Discussion: Integrated Research on Implications of Pressure Ulcers Research

Discussion: Integrated Research on Implications of Pressure Ulcers Research ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Integrated Research on Implications of Pressure Ulcers Research NB: 7 articles will be reviewed. I have 3 of the articles attached. You will have to fine 4 other articles on pressure ulcer. Discussion: Integrated Research on Implications of Pressure Ulcers Research Attached are: – Rubric -PICOT question that will be used in the beginning of the paper -Three articles you will have to use. One of the article is on nutrition and weight not directly related to pressure ulcer but indirectly related picot_question_for_intergrated_research.docx integrated_research_2_rubric.docx a1_article.pdf a2_article.pdf a3_article.pdf PICOT Patient Intensive care patients have a higher risk of pressure ulcers due to immobility. According to Deng, Yu, and Hu (2017), about 34% of all hospitalized patients get hospitalacquired pressure injuries. The cases are common among critical-care patients. Intervention The health sector has witnessed a substantial rise in the use of pressure-relieving mattresses to lower the risk of bedsores. As Deng et al. (2017) state, most of these mattresses offer alternating pressure or especially soft surfaces. They can take the form of alternating pressure mattresses or special foam mattresses. Comparison For many years, regularly turning the patient has been an effective strategy for preventing bedsores. The tactic involves changing the patient’s sitting or lying position frequently. Critical care patients move much less since they are weak, unconscious, or asleep (Deng et al., 2017). As a result, they need someone to recurrently turn them to prevent pressure ulcers. Outcome The outcome is a reduced risk of developing bedsores. ICU patients stay in bed for long, making some of their body parts sore. However, reducing the pressure on their skin can go a long way in preventing pressure ulcers. Time The time is two weeks after admission after admission date. PICOT Question Among intensive care patients (P), do pressure mattresses (I), compared to regularly turning the patient (C), reduce the risk of developing bedsores (O) within the first two weeks of admission (T)? Running head: INTEGRATED RESEARCH 1 Title page 4 points You may use this as a sample title page. If you have another paper. Copy and paste this title page to a new word document. Go into insert: select header, select edit header and put in what you need to. Then click on close at the end of the row which is a large red X. Save this for future papers. Hope this helps. Delete this box after you are finished. Dr. Dahlen Assignment 2: Integrated Research Your Name School Course Number, Section, and Title Course Instructor Abstract 6 points Leave the point value in each section Running head: INTEGRATED RESEARCH 2 This research will focus on the formation of a PICOT question to explore its usefulness in answering clinical questions. PICOT is defined as the problem/population, intervention, comparison, outcome, and time. For this study, the author explored the question of: (P) in patients infected with the human immunodeficiency virus (I) how does anti-retroviral therapy and nutritional support (C) compared to ART alone (O) influence survival rates (T) within six months of treatment? The Model for Evidence-Based Practice Change will be utilized for the study. In addition, this researcher will conduct a literature research review, followed by findings, discussion section, and recommendations for change and implementation of the problem. Keywords: PICOT, HIV, ART, nutritional support, Model for Evidence-Based Practice Change Running head: INTEGRATED RESEARCH 3 Assignment 2: Integrated Research Review Start this with a definition of what a literature review is with a reference and why it is important in a study. Define your topic or concept that you selected in your PICO question. This should be 2 paragraphs. 6 points Integration/Synthesis with Submission of your articles-14 points Integrate the 4 articles retrieved from assignment 1 and discuss them in narrative format with the new additional articles you have identified. Be sure one is from another discipline. Discussion: Integrated Research on Implications of Pressure Ulcers Research This section should be at least 4 solid well-developed paragraphs full page or more. I have provided some tips here for how to cite the articles when you are writing. Remember you must give credit to the authors of the research you examined. Do not overuse quotes. (At this point you should have all of your 7 articles selected to discuss here and 4 tables for the appendices) Synthesis is a form of summarizing your sources of articles you gathered. To synthesize, you should combine summaries from sources that agree on many overall points. The points of agreement should appear in the articles you have selected and cite. Or you may make a point there is a disagreement in what you found with the proper citation. Here are some examples of in-text citations for synthesized sources: APA TIPS: Apples, 2007; Charbonneau, 2008; & Dahlen, 2015;) agree that… Data has shown that Ball, 2008; Oranges, 2011; & Johnson, 2010 have varying views on how to treat childhood obesity. However, all authors agree that inactivity plays a role in the growing epidemic of child who are obese. 1. In text citation format – Please note that points will be ducted for not citing correctly in APA format in this section. a. The author’s name is included (Dahlen, 2015) for paraphrased material. b. “Direct quotes look like this” (Dahlen, 2015, p.25). c. Dahlen and Johnson (2015) look like this when using more than one author in the sentence. d. When the authors names are used at the end of the sentences, then the formatting should be like this (Dahlen & Johnson, 2015). The ampersand (&) is used when the parentheses are used. The period follows the citation and not the sentence (Dahlen, 2015). Image of EBP Model 10 points Running head: INTEGRATED RESEARCH 4 Start this section with an opening paragraph on your model of choice. You may reiterate information from the PICOT critiques. Provide an image of the model you selected with information you gathered from your articles throughout the image. You may have to draw the model with the draw feature. This is an image that I would select if writing an article on online learning. The steps must have the information from your research. You may have to be creative in what is done in each step. https://bestpracticemodels.wiki.staffs.ac.uk/@api/deki/files/98/=summary.JPG Model Steps Once the model is depicted write out the steps and describe what you would do to achieve your PICOT question. 15 points Reflection on Assignment 16 points Write two paragraphs on the value of this assignment. Summary-4 Points This should be at least two paragraphs recounting the main points of the paper in a succinct manner. References-Go on a page alone in alphabetical order-5 Points Running head: INTEGRATED RESEARCH 5 If you had to find another article because you identified one of the critiques wrong you must upload the new critique or you lose 5 points. Original Article Patients’ Perceptions of a Pressure Ulcer Prevention Care Bundle in Hospital: A Qualitative Descriptive Study to Guide Evidence-Based Practice Shelley Roberts, PhD • Marianne Wallis, PhD • Elizabeth McInnes, Discussion: Integrated Research on Implications of Pressure Ulcers Research PhD • Tracey Bucknall, PhD • Merrilyn Banks, PhD • Lauren Ball, PhD • Wendy Chaboyer, PhD ABSTRACT Keywords care bundle, patient-centered care, patient participation, pressure injury prevention, pressure ulcer prevention Background: Pressure ulcers place a significant burden on patients and hospitals. Our team developed and tested a pressure ulcer prevention care bundle (PUPCB) in a cluster randomized trial. As part of the process evaluation conducted alongside the trial, we explored patients’ perceptions of the intervention. Aims: To identify patients’ perceptions and experiences of a PUPCB in hospital. Methods: This qualitative descriptive study explored the perceptions of a subset of patients who participated in a trial testing the PUPCB across four intervention hospitals. A trained interviewer conducted semistructured interviews, which were digitally recorded, transcribed, and analyzed using thematic analysis. Findings: Nineteen patients were interviewed across the four hospitals. Three main themes emerged: (a) importance of personal contact in PUPCB delivery; (b) understanding pressure ulcer prevention (PUP) enhances participation; and (c) individual factors impact patients’ engagement in PUP. Discussion: The extent to which patients adopted the intervention appeared to be influenced by the complexity of education materials, compatibility with patients’ existing knowledge and beliefs, and perceived advantage of the intervention; ability for human interaction; and patientrelated facilitators and barriers to participating in PUP care. Linking Evidence to Action: This study found patients accepted a PUPCB that encouraged participation in care, particularly as it involved personal and positive interactions with nurses and provision of information that was easy to understand and resonated with patients. BACKGROUND Pressure ulcers (PUs) are a significant problem in the clinical setting. PUs cause severe physical, social, and psychological problems for patients, including pain, reduced mobility and functional ability, restricted daily and social life activities, mood changes and emotional problems, and poor self-image (Gorecki et al., 2009; Gorecki, Closs, Nixon, & Briggs, 2011). For hospitals, PUs cause substantial economic burden through longer length of stay, high treatment costs (Graves & Zheng, 2014; Nguyen, Chaboyer, & Whitty, 2015), and financial penalties to institutions (Queensland Government & Queensland Health, 2012). Pressure ulcer prevention (PUP) is therefore a national and international priority for healthcare organizations (Australian Commission on Safety and Quality in Health Care, 2011; European Pressure Ulcer Advisory Panel, National Worldviews on Evidence-Based Nursing, 2017; 14:5, 385–393. C 2017 Sigma Theta Tau International Pressure Ulcer Advisory Panel, & Pan Pacific Pressure Injury Alliance, 2014). Discussion: Integrated Research on Implications of Pressure Ulcers Research Our team recently developed a pressure ulcer prevention care bundle (PUPCB; Chaboyer et al., 2015) and tested its effectiveness and cost effectiveness in a cluster randomized trial (the INTroducing A Care bundle To prevent pressure injury [INTACT] trial) in eight Australian hospitals (Chaboyer et al., 2016). The PUPCB promoted patient participation in PUP care and was delivered to both patients and nurses. Patients received PUP education with a brochure, poster, and DVD, which contained three messages: (a) keep moving, (b) look after your skin, and (c) eat a healthy diet. While a significant reduction in hospital-acquired PUs was seen in intervention patients at the cluster level, the difference was not statistically significant at the individual patient level when adjusted for covariates and 385 Perceptions of a Pressure Ulcer Prevention Care Bundle Processes involving clusters Processes involving individuals Recruitment of clusters Recruitment and reach of individuals Effectiveness of intervention Intervention delivery to clusters Clusters’ response to intervention Intervention delivery to individuals Maintenance of intervention processes Unintended consequences of intervention Individuals’ response to intervention Theory underpinning intervention Context Figure 1. Framework for process evaluations of cluster randomized trials (adapted from Grant et al., 2013). clustering. Despite a sample size of 1,598 patients, the study was found to be underpowered, with a larger-than-expected intraclass correlation coefficient and a small number of clusters (eight). It is important to understand why, how, and for whom the intervention may have worked (or not) in order to interpret the results of the main trial and consider implications for future research and practice. A prespecified process evaluation (i.e., planned prior to trial commencement) was conducted alongside the INTACT trial to understand the processes underpinning its implementation and how these may have affected study outcomes (Craig et al., 2008). The process evaluation was guided by a framework proposed for cluster randomized trials (Grant, Treweek, Dreischulte, Foy, & Guthrie, 2013). The main evaluation domains in this framework include recruitment and reach, intervention delivery, and response to the intervention, for both individuals (patients) and clusters (hospitals). The framework also considers context, maintenance of the intervention, and findings of the main trial. The overall process evaluation for the INTACT trial is reported elsewhere (Chaboyer et al., 2016). This article specifically reports in detail on individuals’ (patients’) response to the intervention. Nurses’ perceptions of the bundle are reported elsewhere (Roberts et al., 2016). Understanding how patients perceive and respond to an intervention provides insight into its acceptability, effectiveness, and likelihood of being sustained in the longer term. It is especially important to assess individuals’ response to an intervention that requires adherence or behavior change (Grant et al., 2013). This study aimed to explore patients’ perceptions of a PUPCB, including 386 its acceptability and usefulness to patients and their perceived facilitators and barriers to participation in PUP care. These insights are important for interpreting the main trial findings and in considering future use of the PUPCB. METHODS Study Design This qualitative descriptive study (Sandelowski, 2000) consisted of semistructured interviews with a subset of patients participating in the INTACT trial at each of four intervention sites, to explore their perceptions of and response to the PUPCB. Ethical approval was gained at each intervention site and from the participating university for patient interviews. Discussion: Integrated Research on Implications of Pressure Ulcers Research This study comprised the “individuals’ response to intervention” domain of Grant et al.’s (2013) framework for process evaluations of cluster randomized trials (Figure 1). Setting This study was conducted in four acute care hospitals (consisting of both public and private hospitals, across two Australian states) that were intervention sites for the INTACT trial. Participants and Recruitment Patients were eligible for inclusion if they had already consented to participate in the INTACT trial, were randomized to the intervention group, and agreed to an interview. Inclusion criteria for the main trial are reported elsewhere (Chaboyer et al., 2015). Purposive sampling was used to include a mix Worldviews on Evidence-Based Nursing, 2017; 14:5, 385–393. C 2017 Sigma Theta Tau International Original Article Table 1. Semistructured Interview Domains and Example Questions Domain Example questions and prompts 1. Remembering and understanding the intervention What did you know about pressure ulcers and pressure ulcer prevention before you came into hospital? Do you remember someone coming to speak to you about pressure ulcers? What can you remember about this? What did they tell you? 2. Using and participating in the intervention Which parts of the study did you find the most interesting or engaging? Can you give examples? When you think about your time in hospital, can you remember any instances when you used the information that you were given about pressure ulcers? For example, did you do anything differently? Why or why not? 3. Perceived value of the intervention Do you think this pressure ulcer prevention information was of any value to you personally? Why or why not? Will you use this information again in the future? How? of male and female, older and younger, medical and surgical patients, with and without experience of PUs. Each patient was provided with a participant information sheet outlining the study, and informed consent was gained from agreeable patients. Data Collection A semistructured interview guide was developed based on previous literature (Latimer, Chaboyer, & Gillespie, 2014; Whiting, 2008) and piloting of the intervention (Gillespie, Chaboyer, Sykes, O’Brien, & Brandis, 2014). Questions were structured within three domains: (a) remembering and understanding the intervention, (b) using and participating in the intervention, and (c) perceived value of the intervention. Example questions and prompts for each domain are shown in Table 1. The interview guide was reviewed by several team members experienced in qualitative research and refined prior to the study. It was piloted in practice interviews (described in the next paragraph) and study site investigators provided feedback, which was used to further refine the guide. Worldviews on Evidence-Based Nursing, 2017; 14:5, 385–393. C 2017 Sigma Theta Tau International A training manual was developed for interviewers, containing information on study background, interviewing technique, preparation for data collection (including practice interviews), recruitment and informed consent, interview process, and ongoing development of interviewer and interview guide. This training manual was used by the study investigator at each intervention site to train one interviewer for that site. After receiving this training, interviewers conducted at least one practice interview with a patient under the supervision of the study site investigator, who provided feedback and further training specific to that interviewer. Pilot interview data were not included in the analysis. Data were collected between November 2014 and March 2015. Interviews were conducted at the patient’s bedside or other private area at a time of conveniencDiscussion: Integrated Research on Implications of Pressure Ulcers Research Discussion: Integrated Research on Implications of Pressure Ulcers Research e for patients. The semistructured interview guide was used to facilitate a conversational style of interviewing; their responses were used to guide the direction of the conversation and determine which prompts or questions were asked next. Interviews lasted approximately 15 to 20 min and were audiotaped and transcribed for analysis. Interviews continued until data saturation was reached (i.e., no new ideas or themes were identified). Data Analysis Interview data were analyzed using thematic analysis (Braun & Clarke, 2006; Vaismoradi, Turunen, & Bondas, 2013). One member of the team led data analysis and transcribed interviews to become familiar with the data. Two independent researchers read and reread transcripts, to allow them to become immersed in the data, and developed codes based on the verbatim statements of participants. Codes were compared and contrasted and aggregated into groups, which became subthemes, and these were grouped into themes based on common threads throughout the codes. Development of labels for subthemes and themes was an iterative process; they were discussed with the team, reviewed, and revised accordingly. Researchers constantly referred back to the raw data to validate themes and subthemes. Trustworthiness was achieved by employing several strategies. First, frequent discussion among the research team ensured that the codes accurately reflected the data and that the themes and subthemes adequately encompassed the data (i.e., credibility). Interviews were conducted within a short time frame at each site, and interviews were transcribed concurrently, which started the analytic process (i.e., to maximize dependability). Finally, purposive sampling was used to ensure a broad representation of patients across all the study sites (i.e., transferability). FINDINGS A total of 19 patients participated in interviews across the four intervention sites. Three sites recruited five patients and one site recruited four patients. Ten patients (53%) were female. The mean (±SD) age of all patients was 68.8 (±16.5) years (range 31–96). At the time of the interview, their mean length 387 Perceptions of a Pressure Ulcer Prevention Care Bundle of stay was 7.8 (±5.6) days (range 3–24) and mean length of time since recruitment into INTACT was 6.9 (±5.8) days (range 2–23). Patients were recruited from medical (n = 5, 26%) or surgical (n = 14, 74%) wards. Patients expressed a number of ways by which they did or did not participate in PUP care, by engaging in the intervention or encountering barriers to participation. Participants’ perceptions of and experience with the intervention are described in three themes: (a) importance of personal contact in PUPCB delivery, (b) understanding PUP enhances participation, and (c) individual factors impact patients’ engagement in PUP. Importance of Personal Contact in PUPCB Delivery P … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10