The National Cost Of Hospital‐Acquired Pressure Injuries Discussion Response

The National Cost Of Hospital‐Acquired Pressure Injuries Discussion Response

Discussion Response

It is true that in addition to increased hospital length of stay, hospital-acquired pressure injuries (HAPI) constitute a major source of economic burden on the US health care system. According to financial reports, about $26.8 billion is spent on hospital-acquired pressure injuries both at the patient level and in the US healthcare system (Padula & Delarmente, 2019). This, therefore, calls for a search for an effective intervention that will decrease the prevalence of the condition. According to a systematic review and meta-analysis research by Avsar et al. (2020), repositioning patients off bony prominences is an effective evidence-based intervention that significantly reduced incidences of hospital-acquired pressure injuries. To be more specific, the frequency of patient repositioning is directly proportional to the effectiveness of the intervention. Findings of the review indicate that more frequent repositioning i.e. every two-hour repositioning significantly reduced HAPI incidences than every four-hour repositioning (Avsar et al., 2020) The National Cost Of Hospital‐Acquired Pressure Injuries Discussion Response.

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The PICOT question you developed was relevant and precise. However, you can adjust it to: In hospitalized adults with decreased mobility, does every two-hour repositioning of the patients (I) compared to every four-hour repositioning of the patients (C) reduce the prevalence of hospital-acquired pressure injuries (O) during a four-week hospital stay (T)? To obtain relevant and up-to-date evidence-based studies that support the intervention, you need to conduct an extensive search in various electronic databases relevant to nursing. In addition to Cochrane and CINAHL databases, you can also conduct your search on electronic databases such as EMBASE, SCOPUS, PubMed, and MEDLINE databases. Use of the Boolean Operators with keywords and phrases during the electronic search can help obtain sufficient articles that extensively address the intervention (Khurshid et al., 2021). Also, employing the inclusion and exclusion criteria can help filter the articles obtained from the search so that only relevant and up-to-date articles are selected for review. For instance, articles published in English, within five years, and have full text will be included for review while articles published in other languages other than English, more than five years ago, and containing abstracts only will be excluded.

In replies offer suggestions to help the person who posted with their search. Also kindly make suggestions on the PICOT questions of classmates to help each other out!
This is the discussion post that has been chosen for response:
The clinical issue I have decided to research is hospital-acquired pressure injuries. Hospital-acquired injuries affect both patients and hospitals. Any hospital-acquired pressure injury treatment is paid by the hospital, and patients are having to stay longer in hospitals to wait for their pressure injury to heal (Kim, et al., 2022). Studies have shown that repositioning patients off bony provinces, among other prevention practices, can help prevent pressure injuries in these areas. My hospital organization requires us to reposition patients with a Braden scale of less than 18 every two hours. I began to wonder why it is that we reposition every two hours and if this too frequent or not frequent enough?

Having this question made me want to dig further into the evidence on pressure injury prevention. It is important that nurses want to understand why we do the things that we do. Asking questions and creating an environment to expand and learn helps provide a higher quality of patient care (Melnyk, et al., 2009). This lead me to develop my PICOT question: In hospitalized adults with decreased mobility how does every two-hour turns compared to every four-hour turn affect the number of hospital-acquired pressure injuries during a four-week hospital stay The National Cost Of Hospital‐Acquired Pressure Injuries Discussion Response?

The two databases I used to search for articles related to my PICOT question were Cochran and CINAHL. In the Cochran database, I first searched for hospital-acquired pressure injuries. 53 articles populated. Most of these were related to pressure injuries, but other topics with the words pressure and injury came up. Of the applicable articles found none of them were related to repositioning patients. By completing an advance search using Boolean I searched “hospital-acquired pressure injuries” and “position.” This search populated one article related to repositioning patients published within the last five years.

While using the CINAHL database I started my search the same as Cochran. I initially searched for “hospital-acquired pressure injuries.” This search populated 233 articles. I narrowed down my search by including “position or turning or reposition.” This search populated 34 articles. I tried to narrow down my search further by adding the word “hourly” and this resulted in no articles. I changed the word “hourly” to frequency and two articles resulted that were appropriate for my topic.

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I think a way that I could improve my research is by familiarizing myself with the different databases in order to select a database with the appropriate material. Having the right database can help narrow down the search and select articles that are relevant to my topic and intervention. Another way that can help with my research is to determine the right words to utilize when searching. Sometimes I am too vague and too many articles results and other times I am too specific and nothing populates. Using Boolean terms can help me do this by directing the database on what to include and what to avoid when searching for articles (Walden, n.d.).

References

Avsar, P., Moore, Z., Patton, D., O’Connor, T., Budri, A. M., & Nugent, L. (2020). Repositioning for preventing pressure ulcers: A systematic review and meta-analysis. Journal of Wound Care, 29(9), 496-508. https://doi.org/10.12968/jowc.2020.29.9.496

Khurshid, Z., Tariq, R., Asiri, F. Y., Abid, K., & Zafar, M. S. (2021). Literature search strategies in dental education and research. Journal of Taibah University Medical Sciences, 16(6), 799-806. https://doi.org/10.1016/j.jtumed.2021.05.012

Padula, W. V., & Delarmente, B. A. (2019). The national cost of hospital‐acquired pressure injuries in the United States. International Wound Journal, 16(3), 634-640. https://doi.org/10.1111/iwj.13071 The National Cost Of Hospital‐Acquired Pressure Injuries Discussion Response