Qualitative research studies

Qiu Sun

Grand Canyon University

Nursing research

Prof. Thatcher

March 13th, 2022

Background of Study

Reddy et al. (2006) researched the effectiveness of various pressure ulcer prevention interventions. The study believes that the pressure ulcer problem is prevalent among most patient care settings and is linked to increased cost of care and adverse health outcomes. In the United States, pressure ulcers are estimated to cause about 2.5 million hospitalizations. Pressure ulcers can result in pain, reduced autonomy, increased infection and sepsis risks, more surgical procedures, long hospital stays, and higher costs for patients, families, and health care systems. Moreover, patients with pressure ulcers may also experience several complications, including depression, pain, osteomyelitis, topical infection, sepsis, and even death. Understanding appropriate and effective interventions for treating pressure ulcers is significant in the nursing profession as it helps in establishing the best treatment for the problem of pressure ulcers. The objective of the research was to evaluate the effectiveness of ulcer prevention strategies, including repositioning patients, supporting surfaces, moisturizing sacral skin, and optimizing nutritional status. The study question was which among the interventions: repositioning patients, support surfaces, moisturizing sacral skin, and optimizing nutritional status are most effective in preventing pressure ulcers.

Lavallée et al. (2019) describe pressure ulcers as painful and a condition that negatively impacts the quality of life related to health and increases the cost of healthcare due to extra time and money required to treat pressure ulcers and other complications that may arise from the problem. Individuals in nursing home facilities are at increased risk of developing the problem. The article links the problem of pressure ulcers to poor prognosis and increased length of hospital stay. Moreover, pressure ulcers lead to low moods, increased pain and social isolation. In some places, for instance, the United Kingdom, the cost of pressure ulcer treatment is believed to be about £3 million. The article aimed to determine the effectiveness of implementing a bundle on reducing or preventing pressure ulcers and improving the patient's quality of life. The study established the SKIN (Surface, Keep moving, Incontinence, and Nutrition) bundle as reliable in reducing and preventing pressure ulcers in hospitals. The research question was whether implementing a bundle strategy is effective in preventing pressure ulcers in hospitals?

How do these two articles support the nurse practice issue you chose?

The articles provide critical and relevant evidence to support various effective interventions for preventing pressure ulcers. For instance, Reddy et al. (2006) found that repositioning on the special mattress, skincare, and nutritional supple effectively reduce pressure ulcers incidence among patients in hospitals. The article provides a strong foundation for developing effective pressure ulcer prevention strategies. Lavallée et al. (2019) researched to determine the effectiveness of implementing a bundle on reducing or preventing pressure ulcers and improving the patient's quality of life. The study established the SKIN (Surface, Keep moving, Incontinence, and Nutrition) bundle to effectively prevent pressure ulcers in hospitals. The studies, through their findings, answer the PICOT question that patients who utilize pressure ulcer prevention strategies achieve better or faster wound healing during the monitoring stage.

The PICOT uses pressure ulcer patients to implement a bundle strategy in preventing pressure ulcers in hospital settings and compares the outcomes, including better or speedy healing process, to patients with no preventive intervention implemented on them. The articles apply various interventions to pressure ulcer patients and compare outcomes to those of groups left without any preventive intervention.

Method of Study

Lavallée et al. (2019) utilized a qualitative semi-structured face-to-face interview method to collect data with questions guided by the Conceptual Framework for Implementation Fidelity, while Reddy et al. (2006) used a randomized controlled clinical trial approach. There are various advantages of the interview data collection method. First, the method allows for accurate screening as the interviewee is more likely to provide true information about their real health status. Through the interview, the interviewer can obtain raw emotions, voice, tone and even choices of words used by the interviewee to gain a deep understanding and collect more information (LoBiondo-Wood & Haber, 2017). The method provides an opportunity to ask follow-up questions grounded on responses and get real-time feedback to get additional information to help understand participants' motivations and attitudes. As Reddy et al. (2006) used, a randomized controlled trial method involves research participants being randomly put into groups; control or experimental groups. The experimental groups receive the intervention being tested, for instance, hydrotherapy, while the control group is for comparison and does not receive any treatment.

The randomized controlled clinical trial allows one treatment to be compared with another to determine which is more superior; however, its validity requires many sites, which can be costly and difficult to manage. Interviews are costly to conduct as they require people staff to conduct the interview (DeJonckheere & Vaughn, 2019). The quality of obtained data relies on the interviewer's ability to collect the data well. The method is a time-consuming process involving transcription, data organization and reporting.

Results of Study

Reddy et al. (2006) examined various pressure ulcer prevention approaches and established repositioning on the special mattress, incontinence care, skin care, nutritional supplement to have more benefits to patients by decreasing or preventing pressure ulcers. These interventions are found to be effective in preventing the health problem and imply that healthcare organizations should adopt the intervention to help address the concern.

Lavallée et al. (2019) established that prevention bundle for pressure ulcers as nursing friendly and acceptable among care staff and effective in improving healthcare delivery and quality of life. The study compared the pressure ulcers prevalence rate before and after implementing bundle intervention and confirmed that the intervention was greatly effective because, within the 5 weeks of implementing the intervention, there was no single reported case of pressure ulcer, unlike the five cases reported before the intervention was implemented. The study is of great clinical significance because it informs about effective approaches to treating pressure ulcers, a prevalent clinical problem in the US system of care. The study established the bundle intervention as easy to follow effective in supporting care continuity and pressure ulcer prevention.

Ethical Considerations

As one of the most important ethical considerations, informed consent ensures that an individual is aware of the research and voluntarily agrees to participate. This ensures that the participant is willing to participate in the study. Secondly, the researcher needs to ensure participants are free from physical, emotional, or psychological harm. In both studies, informed consent was obtained from the participants prior to the beginning of the research. As such, it demonstrated that the participants voluntarily agreed to participate in the study, and that they were adequately informed about the process and the anticipated results (Dickert et al., 2020). Additionally, these studies were approved by the relevant ethics authorities to ensure they met all the requirements and did not adversely affect the participants. For instance, the University of Manchester approved Lavallée et al. (2019).

References

DeJonckheere, M., & Vaughn, L. M. (2019). Semistructured interviewing in primary care research: a balance of relationship and rigour. Family Medicine and Community Health, 7(2).

Dickert, N. W., Bernard, A. M., Brabson, J. M., Hunter, R. J., McLemore, R., Mitchell, A. R.,…& D. Pentz, R. (2020). Partnering with patients to bridge gaps in consent for acute care research. The American Journal of Bioethics, 20(5), 7-17.

Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: a feasibility study. Health & Social Care in the Community, 27(4), e417-e427.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing research-e-book: methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.