The Impact of Repositioning Strategies on Preventing Pressure Ulcers in Hospitalized Patients (Research Paper Sample)

The Impact of Repositioning Strategies on Preventing Pressure Ulcers in Hospitalized Patients Student Name Institution Course Professor Date Introduction Background Information Pressure ulcers, also known as bed sores, are one of the most prevalent complications in patients admitted to hospitals, especially those who cannot move around much. These ulcers are due to prolonged time pressure on the skin, which deprives the area of blood supply and thus causes tissue damage. In the United States, approximately 2.5 million people get pressure ulcers every year, which leads to severe complications and about 60 thousand deaths per year (Angelico, 2024). It is essential to prevent these outcomes, and implementing effective prevention measures is significant. An efficient measure that can be used to prevent pressure ulcers is to turn the patient periodically to avoid pressure on the heels, hips, and sacrum. Research shows a high potential to minimize pressure ulcers by changing the patients' positions more often (Manzano et al., 2014). However, there are questions regarding the frequency and proper repositioning techniques. Statement of the Problem Pressure ulcers cause severe pain and infections. They also lead to more extended hospital stays and increased healthcare costs. Therefore, it is vital to find effective prevention methods. Significance of the Study Understanding the best repositioning strategies can improve patient care and lessen the occurrence of pressure ulcers. This will enhance patients' quality of life and decrease healthcare expenses. Focus/Aim of the Review This review focuses on evaluating the effectiveness of regular repositioning in averting pressure ulcers in hospitalized patients. It aims to analyze current research and provide evidence-based recommendations. Main Statement The purpose of this review is to answer the clinical question: In hospitalized patients (P), how effective is regular repositioning (I) compared to standard care (C) in preventing pressure ulcers (O)? Overview of the Review Structure This review will include a methods section detailing the search strategy and criteria. The results section will summarize findings from relevant studies. The discussion will explore the implications of these findings. Finally, the conclusion will offer practice recommendations. Methods Sources and Databases The sources for this literature review include peer-reviewed journal articles. The databases searched were PubMed, CINAHL, Cochrane Library, and Google Scholar. The keywords used in the search were: "pressure ulcers," "pressure injury," "bedsore prevention," "repositioning," "hospitalized patients," "nursing care," and "pressure ulcer prevention." Inclusion and Exclusion Criteria The inclusion criteria for this review comprised studies published in the last ten years, peer-reviewed journal articles, and research focused on hospitalized patients. Additionally, only studies involving repositioning as a method to prevent pressure ulcers and articles available in English were considered. Conversely, articles that were not peer-reviewed, studies that were not focused on hospitalized patients, research that did not involve repositioning techniques, and articles that were not available in full text were excluded from the review. Levels of Evidence The review encompassed systematic review, meta-analysis, Randomized controlled trial, and Pre-test and post-test study. These levels of evidence contribute to the credibility of the findings based on the reviewed literature. For this reason, only articles that met the standard of high-quality peer-reviewed articles were used in the study. All articles were critically reviewed based on the clinical question's methodological quality. Thus, the review presents credible findings and sound and supports the notion of the usefulness of repositioning in preventing pressure ulcers. Results The Literature Review Summary Table: Synthesizing Information Sources Cortés et al. (2021) Gillespie et al. (2020) Angelico, (2024) Woodhouse et al. (2019) Avsar et al. (2020) Similarities or differences Problem or purpose Evaluate the effectiveness of different repositioning frequencies on pressure ulcer prevention. Assess clinical and cost-effectiveness of repositioning schedules Impact of frequent repositioning on pressure ulcer prevention in immobile patients Examine the consistency and effectiveness of current repositioning strategies Evaluate the effectiveness of repositioning in preventing pressure ulcers All studies aim to evaluate the effectiveness of repositioning strategies to prevent pressure ulcers. Design Randomized controlled trial Systematic review Review of two critical articles Pre-test and post-test study Systematic review and meta-analysis All studies employ a robust methodology to evaluate repositioning strategies. Sample 500 patients 3941 participants Two key articles 12 nurses 629 participants Sample sizes vary significantly, from as small as 12 participants to as large as 3941 participants. Methods Patients are repositioned every two, three, or four hours Review of eight randomized controlled trials Review using data from ScienceDirect and the Mark Allen Group Observation before and after reviewing written guidelines Review of 16 studies Methods vary from direct patient repositioning and observation to reviewing existing literature and synthesizing data. Instruments Patient health records, observation Data extraction forms, the GRADE approach Database search, article review Inclinometer device, observation Data extraction forms, meta-analysis tools The use of data extraction forms and observational tools is common across the studies Findings Repositioning every two hours reduced pressure ulcer incidence by 30% Frequent repositioning reduces the risk of pressure ulcers; optimal frequency is unclear 25% reduction in pressure ulcer development with frequent repositioning Significant variability in techniques, minimal improvement post-guidance 8% incidence with repositioning every 2-3 hours vs. 13% with repositioning every 4-6 hours The exact reduction rates and effectiveness vary, with some studies finding significant improvements and others noting minimal improvements post-guidance Implications Support for frequent repositioning to prevent pressure ulcers Need for standardized repositioning protocols Importance of frequent repositioning in immobile patients Need for practical demonstrations in training Support for more frequent repositioning schedules All studies suggest the need for frequent repositioning and highlight its importance in clinical practice. Limitations Variability in repositioning techniques among staff Moderate quality of evidence due to variability Reliance on a small number of sources Small sample size, limited generalizability Heterogeneity of included studies Common limitations include variability in techniques and study heterogeneity. (Author, 2024) Synthesis of findings Themes Cortés et al. (2021) Gillespie et al. (2020) Angelico, (2024) Woodhouse et al. (2019) Avsar et al. (2020) Effectiveness of Frequent Repositioning Repositioning every two hours reduces pressure ulcer incidence by 30% Frequent repositioning reduces the risk of pressure ulcers 25% reduction in pressure ulcer development with frequent repositioning Minimal improvement post-guidance despite frequent repositioning 8% incidence with repositioning every 2-3 hours vs. 13% with repositioning every 4-6 hours Optimal Repositioning Frequency Two-hour intervals were the most effective Optimal frequency unclear Frequent repositioning is effective Not explicitly addressed Frequent repositioning every 2-3 hours is effective Implementation Challenges Variability in techniques among staff Differences in study designs and protocols A limited number of studies reviewed Significant variability in techniques Heterogeneity of studies Impact on Healthcare Costs Supports investment in frequent repositioning to lower costs related to ulcer treatment The analysis includes a cost-effectiveness discussion Highlight on reducing complications and related costs Emphasis on the need for proper training to avoid costs Support for frequent repositioning to reduce ulcer treatment costs (Author, 2024) Discussion The findings from the literature indicated that patient rotation is effective in the prevention of pressure ulcers particularly among the hospitalized patients. Most of the reviewed studies support the notion that the patient should be turned or shifted every two to three hours to prevent pressure sore development. For example, Cortes et al. (2021) stated that pressure ulcers were decreased by 30% with the use of turning the patients every two hours. Likewise, Avsar et al. (2020) also mentioned that there is a reduced pressure ulcer incidence amongst the patients who are turned more often. However, it is still a matter of how often it is more effective to do so, and opinions on this matter can also diverge. In their recent study, Gillespie et al. (2020) stressed on the positive aspects of repositioning, though the authors admitted that the literature review showed that the repositioning rate was not well defined. Thus, this indicates that there is a need for the development of standard repositioning protocols. Another author, Angel...