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6 pages/≈1650 words
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APA
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Health, Medicine, Nursing
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Research Paper
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English (U.S.)
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Topic:
The Impact of Repositioning Strategies on Preventing Pressure Ulcers in Hospitalized Patients (Research Paper Sample)
Instructions:
This task involved evaluating the effectiveness of repositioning strategies to prevent pressure ulcers in hospitalized patients. The review examined current research, identified optimal repositioning frequencies, and discussed implementation challenges and impacts on healthcare costs. It aimed to provide evidence-based recommendations for improving patient care and reducing pressure ulcer incidence. source..
Content:
The Impact of Repositioning Strategies on Preventing Pressure Ulcers in Hospitalized Patients
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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...
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