INTRODUCTION
Evidence-based nursing practice is imperative for improving the quality of nursing care. The selected scenario is two and the main aim is to prevent the occu
ence of pressure ulcers. The research question is "In adults, does the use of prophylactic dressing prevent the onset of pressure ulcers?" This paper presents the search strategy and appraisal of the available evidence that supports the use of prophylactic dressing for pressure ulcer prevention.
ACQUIRE
The databases searched were Ebscohost, Medline, and PubMed. The keywords used were developed from the PICO questions as highlighted in table 1. The Boolean operators AND linked the keywords.
Table 1: PICO Table for Structuring Search Terms
PICO
Keywords
Boolean Operators
Patient
Adults
AND
Intervention
Prophylactic dressing
AND
Comparison
No prophylactic dressing
-
Outcome
Pressure ulcers
AND
The search strategy in the three databases involved the use of a MeSH
owser. The topic, abstracts, and entire articles were searched using the keywords and the Boolean operators (table 2). The Boolean operator OR linked the identified additional keywords that were synonymous to the initial keywords.
Table 2: Search strategy
Ebscohost, Medline, and PubMed searches
((("pressure ulcers" [MeSH Major Topic]) OR ((pressure injuries)) [MeSH Major Topic]) AND ("prophylactic dressing" [MeSH Major Topic]))) OR ("pressure ulcers"[Title/Abstract]) OR ("pressure injuries"]) AND ("pressure ulcer"[Title/Abstract])) AND ("patients"[MeSH Major Topic])
Inclusion criteria were primary studies and relationship to the research question. The year of publication in the search databases was limited to the last five years and publication language set as English. A record of 55 articles was identified. Records not linked to full-text articles were deleted. A critical review of the identified articles for methodological rigour led to a selection of six articles (table 3).
Table 3: Selected articles
Autho
Design
Findings
Padula (2017)
Retrospective cohort.
Foam dressing reduced sacral pressure ulcers.
Forni et al. (2018)
Randomized control trials
Foam dressing is preventing pressure ulcers at a relative risk of 0.29.
Kalowes et al. (2016)
Randomized control trials.
Foam dressing led to a significant reduction of pressure ulcers by about 5%
Yoshimura et al. (2018)
Prospective cohort.
Foam dressing is the most effective for preventing pressure ulcers.
Karimi et al. (2020)
Randomized control trials.
Oil prophylactic dressings are effective for preventing heel pressure ulcers.
Hahnel et al. (2020)
Randomized control trials.
Silicone dressing is preventing pressure ulcers at a relative risk of 0.26.
APPRAISE
Critical appraisal is an in-depth assessment of a published study to determine if the findings can be utilized in the clinical environment for evidence-based practice (Buccheri & Sharifi, XXXXXXXXXXEvidence-based practice is important for improving the quality of nursing care (Buccheri & Sharifi, 2017), thus, good diseases prognosis and enhanced life expectancy for the patients. The NHMRC level of evidence is six named from I to IV (Considine et al., XXXXXXXXXXThe highest level is I that includes a systematic review of randomized control trials. Level II involves randomized control trials. Level III-1 involves pseudo-randomized clinical trials such as studies utilizing alternative allocations. Level III-2 includes comparative studies that have control groups such as non-randomized experimental, cohort, case-control, and time series. Level III-3 includes comparative studies that do not have concu
ent controls such as historical control and single arm. Finally, level IV is the case series that have outcomes of either pre-test or posttest. Studies by Forni et al. (2018), Kalowes et al. (2016), Karimi et al. (2020), Hahnel et al XXXXXXXXXXare level II since they are randomized control trials. Yoshimura et al XXXXXXXXXXare level III-1 since it is an independent comparative study. Padula XXXXXXXXXXis level III-2 as it is a retrospective cohort. Outcomes from level II and III studies are used as the basis for practice change (Considine et al., XXXXXXXXXXSince the selected evidence is level II and III, the findings are applicable for the adoption of prophylactic dressing to prevent pressure ulcers and the development of policies and procedures on the application of dressing to reduce the likelihood of the adult patients developing pressure ulcers.
CONCLUSION
The search strategy led to the identification of six articles that support the use of prophylactic dressings to prevent pressure ulcers. The dressing material can either be foam, oil, or silicone. Since the six studies were of level II to III, the findings are reliable and applicable for evidence-based practice. The implication of the available evidence is the health care facility to adopt the use of prophylactic dressing to prevent pressure ulcers, and policies as well as procedures developed on the application of prophylactic dressings.
REFERENCES
Buccheri, R. K., & Sharifi, C XXXXXXXXXXCritical appraisal tools and reporting guidelines for evidence‐based practice. Worldviews on Evidence‐Based Nursing, 14(6), XXXXXXXXXXhttps:
doi.org/10.1111/wvn.12258
Cortés, O. L., Salazar-Beltrán, L. D., Rojas-Castañeda, Y. A., Alvarado-Muriel, P. A., Serna-Restrepo, A., Grinspun, D., Cortés, O. L., Salazar-Beltrán, L. D., Rojas-Castañeda, Y. A., Alvarado-Muriel, P. A., Serna-Restrepo, A., & Grinspun, D XXXXXXXXXXUse of Hydrocolloid Dressings in Preventing Pressure Ulcers in High-risk Patients: A Retrospective Cohort. Investigación y Educación En Enfermería, XXXXXXXXXXhttps:
doi.org/ XXXXXXXXXX/udea.iee.v36n1e11
Considine, J., Shaban, R. Z., Fry, M., & Curtis, K XXXXXXXXXXEvidence-based emergency nursing: designing a research question and searching the literature. International emergency nursing, 32, XXXXXXXXXXhttps:
doi.org/10.1016/j.ienj XXXXXXXXXX
Forni, C., D'Alessandro, F., Gallerani, P., Genco, R., Bolzon, A., Bombino, C., Mini, S., Rocchegiani, L., Notarnicola, T., Vitulli, A., Amodeo, A., Celli, G., & Taddia, P XXXXXXXXXXEffectiveness of using a new polyurethane foam multi-layer dressing in the sacral area to prevent the onset of pressure ulcer in the elderly with hip fractures: A pragmatic randomised controlled trial. International Wound Journal, 15(3), 383–390. https:
doi.org/10.1111/iwj.12875
Hahnel, E., Genedy, M. E., Tomova‐Simitchieva, T., Hauß, A., Stroux, A., Lechner, A., Richter, C., Akdeniz, M., Blume‐Peytavi, U., Löber, N., & Kottner, J XXXXXXXXXXThe effectiveness of two silicone dressings for sacral and heel pressure ulcer prevention compared with no dressings in high-risk intensive care unit patients: A randomized controlled parallel-group trial. British Journal of Dermatology, 183(2), 256–264. https:
doi.org/10.1111
jd.18621
Kalowes, P., Messina, V., & Li, M XXXXXXXXXXFive-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit. American Journal of Critical Care, 25(6), e108–e119. https:
doi.org/10.4037/ajcc2016875
Karimi, Z., Mousavizadeh, A., Rafiei, H., Abdi, N., Behnammoghadam, M., Khastavaneh, M., & Shahini, S XXXXXXXXXXThe Effect of Using Olive Oil and Fish Oil Prophylactic Dressings on Heel Pressure Injury Development in Critically Ill Patients. Clinical, Cosmetic and Investigational Dermatology, 13, 59–65. https:
doi.org/10.2147/CCID.S237728
Padula, W. V XXXXXXXXXXEffectiveness and Value of Prophylactic 5-Layer Foam Sacral Dressings to Prevent Hospital-Acquired Pressure Injuries in Acute Care Hospitals. Journal of Wound, Ostomy, and Continence Nursing, 44(5), 413–419. https:
doi.org/10.1097/WON XXXXXXXXXX
Yoshimura, M., Ohura, N., Tanaka, J., Ichimura, S., Kasuya, Y., Hotta, O., Kagaya, Y., Sekiyama, T., Tannba, M., & Suzuki, N XXXXXXXXXXSoft silicone foam dressing is more effective than polyurethane film dressing for preventing intraoperatively acquired pressure ulcers in spinal surgery patients: The Border Operating room Spinal Surgery (BOSS) trial in Japan. International Wound Journal, 15(2), 188–197. https:
doi.org/10.1111/iwj.12696
NUR2300: Written Assessment 2
Task overview
Assessment name
Written Assessment 2
Brief task description
You are to respond to a clinical scenario by applying the key concepts of evidence-based nursing practice.
Rationale for assessment task
Contemporary nursing practice requires the use of evidence to improve health outcomes for patients, families, and populations. It is important for nursing students to understand the relationship between the generation of evidence and the delivery of safe and effective nursing care.
Due Date
January 25, 2021 by 2355 AEST
Length
1500 words +/-10% (Introduction & conclusion required. Word length includes in-text referencing and excludes your reference list and appendices)
Marks out of:
Weighting:
Marks out of: 40
Weighting: XXXXXXXXXX%
Course Objectives measured
1. Define evidence-based practice and identify key stages, principles, and processes of an evidence-based practice approach in nursing
2. Define the research process and identify common research methods within qualitative and quantitative paradigms
3. Describe the relationship between research and identify evidence-based nursing praxis
4. Evaluate data and research findings
5. Determine ways to improve nursing practice and patient outcomes by using an evidence-based practice approach to planning, implementing and evaluating nursing care
6. Examine the issues and ethical considerations which impact on nursing and health care research
Exempla
No. Information of a general nature will be posted to Study Desk to facilitate an informed response.
Task information
Task detail
You are to continue using the Scenario you chose in Written Assessment 1:
Scenario 1
· You attend clinical placement at an aged care home where the Nurse Unit Manager tells you they are wanting to find out best practice for preventing constipation in residents. The research question they want you to answer is: “In adults, what nurse-initiated interventions are effective for treating constipation?” XXXXXXXXXXO
Scenario 2
· You attend clinical placement in a hospital where the Nurse Unit Manager tells you they are wanting to find out best practice for preventing pressure ulcers. The research question they want you to answer is: “In adults, what nurse-initiated interventions prevent the onset of pressure ulcers?”
TASK
You are to APPLY evidence that is categorized by the National Health and Medical Research Council as Level I (systematic reviews/meta-analyses of randomized controlled trials) or Level II (randomized controlled trials) to answer your research question. This means, you are to include:
1. A table of included studies with the following information summarized from each