I have an 8 hour deadline to meet and an emergency popped up!I have a lot of the paper completed.Can anyone have this finished in 8 hours?I have attached my 1st week paper, the current assignment instructions, the work I have completed (along with a picture from my text or rapid appraisal questions referred to in the instructions) and the research article for the assignment. I just need it finished off!
I have an 8 hour deadline to meet and an emergency popped up! I have a lot of the paper completed. Can anyone have this finished in 8 hours? I have attached my 1st week paper, the current assignment i
Assignment 2: Quantitative Research Write a fully developed and detailed APA essay addressing each of the following points/questions. There is no required word count; be sure to completely answer all the questions for each question in detail. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least one (1) source using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page are required. Review the rubric criteria for this assignment. Conduct a literature search to select a quantitative research study related to the problem identified in Module 1 and conduct an initial critical appraisal. Respond to the overview questions for the critical appraisal of quantitative studies, including: Is this quantitative research report a case study, case control study, cohort study, randomized control trial or systematic review? Where does the study fall in the hierarchy of evidence in terms of reliability and risk of bias? Why was the study done? (Define the problem and purpose.) Were the steps of the study clearly identified? What was the sample size? Are the measurements of major variables reliable and valid? Explain. How were the data analyzed? Were there any untoward events during the conduct of the study? How do the results fit with previous research in the area? (This may be reflected in the literature review.) What does this research mean to clinical practice? Additionally, be sure to include the rapid appraisal questions for the specific research design of the quantitative study that you have chosen. These can be found in Chapter 5 of the textbook (Melnyk and Fineout-Overholt, 2015). This critical appraisal should be written in complete sentences (not just a numbered list) using APA format. Provide a reference for the article according to APA format and a copy of the article. Assignment Expectations: Length: Clearly and fully answer all questions; attach a copy of the articleStructure: Include a title page and reference page in APA format. Your essay must include an introduction and a conclusion.References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of one (1) scholarly source for the article is required for this assignment.
I have an 8 hour deadline to meet and an emergency popped up! I have a lot of the paper completed. Can anyone have this finished in 8 hours? I have attached my 1st week paper, the current assignment i
Running head: PRESSURE INJURY PREVENTION DRESSINGS 0 Preventing Pressure Injuries in Prolonged Surgical Cases Stacey L. Willis Aspen University Author Note N424 – Essentials of Nursing Research MSN, RN June 1, 2020 Abstract In surgical patients (P), does the use of prophylactic pressure injury dressings for prolonged cases (I) reduce the incidence of hospital acquired skin injuries/ulcers (O) when compared to surgical patients without a pressure injury prevention dressing in place (C)? The review and analysis of resources in this paper are to discern the efficacy of pressure protection dressings in prevention of pressure injuries/ulcers. Surgical patients who have long-lasting cases are at risk for the development of pressure injuries/ulcers. Patients in the operating room are not only immobile, but may be placed one position for several hours depending on the type of surgery they are receiving. Long-lasting surgeries, age of the patient and comorbidities make them more prone to developing pressure injuries/ulcers. Recovering from their surgery should be the only problem patients are faced with once they are out of the post-operative setting. The primary study cited compared incidences of pressure ulcers in post-operative patients who did not receive proper protective dressings in the operating room, to patients who were positioned on a low-profile overlay that provides alternating pressure (AP-overlay) in addition to current facility protocol. Findings indicate the reduction of pressure injuries/ulcers for surgical patients when pressure protective dressings and protective overlay are utilized. Key Words: Operating room, pressure injury prevention, risk of pressure ulcers for surgical patients, use of pressure preventing dressings Preventing Pressure Injuries in Prolonged Surgical Cases There are a number of contributing factors that not only increase the potential for pressure related wound development, but also slow or prevent the healing of them once they occur. Those with chronic health conditions or other contributing factors, typically have lengthier hospital stays and increased expenses for the patient and patient care facilities. For these patients, a long surgical case means that they are immobilized and solely dependent on healthcare workers to position and protect them appropriately. Yet, according to Black, Fawcett, and Scott (2014) up to 45 percent of hospital acquired pressure injuries (HAPI’s) could be attributed to the operating room. A search of evidence-based studies produced several informational documents on pressure injury development in the operative phase of care, as well as a study on what changes can be made in the operating room versus the areas that are invariable. Surgical patients, especially those who undergo procedures lasting greater than four hours, are especially at risk of developing a pressure related injury. Their body has no sensation, their core temperature is lowered; reducing circulation, and in most cases, the patient cannot be moved during the procedure (Gefen, 2020). Implementing a standard protocol for protection from sheering and pressure injuries in the operating room would significantly reduce the overall HAPI’s and lessen the burden of additional expenses. Focusing on More Than Surgery in Operating Room The very definition of a pressure ulcer describes the primary factors involved in its development. They develop when tissue damage occurs and may be caused by a multitude of factors such as; ischemia from occlusion, prolonged deformation of the tissues from shearing, or reperfusion injury (Cooper, Jones, & Currie, 2015). Additionally, surgical patients are at risk of developing decubitus ulcers as they undergo mechanical ventilation, immobility, use of vasopressors, and can have prolonged case times (Cooper, Jones, & Currie, 2015). Studies have also shown pressure injuries/ulcers that were caused in the operating room could take as long as 72 hours to appear, which in all likelihood means that pressure injuries acquired in the operating room are being under-reported (Goudas & Bruni, 2019). Not only do these preventable injuries lead to poor patient outcomes, they give rise to increased hospital cost as well; when a surgical patient acquires a pressure ulcer in can add approximately 44 percent to the cost of their surgical stay (Al-Majid, Vuncanon, Carlson, & Rakovski, 2017). The largest physical hardship from the acquisition of a pressure ulcer is obviously carried by the patient. The largest financial burden from a HAPI, is shouldered by the hospital. The Virginia Commonwealth University Medical Center (VCUMC) is one group who has become focused on the solution and prevention of HAPI’s, rather than just the treatment. This approach has literally paid off; VCUMC increased their quarterly pressure ulcer surveys to monthly rounds, they have a Champions of Skin Integrity (CSI) team who work collaboratively with the hospital’s wound team, and after a year of implementing best practice in ulcer prevention, they have a cost savings of $84,000 (Cooper, Jones, & Currie, 2015). Additional risk factors of pressure ulcers are numerous and wide-ranging. The general health status of a patient must be considered in seeking prevention of pressure ulcers. The patient may present with systemic diseases or be immune compromised. Nutritional status and body mass are also important factors. However; according to Gefen (2020), the utmost risk factors to consider are the things that cannot be changed during the operative phase of care. There are many distinct limitations that apply in the operating room which are not a concern elsewhere in the hospital. The operating table has to be stable, offers little padding for the patient, and has seen scarce change in design over the last century (Gefen, 2020). As if the challenges of the operating room table were not enough, there is the inability to change the position of the patient during surgery. Gefen (2020) writes from the perspective of a bioengineer and highlights a new overlay system that is designed for use in the operating room. Keep in mind that patients in the operating room are exposed to unique group of risk factors such as positioning aides, slowed perfusion, blood loss, and a drop in core temperature (Gefen, 2020). These are all factors contributing to pressure injury/ulcer development and they must be assessed and recognized promptly to adequately decrease the likelihood of pressure wound occurrence. Summary of Article A peer-reviewed supporting article is printed in, Wounds International Journal on the website CINAHL. According to the published retrospective study, Gefen (2020) researched the study and found that the “work demonstrated that none of the patients who received the AP-overlay developed perioperative PUs, as opposed to an incidence rate of 6% in the historical controls (i.e. 18 PUs for the 292 patients).” There was a cohort of 100 patients in the study that were compared to with historical control group of 292 patients. The study monitored the blood flow of the sacral skin using a 2-mm, low-profile laser to compare a standard operating room table pad with the AP-overlay. The findings were significant in that there was 40 percent greater overall blood flow to the patient when using the overlay in addition to the typical padding and a staggering 76 percent greater blood flow to the sacral skin when using the AP-overlay with the standard padding (Gefen, 2020). Conclusion HAPI’s are devastating to patients and costly as well. Acquiring a pressure injury in the operating room is more common than most realize, it affects one out of every ten patients (Gefen, 2020). The debilitating effects of pressure ulcers demand the implementation of stronger and consistent preventative measures for surgical patients. Many steps are being taken to improve outcomes and reduce pressure injuries for surgical patients and lacing protective dressings over at risk areas is a great start. However; our surgeons and hospital staff must collaboratively work to seek the most up to date research and implement best practice. Surgical patients do not deserve to wake up with increased challenges to heal from, pressure injuries are preventable. References Al-Majid, S., Vuncanon, B., Carlson, N., & Rakovski, C. (2017). The Effect of Offloading Heels on Sacral Pressure. AORN journal, 106(3), 194–200. https://doi.org/10.1016/j.aorn.2017.07.002 Black, J., Fawcett, D., & Scott, S. (2014). Ten top tips: preventing pressure ulcers in the surgical patient. Wounds International, 5(4), 14–18. Cooper, D., Jones, S., & Currie, L. (2015). In Our Unit. Against All Odds: Preventing Pressure Ulcers in High-Risk Cardiac Surgery Patients. Critical Care Nurse, 35(5), 76–82. https://doi.org/10.4037/ccn2015434 Gefen, A. (2020). Minimising the risk for pressure ulcers in the operating room using a specialised low-profile alternating pressure overlay. Wounds International, 11(2), 10–16. Goudas, L., & Bruni, S. (2019). Pressure injury risk assessment and prevention strategies in operating room patients — findings from a study tour of novel practices in American hospitals. Journal of Perioperative Nursing, 1(32), 33–38.
I have an 8 hour deadline to meet and an emergency popped up! I have a lot of the paper completed. Can anyone have this finished in 8 hours? I have attached my 1st week paper, the current assignment i
The article used in responding to the PICOT question “Will the use of prophylactic pressure injury dressings decrease the incidence of decubitus ulcers in surgical patients?” is a cross-sectional, or prevalence study. Observational data was collected and reviewed within a specific time frame. The study falls in the lowest level in the hierarchy of evidence due to its cross-sectional study status. In the article, the authors acknowledge that the research collected has inconsistencies with prior studies with larger sample sizes. The authors utilized descriptive statistics, univariate and multivariate logistic regression to minimize risk of bias. Pressure injuries are a common complication affecting surgical patients. It increases length of convalescence and decreases hospital reimbursement from Centers of Medicare and Medicaid making it a costly, albeit preventable obstacle. The study was conducted to identify risk factors that increase the risk of decubitus ulcerations from forming within 72 hours post-operatively. The steps of the study were clearly identified from sample subject selection, data collection, and data interpretation. The sample size in the article reviewed was 191 patients across three teaching hospitals in Mazandaran Province, Iraq. The patients were general surgical patients greater than eighteen years of age with a procedural duration of greater than two hours and a post-operative length of admission of greater than 48 hours. The major variables included in the study such as emergent surgeries versus planned or elective surgeries are valid in the sense that such events come with their own complications unrelated to the PICO question. The data was analyzed using t-test, Chi-square, descriptive statistics, and univariate and multivariate logistic regression. There are no untoward events during the conduct of the study described in the article. There are some inconsistencies with the research reflected in the article and prior studies conducted in the same areas. Medical history proved to be a primary inconsistency which was attributed to the small sample size of the study outlined in the article when compared to larger, older studies. The research provided in the article examined will serve to direct prophylactic measures in populations that are noted to be of higher risk at developing perioperative pressure injuries.




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