effects of pressure ulcers on the lives of those affected is great. Some of the complications are cellulitis, gas gangrene, blood poisoning, necrotizing farciitis. Others are physical disability (NHS inform, 2015). PRESSURE ULCERS 6 Reference


Charmaz, Kathy. "Grounded Theory." The SAGE Encyclopedia of Social Science Research Methods. 2003. SAGE Publications. 24 May. 2009.


Courtney H. Lyder, (2010), Pressure Ulcer Prevention and Management. JAMA


2003 ;289(2):223-226 (doi:10.1001/jama .289.2.223) http://jama.ama


Maureen Benbow, (2012). Management of pressure ulcers. /article/management -pressure-ulcers


Newham, R., & Hudgell, L. (2015). Pressure-ulcer management and prevention in acute


and primary care. British Journal Of Nursing , 24S4-S 11 1p.


Ray, Samuriwo, (2014) Effects of education and experience on nurses' value of ulcer prevention.https ://www.researchgate .net/publication/ 47755947_Effects_ of_education_and_exper


ience_on_ nurses'_value_ of_ulcer_prevention


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