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Translational Research for Practice Population Identify aResearch Paper

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Translational Research for Practice Population

Identify a current nursing practice within your healthcare setting that requires change.

DEVELOPING OR CREATING AN INDEX TO MINIMIZE RISKS OFPRESSURE SORE

Describe the current nursing practice.

An instrument specifically designed to aid health care workers evaluate the dangers of pressure sores that a patient faces is called the Braden Scale. After assessment, the victim is categorized depending on six aspects: capability of physical activity, hydration and nutrition status, capacity to alter position, the ability to respond after sensing discomfort related to pressure, shearing or exposure of the skin to friction during locomotion, and skin exposure to moisture. If the overall score is lower it means the risk of pressure sore is higher (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d).

Discuss why the current nursing practice needs to be changed

In a multisite trial, Braden scale was tested by clinics bringing together skilled nursing facilities, Veterans Administration or VA medical centers and hospitals providing tertiary care. Of those who took part, none had experienced pressure sores earlier. Nurses evaluated those who took part in the trial with the Braden scale during a period covering 0ne to four weeks for every two to three days. During the survey, nearly one quarter of residents in nursing homes and almost 10% of VA or hospital patients underwent development of pressure sores. Older white female patients were more prone to pressure sores; and the outcome of the evaluation showed that the ability of the Braden scale to predict and identify the patients with high risks of pressure sores was reliable (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d).

Variously referred to as bed sores, pressure ulcer or pressure sore condition is a major health concern in various nursing settings such as nursing homes and hospitals for the elderly. When a patient or victim remains in the same position for too long in a state of immobility the pressure sores begin developing. This is because the continued pressure exerted at the same sites cuts off proper blood supply to the underlying tissues of the skin leading to the death of tissue and onset of open sores. Every year, it is estimated that more than 4 million patients suffer pressure sores especially those with major injuries, chronic diseases or the elderly; and this translates into an additional $9 billion to the annual health care budget. Bed sores are also responsible for complicating patient recovery or care, and hence the best remedy for this condition before its onset is to identify those who are likely to be victims before they are attacked by the sores (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d).

B. Identify the key stakeholders within your healthcare setting who are part of the current nursing practice

Victims of chronic diseases or major injury

Health care insurance firms

1. Describe the role each identified key stakeholder will play to support the proposed practice change.

Victims of chronic diseases or major injury

There exists a remarkable link between particular pressure points and diagnoses. Other than ulcer that has been identified, others are circulatory disease, cardiac surgery in patients with respiratory diseases or diabetes, neoplasm; and hip or fracture surgery. As has been noted, pressure or bed sores delay patient recovery and complicate care given to them. The conceptualized criteria of immobility allow classification according to the variety of functions though in many risk scales, the variety is limited to 1-4. This classification is simple to use, more informative and is clinically acceptable and applicable (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d).

Insurance firms covering health care

The cost of medical claims from employees and insurance premiums has hit a high peak and goes on to climb higher. Annually, it is estimated that about 4 million individuals' contract sores and this are basically people suffering from chronic diseases or major injuries and the elderly. This is responsible for a further $9 billion in the cost of health care. In order to help minimize this runaway cost, organizations and businesses are urged to make improvements in workplaces (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d).

A. Create an evidence critique table

Full APA citation for at least 5 sources

Evidence Strength (1-7) and Evidence Hierarchy

1. Joseph, J., & Davies Clifton, S. (2013). Nurses' knowledge of pressure ulcer risk assessment. Nursing Standard, 27(33), 54-60.

5 and some evidence

2. Peterson, M.J., Gravenstein, N., Schwab, W.K., van Oostrom, J.H., & Caruso, L.J. (2013). Patient repositioning and pressure ulcer risk-Monitoring interface pressures of at-risk patients. Journal Of Rehabilitation Research & Development, 50(4), 477-488. doi:10.1682/JRRD.2012.03.0040

3 some evidence supported by science

3. Page, K.N., Barker, A.L., & Kamar, J. (2011). Development and validation of a pressure ulcer risk assessment tool for acute hospital patients. Wound Repair & Regeneration, 19(1), 31-37. doi:10.1111/j.1524-475X.2010.00647.x

3 and some evidence scientifically supported

4. Rich, S.E., Margolis, D., Shardell, M., Hawkes, W.G., Miller, R.R., Amr, S., & Baumgarten, M. (2011). Frequent manual repositioning and incidence of pressure ulcers among bed-bound elderly hip fracture patients. Wound Repair & Regeneration, 19(1), 10-18. doi:10.1111/j.1524-475X.2010.00644.x

2 and some evidence scientifically supported

5. Swart, C.P. (2011). Use of the Braden Scale for Predicting Pressure Sore Risk at a school for learners with special needs. Wound Healing Southern Africa, 4(2), 74-79.

4 and some evidence scientifically supported

1. Identify five sources from scholarly peer-reviewed journals, published within the past five years and relating to the change identified in part A

Joseph, J., & Davies Clifton, S. (2013). Nurses' knowledge of pressure ulcer risk assessment. Nursing Standard, 27(33), 54-60.

Peterson, M.J., Gravenstein, N., Schwab, W.K., van Oostrom, J.H., & Caruso, L.J. (2013). Patient repositioning and pressure ulcer risk-Monitoring interface pressures of at-risk patients. Journal Of Rehabilitation Research & Development, 50(4), 477-488. doi:10.1682/JRRD.2012.03.0040

Page, K.N., Barker, A.L., & Kamar, J. (2011). Development and validation of a pressure ulcer risk assessment tool for acute hospital patients. Wound Repair & Regeneration, 19(1), 31-37. doi:10.1111/j.1524-475X.2010.00647.x

Rich, S.E., Margolis, D., Shardell, M., Hawkes, W.G., Miller, R.R., Amr, S., & Baumgarten, M. (2011). Frequent manual repositioning and incidence of pressure ulcers among bed-bound elderly hip fracture patients. Wound Repair & Regeneration, 19(1), 10-18. doi:10.1111/j.1524-475X.2010.00644.x

Swart, C.P. (2011). Use of the Braden Scale for Predicting Pressure Sore Risk at a school for learners with special needs. Wound Healing Southern Africa, 4(2), 74-79.

Identify the evidence strength of each chosen source, using the Strength of Evidence Table in the study plan.

Strategy

Expected outcome

Sources

Evidence Strength

Assessing the development in SCI (spinal cord injury) learners and the risk of PU (pressure ulcers)

A holistic prevention protocol for caregivers and learners was documented so as to minimize the risks identified

Swart, C.P. (2011). Use of the Braden Scale for Predicting Pressure Sore Risk at a school for learners with special needs. Wound Healing Southern Africa, 4(2), 74-79.

Part of the evidence was

Scientifically supported

Linking

repositioning to patients who are bed-ridden

Questioning the how resources for repositioning are allocated

Rich, S.E., Margolis, D., Shardell, M., Hawkes, W.G., Miller, R.R., Amr, S., & Baumgarten, M. (2011). Frequent manual repositioning and incidence of pressure ulcers among bed-bound elderly hip fracture patients. Wound Repair & Regeneration, 19(1), 10-18. doi:10.1111/j.1524-475X.2010.00644.x

Some evidence was Scientifically supported

Using The Northern Hospital

Pressure Ulcer Prevention Plan (TNH-PUPP)

Minimize unnecessary

Harm to patients and costs from pressure ulcers in hospitals with acute needs

Page, K.N., Barker, A.L., & Kamar, J. (2011). Development and validation of a pressure ulcer risk assessment tool for acute hospital patients. Wound Repair & Regeneration, 19(1), 31-37. doi:10.1111/j.1524-475X.2010.00647.x

Scientifically supported

Some Evidence

Regularly repositioning patients to reduce pressure ulcers

The practice of repositioning itself should be improved

Peterson, M.J., Gravenstein, N., Schwab, W.K., van Oostrom, J.H., & Caruso, L.J. (2013). Patient repositioning and pressure ulcer risk-Monitoring interface pressures of at-risk patients. Journal Of Rehabilitation Research & Development, 50(4), 477-488. doi:10.1682/JRRD.2012.03.0040

Part of the evidence scientifically supported

Review of Literature

Understanding the importance of clinical judgments and risk assessment in relation to pressure ulcers

Joseph, J., & Davies Clifton, S. (2013). Nurses' knowledge of pressure ulcer risk assessment. Nursing Standard, 27(33), 54-60.

Some Evidence

Identify the evidence hierarchy of each chosen source, using the Evidence Hierarchy Table in the study plan

Level

Description

Source

Three

Evidence from time series, matched cases, well designed trials without randomization: cohort, matched cases or case controlled studies

Swart, C.P. (2011). Use of the Braden Scale for Predicting Pressure Sore Risk at a school for learners with special needs. Wound Healing Southern Africa, 4(2), 74-79.

Three

Evidence from time series, matched cases, well designed trials without randomization: cohort, matched cases or case controlled studies

Peterson, M.J., Gravenstein, N., Schwab, W.K., van Oostrom, J.H., & Caruso, L.J. (2013). Patient repositioning and pressure ulcer risk-Monitoring interface pressures of at-risk patients. Journal Of Rehabilitation Research & Development, 50(4), 477-488. doi:10.1682/JRRD.2012.03.0040

Two

Evidence from at least a properly designed RCT of the correct size

Page, K.N., Barker, A.L., & Kamar, J. (2011). Development and validation of a pressure… [END OF PREVIEW]

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