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Evidence based practice critique
Evidence based practice critique
Pressure ulcer: prevent and manage case study
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SSKIN is a group of evidence based interventions that, if used properly, will reduce the incidence of pressure ulcers (Whitlock, 2013). The effectiveness of this method can be measured by using each step efficiently and collaborating with other members of the health care team. The outcome of these interventions will result in prevention of pressure ulcerations on patients. These interventions will be evaluated by the number of patients who still obtain pressure ulcers even while using these steps. Educating staff should be implemented if a patient obtains a pressure ulcer after using the SSKIN tool. Education and training are the key in using the SSKIN methods, as well as a stable knowledge base on maintaining skin integrity (Whitlock, 2013).
The effectiveness of these evidence based practice interventions can all be measured through trial and error. The nurse should document each evaluation outcome for analyzing to improve or continue with these interventions.
Conclusion
In conclusion the role of the nurse when dealing with impaired skin integrity; especially dealing with pressure ulcers include, but is not limited to the prevention of skin breakdown, wound care after the formation of pressure ulcers, and proper teaching of healthcare personnel in reference to the most current evidence based practice on prevention and care.
Based on current evidence based practice and nursing standards, the patient who has increased risk for pressure ulcer formation should be turned at the minimum of one time in a given two hour period. This will dramatically decrease the possibility of skin breakdown that could become a pressure ulcer by quite a bit. Some ideas that have come up recently include trying to find special mattresses that help shi...
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...ve basic knowledge on how to help keep normal skin integrity prior to using the SSKIN method. However, in the end all methods of intervention are best done by use of trial and error. Being patient centered we want to make sure that if our interventions are not correcting the situation, then we need to change our process to provide better care to our patients. There is a new bandage created called the “smart bandage”, which could potentially help reduce the possibility of pressure ulcers. It is being tested out now in clinical trials (Yang, 2015).
With these implementations nurses can help to prevent pressure ulcers. As we move forward in technology the potential for unlocking new ways to prevent, care for, and teach not only our patients but staff about pressure ulcers. Again, we always need to look forward and always look for the best evidence based practice.
Risk assessment scales have been in situ for over 50 years within the adult sector. These scales consist of several categories, which are thought to be associated with the potential occurrence of a pressure ulcer. Factors such as mobility and incontinence etc. are considered. Each category of the assessment is added up to give a total. The score then suggests whether a patient is at low, medium or high risk of developing a pressure ulcer. Higher-risk patients are therefore more susceptible to develop pressure ulcers and interventions are implemented such as, Air mattresses or nutritional support which is hoped to reduce the occurrence of pressure
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
The Braden Scale is a clinically valued tool that is used to predict pressure ulcers. The scale is broken down into six sub-scales; these subscales determine the risk factors associated with skin break down. Multiple aspects of a patients condition are examined, (sensory perception, moisture, activity, mobility, nutrition, friction and shear), to limit the patients susceptibility for skin break down. Since pressure ulcers are a financial burden and a cause for patient discomfort and possible infection, predicting and assessing risk has enormous benefit and significance.
Werner-Rutledge, C. (2012). Evidence-Based Practice Preparation in Nursing Education: Recent BSN Graduates and Their Experience With Applying Evidence-Based Practice. (Doctoral Dissertation). Capella University. Retrieved from ProQuest Digital Dissertations. (3502734) http://search.proquest.com.ezp-02.lirn.net/pagepdf/993006005/Record/3CA1ED1ED991402DPQ/1?accountid=158614
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.
Maintenance of an appropriate healing environment is also essential throughout the management of diabetic foot ulcers. The choice of dressing is dependent on many factors including presence of infection, amount of exudate and the required frequency of wound bed inspection.
“Living with Burn Trauma,” an online article, states that “human skin is the largest organ of the body.” It provides many functions which assist humans to survive. What happens if this vital organ is destroyed? This is a question with which thousands of Americans are challenged annually. In the United States alone, 4,000 people die in burn accidents or from complications of burn injuries (“Prevention”). One common misconception is that burn victims have all come into contact with flames. Burns result from fires, electricity, hot liquids, chemicals, and even ultraviolet rays. Seeking medical attention for a proper diagnosis is critical to ensuring quality treatment and management of burns. Burn Centers have been established to help patients adapt to life after burns, which can be a great challenge. In today’s society, hospitals and medical professionals can treat burn victims, but the best remedy for burns is prevention.
In providing quality patient outcomes, current evidence based research has to be an important part of this process. With every new research proposal, a solid foundation has to be the basis for that specific research. The following paper is a literature analysis of current studies that support the use of negative pressure wound therapy (NPWT) in healing diabetic foot ulcers in adults. This paper will also discuss what search methods were used, strengths and weaknesses of each study, and the validity and relevancy of the research on the issue of non-healing diabetic foot ulcers in healthcare today.
One feature of evidence based practice is a problem-solving approach that draws on nurses’ experience to identify a problem or potential diagnosis. After a problem is identified, evidence based practice can be used to come up with interventions and possible risks involved with each intervention. Next, nurses will use the knowledge and theory to do clinical research and decide on the appropriate intervention. Lastly, evidence base practice allows the patients to have a voice in their own care. Each patient brings their own preferences and ideas on how their care should be handled and the expectations that they have (Fain, 2017, pg.
The importance of Evidence-Based Practice is to ensure the best possible care is provided for patients. Evidence-Based Practice functions by measuring the effectiveness of a treatment and differentiating findings between high-quality and low-quality. It also helps with health development and improves the reliability and facilitates students to become reflecti...
Our approach in managing wounds was far from being optimal in our own setting. After having read the article of Sibbald et al (1) and assisting to presentations during the first residential week-end, our approach at St. Mary 's Hospital Center 's Family Medicine Clinic must change. We were not classifying wounds as healable, maintenance or non-healable. We were always considering the wounds in our practice as healable despite considering the system 's restraints or the patients ' preferences. In the following lines, I will define and summarize the methods one should use in order to initial management of wounds and how to integrate it better to our site. The first goal we need to set is to determine its ability to heal. In order to ascertain if a wound is healable, maintenance or a non-healable wound.