Pressure Ulcer Prevention – Dermatology Example

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"Pressure Ulcer Prevention" is a wonderful example of a paper on dermatology. Pressure ulcers are localized areas of tissue damage that result from direct pressure or shearing forces on the skin that causes pressure ischemia or mechanical stress to tissues. Since it is a painful experience and costly to treat, both commissioners and regulators of nursing care use the prevention of pressure ulcers as an indicator of quality (DH, 2008). This has necessitated studies to establish the best way to prevent pressure ulcers in nursing, from which several questions arise. From a qualitative perspective, this paper aims to answer the question “ should nurses advocate for the inclusion of patients in the implementation of pressure ulcer prevention (PUP) strategies to help reduce cases of pressure ulcers in hospitals and nursing homes? ” Although the two articles are both designed to address the prevention of pressure ulcers in nursing, one is designed to take on a quantifying approach while the other approaches the topic with an aim of understanding the concepts underlying it.

From this understanding, Mertens et al (2008) take a quantitative approach while Chaboyer and Gillespie (2014) adopt a qualitative approach.

Unlike a quantitative approach that seeks to measure incidences of various opinions and views of a particular sample, a qualitative approach avails insight into the setting of an issue and reveals prevalent trends in opinion and thought (Johnson & Christensen, 2008). Hence, Chaboyer and Gillespie (2014) will appropriately answer the question as to whether nurses should advocate for the inclusion of patients in the implementation of PUP strategies to help reduce cases of pressure ulcers in hospitals and nursing homes.

Essentially, this is because the question is about understanding and interpreting social interactions and applying them to a nursing scenario. From that perspective, Chaboyer and Gillespie (2014) seek to investigate how nurses view the implementation of a patient-focused care bundle in PUP. This is a significant approach towards answering the research question because once it is understood what nurses consider as barriers or facilitators to patient-oriented PUP, it can be used to supplement patients’ opinions. Qualitative research recruits a fairly small but highly specific sample population that is representative of a wide range of target population conditions (Fineout-Overholt, Melnyk & Schultz, 2005).

Similarly, the qualitative research chosen used only 20 participants but represented a wide scope of patients. Since the nurses understand their patients better than other professionals in the healthcare fraternity, they are better placed to raise awareness among them on the significance of their role in PUP (Marchionni & Ritchie, 2008). Data were collected through open-ended interviews that directly reflected the opinions of the patients, which means their input could be factored into the strategies (Melnyk & Fineout-Overholt, 2011).

This is from the understanding that if patients accepted and facilitated the implementation of strategies that were focused on their needs, the interventions could be more effective. Chaboyer and Gillespie (2014) were creating awareness and seeking patients’ views. According to Polit and Beck (2003), qualitative researches are smaller and the samples not selected randomly, which means subjectivity is not minimized. However, Elo and Kyngas (2008) point out that qualitative research not only identifies patterns, themes, and features but their scientific methods are also exploratory and study the whole rather than simply variables.

Therefore, Chaboyer and Gillespie (2014) appropriately recruited a small sample but covered a wide scope of patients from which opinions could be gathered. Since the opinion of patients will potentially advise nurses whether to push for their inclusion in PUP strategies, qualitative analysis is better placed to answer the question because it approaches it from a personal, social, situational, and dynamic angle (Arora et al, 2005). This ensures that in such research, the selected respondents will fulfill the intended quota. Conclusion The qualitative piece was chosen because it aimed at establishing the dominant patient behavior towards PUP rather than simply examine the prevalence of the pressure ulcers.

It is has been shown that a quantitative data analysis aims to count and classify features then construct statistical figures and models to explain the observations (Hutchinson & Johnson, 2006). Therefore, it could not answer the question appropriately. As Polit and Beck (2010) explain, quantitative research is separated objectively from the subject matter because the approach mainly seeks precise measurements. However, the qualitative research used in this case adequately involved the patients and gathered information that can be used to determine whether nurses should advocate for their inclusion in PUP strategies.

Hence, the qualitative research was able to gather information from patients and establish that their inclusion would improve PUP.                              

References

Arora, NK, Avanian, JZ & Guadagnoli, E 2005, ‘Examining the relationship of patients’ attitudes and beliefs with their self-reported level of participation in medical decision-making’, Medical Care, vol. 43, no. 9, pp. 865-872.

Chaboyer, W & Gillespie, BM 2014, ‘Understanding nurses’ views on a pressure ulcer prevention care bundle: the first step towards successful implementation’, Journal of Clinical Nursing, vol. 23, pp. 3415-3423.

Department of Health (DH) 2008, Using the Commissioning for Quality and Innovation (CQUIN) Payment Framework, viewed 7 June 2015, http://tiny.cc/ngcbo

Elo, S & Kyngas, H 2008, ‘The qualitative content analysis process’, Journal of Advanced Nursing, vol. 62, no. 3, pp. 107-115.

Fineout-Overholt, E, Melnyk, BM & Schultz, 2005, ‘Transforming healthcare from inside out: advancing evidence-based practice in the 21st century’, Journal of Professional Nursing, vol. 21, no. 6, pp. 335-344.

Greiner, A & Knebel, E 2008, Health professional education: a bridge to quality, National Academic Press, Washington, DC.

Hutchinson, A & Johnson, L 2006, ‘Beyond the barriers scale: commonly reported barriers to research use’, Journal of Nursing Administration, vol. 36, no. 4, pp. 189-199.

Johnson, B & Christensen, L 2008, Educational research: quantitative, qualitative, and mixed approaches, Sage, California.

Levin, R 2007, Advancing research and clinical practice through close collaboration, International Evidence-Based Practice Conference, Arizona

Lichtman, M 2006, Qualitative research in education: a user’s guide, Sage, California.

Marchionni, C & Ritchie, J 2008, ‘Organizational factors that support the implementation of a nursing best practice guideline’, Journal of Nursing Management, vol. 16, no.2, pp. 266-274.

Melnyk, BM & Fineout-Overholt, E 2011, Evidence-based practice in nursing &healthcare Lippincott, Philadelphia.

Mertens, EI, Halfens, RJ, Dietz, E, Scheufele, R & Dassen, T 2008, ‘Pressure ulcer risk screening in hospitals and nursing homes with a general nursing assessment tool: evaluation of the care dependency scale’, Journal of Evaluation in Clinical Practice, vol. 14, pp. 1018-1025.

Polit, DF & Beck, CT 2003, Nursing research: principles and methods, Lippincott, Philadelphia.

Polit, DF & Beck, CT 2010, Appraising evidence for nursing practice, Lippincott, Philadelphia.

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