The clinical question of the proposed project is as follows: In patients that are identified as high risk for developing a pressure ulcer, does the implementation of a pressure ulcer protocol initiated in an emergency department, as compared to patients who receive usual care, reduce the incidence of hospital-acquired pressure ulcers on day three of hospitalization?
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Two protocols will be implemented within the framework of the proposed intervention. The first protocol is for patients in critical conditions and is focuses on preventive measures; e.g., triggering the treatment of pressure ulcers by patients and their families as well as nursing care providers. The second protocol will ensure that there is a sufficient number of nurses available (and their work is scheduled properly) to take care of bedridden patients by repositioning them every hour. This protocol also applies to patients who are not bedridden and suggests that nurses should encourage them and help them get up from their beds and move around in their chairs.
Analysis of Outcomes
The main outcome to be analyzed is the effect of the intervention on the occurrence of pressure ulcers. It will be analyzed by measuring the pressure ulcer incidence among the recipients of the intervention and comparing it to the incidence among patients who receive usual care and act as a control group. However, there is one more important outcome: the effect of patient education on patients and their families in the context of self-care and prevention of the addressed condition. To analyze the outcome, it is necessary to develop a system of evaluating patients’ and their family members’ understanding of the educational materials provided along with the interaction. According to White, Garbez, Carroll, Brinker, and Howie-Esquivel (2013), the teach-back approach (i.e., asking patients or their family members to repeat the materials back to the provider) can be an effective tool for further analyzing how well patient education was retained.
Statistical Analysis Description
The statistical analysis will be based on inputting pressure ulcer incidence data collected from the intervention group and the control group in software capable of statistical calculations, such as Microsoft Excel. As shown by Cameron et al. (2012), this software applies to calculate the effects of clinical interactions on inpatient scenarios, such as falls discussed by the authors or the emergence of pressure ulcers addressed in the proposed project. The software will help reveal statistically significant incidence differences between the two groups. Educational outcomes will be analyzed in the same software by revealing the dynamics of patient retention.
Types of Demographic Data
Demographic data that will be considered include patients’ gender, age, and race. It is not the specific purpose of the proposed project to reveal differences among different demographic groups in terms of the development of pressure ulcers or responsiveness to education and intervention. However, the inclusion of these considerations will help the researcher avoid overlooking possibly important statistical results and ensure that the findings are relevant and generalizable (as opposed to being applicable, for example, exclusively to older Black men).
The primary expected outcome is that the incidence of pressure ulcers among the recipients of the intervention will decrease. Further, it is expected that the retention of patient education will be sufficient for the successful prevention of the condition. Finally, it is expected that the statistical analysis will confirm that the proposed intervention ensures statistically significant improvements in the pressure ulcer incidence rates.
Cameron, I. D., Gillespie, L. D., Robertson, M. C., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2012). Interventions for preventing falls in older people in care facilities and hospitals. Web.
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White, M., Garbez, R., Carroll, M., Brinker, E., & Howie-Esquivel, J. (2013). Is “teach-back” associated with knowledge retention and hospital readmission in hospitalized heart failure patients? Journal of Cardiovascular Nursing, 28(2), 137-146.