NUR2300 Evidence-Based Practices in Nursing For Ulcer Prevention Assessment 1 Answer
Evidence-based practise (EBP) is the method by which study findings are gathered, analysed, and applied to enhance clinical practise the job responsibilities, or patient outcomes (Ellis, 2019). The use of the EBP strategy to clinical practice allows healthcare professionals to deliver the best possible efficiency and more cost-efficient clinical care (Skaggs et al., 2018). This assessment aims at highlighting the scenario 2 to find the evidence-based interventions and to address the research question “In adults, what nurse-initiated interventions prevent the onset of pressure ulcers?”. Also, it deals with the analysis of search strategy and levels of evidence as per NHMRC.
Nurses use various evidence-based strategies to formulate particular research questions that will be used to determine the methodological approaches which can provide patients with evidence-based treatment. Through a concept called PICO question, such questions are posed. A properly structured study question/topic requires extreme specificity and accuracy that by taking into account multiple variables and target audience, helps to implement the work. In this case, the research question is established is using the PICO model that is composed of three components, population, intervention, and context. Population refers to an interest group that poses a particular problem identified by the researcher. PICO makes it easy to describe the person or group, the intervention or issue, the consequences of the interventions and the time needed to address the questions (Eriksen & Frandsen, 2018).
In adults, what nurse-initiated interventions prevent the onset of pressure ulcers?
The search strategy comprises of Boolean operators and use of keywords. The various keywords include pressure ulcers, nursing-based interventions, pressure ulcer interventions, nurse-initiated interventions and onset of pressure ulcer. The various Boolean operators used are Pressure ulcers OR pressure injury OR pressure sores, pressure ulcers AND nurse-initiated interventions, prevention OR intervention AND nurse-initiated interventions, pressure ulcer AND interventions, pressure ulcers AND nurse-led interventions. Systematic analysis is the method used to analyse the evidence. A systematic analysis is an important effort to promote evidence-based practice and healthcare-related initiatives (Cantor & Poh, 2018). It is a consistent and measurable methodology for drawing the inference from the different facts available. The identified databases include PubMed, Cinhal, Google Scholar, PsycINFO and Medline. These databases will be reviewed using valid keywords, evidence-based protocols, for pressure ulcer procedures. The papers that do not include these main terms will be exempted from the technique of search. The appropriate keywords for evaluating the repositories were used to document a total of five articles. The articles were selected since they had at least 2 different keywords used to search for the publications. Critical research was conducted for the compilation of these papers. To this end, the CASP tool was used. This approach is effective in selecting the best papers and seeks to produce the right results (Bramer et al., 2018).
The first study by Gunningberg et al., (2017) is a randomised controlled trial and hence can be evaluated as the evidence level II as per NHMRC level. This is because the study includes a comparison with an adequate reference standard (NHMRC, 2009). This research failed to show the positive effect of a pressure mapping system on the frequency and occurrence of pressure ulcers. The research may, however, have improved staff understanding and emphasis on the prevention of pressure ulcers, thereby positively impacting the frequency and occurrence of pressure ulcers in all study populations. The second study by Sharp et al. (2019) is at level IV as per NHMRC as it is a cross-sectional analytical survey. The quality implications show that results might not be reliable and effective.
The third study by Avsar et al. (2020) is level I being a systematic review. The quality implications show that the findings of this systematic review demonstrate that pressure ulcer incidence is reduced by regular repositioning and the use of a rotating team. Considering the low surety of the evidence the results are inconsistent and should be interpreted with caution. Next study by Serraes et al. (2018) meets the criteria I of NHMRC being a systematic review. Quality implication includes reliable results and improved patient health outcomes. The fifth study is by Damanik et al. (2020) is a randomized control trial and meets the NHMRC at level II. The study is appropriate and reliable as it meets the high-quality levels and ensures the evidence-based practice (NHMRC, 2009).
From the above, it can be concluded that evidence-based practice is essential for appropriate and reliable approaches for pressure ulcer preventions. The major nurse-initiated interventions include appropriate nutrition, use of adequate mattress and repositioning as per the high-quality evidence rated according to NHMRC levels of evidence.