Introduction
The selected article describes the major challenges and issues encountered by nurses while providing adequate care to patients with severe Acute Respiratory Distress Syndrome (ARDS). The authors of the article identified that “earlier trials to provide proper support to patients with ARDS did not show the targeted benefits and outcomes of prone positioning (Guerin et al., 2013)”. That being the case, the authors wanted to evaluate the effect of early use of “prone positioning” on results in individuals with severe acute respiratory distress. The main research problem for the study was to evaluate the implications of prone positions on results in individuals with the condition. Although the authors did not provide a specific research question, it would be notable to examine the implications of prone positioning, especially during what is known as the mechanical ventilator process on patients’ outcomes. The authors support their points using various studies and analyses. By so doing, they explain how the current knowledge is inadequate. With suggestions and ideas, the authors were able to conduct the study and come up with new findings that can provide adequate support to patients with the condition.
Authors’ Initial Objectives
During the study, the authors wanted to examine the best ways to improve patients’ outcomes using “prone positioning” and “supine positioning”. According to the researchers, most of the studies did not explain the benefits of such methods. As well, the authors observed that prone positioning was incapable of preventing ventilator-induced injuries of the lungs (Guerin et al., 2013). That being the case, the practices did not result in the best outcomes. However, the use of prone positioning for patients with ARDS improves the rate of survival. The study sought to establish whether early use of prone positioning would significantly improve the rate of survival among patients suffering from the condition (Guerin et al., 2013). That being the case, the hypothesis was that “early application use and application of prone positioning would significantly improve the survival rates of ARDS patients had already received mechanical ventilation with the needed Positive End-Expiratory Pressure (PEEP)” (Guerin et al., 2013).
To arrive at the hypothesis, the researchers examined the findings from recent studies and research. They observed that most of the ideas of prone positioning helped improve the rate of oxygenation in individuals who are in need of mechanical support. As well, the researchers observed that prone positioning was much better and more effective than supine positioning (Guerin et al., 2013). However, the researchers did not understand whether early introduction of prone positioning would improve the chances of survival in patients with ARDS. This formed the basis for their study.
Evaluation of the Research Methods and Approach
It is agreeable that the research methods used by the authors are effective and applicable for the study. To begin with, the authors have presented a short literature review to examine the recent developments in the treatment of severe acute respiratory distress using both prone and supine positioning. The literature review identifies the existing gaps thus making it easier to establish and define the best research question (Guerin et al., 2013). However, it is notable that the authors do not indicate the literature review in the article.
The other important thing to observe from the article is that it presents a current and relevant issue to today’s healthcare practice. Nurses and doctors continue to look for new ways to save lives (Matthay, 2009). In this article, the authors have presented new ideas by explaining the benefits of early introduction to prone positioning for patients with severe acute respiratory distress (Guerin et al., 2013). The research is recent thus making it easier for the reader to gain new insights about prone positioning in dealing with ARDS. This continues to be a major health concern today.
Type of Research Used
From the article, it is notable that the authors used experimental research for their study. They used patients from Spain and France for the study. The researchers conducted the procedure effectively to verify or establish the accuracy of the stated study hypothesis. The experimental study included adults who met the targeted criteria. The patients were “examined” in order to ensure they were eligible for the study. With the use of this research type, it was possible to get the targeted information and findings thus making the study successful (Guerin et al., 2013).
The other important thing is the nature of the sample. The authors conducted the study in 27 intensive care units (ICUs), one in Spain and 26 in France. The study was conducted between January 2008 and July 2011. During this period, 474 patients were included in the study. Around 3449 patients were admitted to the selected ICUs. However, only 466 individuals participated in the experiment. There were 229 patients included for the supine positioning and 237 for the prone positioning. The authors selected the sample in a proper manner whereby the patients were supposed to meet certain conditions. For example, the participants were adults with ARDs. These individuals were in ICUs.
The researchers ensured all ventilator systems and blood-gas analyses were similar in the two groups. That being the case, it would be agreeable that the sample size for the study was appropriate. This made it easier to come up with the targeted results. The sample was effective because it helped the researchers get the targeted goals. As well, it was notable that the Safety and Data Monitoring Board (SDMB) recommended the need to continue undertaking the tests in the coming years (Guerin et al., 2013). This explains why the researchers managed to present the best findings and conclusions for future medical practice.
The practicability of the Work
After conducting the research, the authors presented new ideas and strategies to provide the best care to patients with ARDS. For instance, the meta-analyses suggested that the use of prone positioning presents better results in patients with hypoxemia. The authors also explained the importance of introducing patients with severe hypoxemia and ARDS to prone positioning. This kind of treatment can be beneficial to the patients especially when used for longer sessions and early enough (Guerin et al., 2013). The results also explain how doctors and patients can use the ideas to promote service delivery and prevent injury of lungs in patients (Duetschman, 2010). As well, researchers and analysts should embrace these findings and come up with new studies to ensure there are better and more effective measures to help individuals with ARDS.
The authors have suggested ways of applying the results adequately to patients with severe acute respiratory distress. It is also notable from the analyses, discussions, and recommendations that the results can be widely used to deal with the disadvantages of prone positioning. As well, the authors present some benefits of prone positioning. This makes it the best approach to help patients with severe Acute Respiratory Distress Syndrome (ARDS). The arguments and suggestions presented by the authors are therefore true.
Improving the Study
The study was successful as observed from the findings. However, it is agreeable that the authors could have improved their study by including more patients in the study. By so doing, it would be easier to appreciate the physical and psychological aspects of more patients and eventually record the best goals (Abroug et al., 2008). As well, the authors could have improved their study by considering other ICU units and patients from different age groups. This explains why further research is possible using such issues. The new findings would be useful for future medical practices.
Conclusion
The authors properly conducted the study thus making it possible to present the best findings to the reader. The authors have also used a “straightforward approach” to present their ideas while at the same time ensuring the work is clear. This explains why the findings and discussions offer ideas for supporting patients with severe Acute Respiratory Distress Syndrome. Caregivers and nurses should introduce their patients to prone positioning promptly and for longer periods to make the process effective. From my knowledge, I strongly believe that the authors have presented the best findings and discussions that can improve the quality of knowledge on the subject. Although some weaknesses make the study less effective, it is agreeable that the authors could have improved the study using the suggestions provided above. This can make it easier to have the best practices and support for patients with severe acute respiratory distress.
Reference List
Abroug, F., Ouanes-Besbes, L., Elatrous, S. & Brochard, L. (2008). The effect of prone positioning in acute respiratory distress syndrome or acute lung injury: a meta-analysis. Areas of uncertainty and recommendations for research. Intensive Care Medicine, 34(1), 1002-1011.
Duetschman, C. (2010). Evidence-based Practice of Critical Care. New York: John Wiley and Sons.
Guerin, C., Reignier, M., Richard, J., Beuret, P., Gacouin, A., Boulain, T,… Ayzac, L. (2013). Prone Positioning in Severe Acute Respiratory Distress Syndrome. The New England Journal of Medicine, 368(23), 2159-2168.
Matthay, M. (2009). Acute Respiratory Distress Syndrome. New Jersey: Prentice Hall.