Introduction
The problem of pressure ulcers among patients is a topical issue that has been addressed by many healthcare specialists using different methods. This condition is the result of physiological and external factors and usually occurs due to pressure on the tissue for a long period. Nurses, as the primary providers of care for patients with pressure ulcers, have to be skilled and possess enough knowledge to treat and potentially prevent this condition. Nevertheless, some studies show that there is a deficit in information about the treatment and prevention of pressure ulcers among nursing professionals (Galvão et al., 2017). Pressure ulcers are common among the elderly and people with limited mobility capacity, and with conditions such as cardiovascular disease, obesity, diabetes. Patients with the aforementioned conditions tend to stay at home rather than at hospitals and, therefore, require the help and assistance of home health nurses. Thus, it is interesting to research to determine whether implementing educational programs for home health nurses on pressure ulcers prevention can result in the reduction of the condition’s incidence.
Problem and Question Statement
As it was mentioned earlier, pressure ulcers affect many people who experience a lack of movement due to their health issues. According to one study, in acute care settings, the potential worldwide prevalence of pressure ulcers ranges between 6% and 18.5% (Tubaishat et al., 2017). There are several procedures aimed at the prevention of acquiring this condition in hospitals, including implementing special beds, which reduce pressure, dietary restrictions and guidelines, and change of posture (Lam et al., 2018). Moreover, it can be assumed that people who choose to receive treatment at home will be more likely to experience pressure ulcers since they will not be checked by trained wound nurses. Providing home health nurses with the necessary training to counter the development of pressure ulcers in their patients can potentially be an effective method of prevention. Thus, the question of the study is: does the implementation of educational programs on pressure ulcers prevention for home health nurses, comparing the rate of pressure ulcers before and after the program, reduce the pressure ulcers incidence in 16 weeks?
Population of Interest
The subjects of the study will be home health nurses and the patients they care for with risk factors associated with the higher incidence of pressure ulcers. The volunteering specialists will be divided into two groups to test and compare the results received after conducting the research. The first group will be provided a special educational program containing information on the means and methods of pressure ulcers prevention. The second group of nurses will proceed to adhere to their current practices and will serve as a control group. After completing the research, the health of the patients of the two groups of nurses will be assessed to determine whether the implementation of the educational program has had any effect on the prevention of pressure ulcers.
Intervention of Interest
The group of nurses selected to enroll in the educational program will be taught strategies on how to prevent the emergence of pressure ulcers in their patients. The specialists will receive information on how to detect areas on patients’ skin, which are prone to developing the condition in question, especially bony prominences and the sacral area (Mitchell, 2018). The nurses will be recommended to thoroughly study all the skin regions which show redness, induration, or heat and then act according to an established skin-care protocol that contains tested products (Swafford et al., 2016). Nurses will be advised to apply “Allevyn Life silicone adhesive dressings” to every pressure point on the patient’s body (Swafford et al., 2016, p. 153). The program will also include guidelines on the repositioning procedures to alleviate certain areas from constant pressure. The nurses will be taught to encourage their patients to change their posture and position every six hours as well as remove any excess moisture from their skin (Mitchell, 2018). After completing this educational program, the nurses will be asked to complete a questionnaire to assess their level of newly-acquired knowledge.
Comparison of Interest
The group which will participate in the educational program will be compared to the control one, based on the assessment of their patients’ health. The patients cared for by the two groups will be checked by researchers to determine whether the program is beneficial. The reduced number of instances of pressure ulcers among the patients of the nurses enrolled in the program, compared to the control group, will demonstrate the effectiveness of the education.
Outcome of Interest
During the research, studies concerning educational programs on pressure ulcers prevention for home health nurses have not been identified, yet some articles describe the effects of such programs for hospital-based nurses. Studies show that educational programs and training on pressure ulcer prevention using workshops significantly improve the performance of nurses (Sardari et al., 2019). In a study that used a comprehensive training program, the incidence of hospital-acquired pressure ulcers was reduced by more than two-thirds (Swafford et al., 2016). This evidence makes it possible to suggest that implementation of the same strategy, but in the context of the practice of home health nurses, can have similar results. Another study, conducted over three years, was based on adhering to a guideline of seven basic preventive measures. The result demonstrated that the hospital managed to decrease its incidence of hospital-acquired pressure ulcers from 1.36% to 0.39% (Lam et al., 2018). The evidence of the presented research displays the effectiveness and positive implications of educational programs on the reduction of the pressure ulcers incidence and provides the basis for their recommendation for home health nurses.
Timeframe
The study will take place over sixteen weeks, the first four of which will be dedicated to training and the rest to observing the effects of the educational program.
Conclusion
Pressure ulcers affect people with mobility problems, some of them choose not to receive treatment at hospitals, and the home health nurses’ role in such cases is to prevent their patients from developing this condition. This fact highlights the importance of studying the effects of educational programs on pressure ulcers for home health nurses. Conducting this research will require choosing a group of nursing specialists who will be enrolled in the training program and a control group. After a sixteen-week experiment, the health results of the patients of the two groups will be assessed to detect any impact of the program on the incidence of pressure ulcers. Previous studies demonstrate that there is a strong positive correlation between the implementation of educational programs on pressure ulcers prevention and the reduction of the incidence of this condition. Based on the analysis of the results and the methods of the prior research, it can be supposed that theoretically, the same correlation will be found in the case with home health nurses.
References
Galvão, N. S., Serique, M. A. B., Santos, V. L. C. de G., & Nogueira, P. C. (2017). Knowledge of the nursing team on pressure ulcer prevention. Revista Brasileira de Enfermagem, 70(2), 294–300. Web.
Lam, C., Elkbuli, A., Benson, B., Young, E., Morejon, O., Boneva, D., … McKenney, M. (2018). Implementing a novel guideline to prevent hospital-acquired pressure ulcers in a trauma population: A patient-safety approach. Journal of the American College of Surgeons, 226(6), 1122–1127. Web.
Mitchell, A. (2018). Adult pressure area care: preventing pressure ulcers. British Journal of Nursing, 27(18), 1050–1052. Web.
Sardari, M., Esmaeili, R., Ravesh, N. N., & Nasiri, M. (2019). The impact of pressure ulcer training program on nurses’ performance. Journal of Advanced Pharmacy Education & Research, 9(3), 145–149. Web.
Swafford, K., Culpepper, R., & Dunn, C. (2016). Use of a comprehensive program to reduce the incidence of hospital-acquired pressure ulcers in an intensive care unit. American Journal of Critical Care, 25(2), 152–155. Web.
Tubaishat, A., Papanikolaou, P., Anthony, D., & Habiballah, L. (2017). Pressure ulcers prevalence in the acute care setting: A systematic review, 2000-2015. Clinical Nursing Research, 27(6), 643–659. Web.