Research Question and Nursing Article Review

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Preventing Pressure Ulcers in Nursing Home Patients

With growing numbers of the American population joining the elderly ranks, there has been a corresponding increase in the number of residents of long-term care facilities including approximately 16,100 nursing homes in recent years (Palumbo & Mclaughlin, 2011). As a result, there has also been increased interest among clinicians concerning optimal turning and repositioning rates for immobile nursing home patients to reduce pressure ulcers (Miller & Ward, 2010). The need for improved care of pressure ulcers is great, and it has been estimated that the cost of each pressure ulcer incident ranges between $500 and $70,000 for a staggering total of $11 billion annually (Lilly & Estocada, 2014). Therefore, the question of interest for this study is whether turning and repositioning a patient more frequently (i.e., every 2 hours) reduces the risk of patients developing pressure ulcers compared with patient turned and repositioned less frequently (i.e., every 4 hours). To develop an informed and timely answer to this question, this paper reviews a study by Rich, Margolis, Shardell et al. (2011) concerning optimal manual repositioning pressure ulcer prevention protocols for a population of immobilized hip fracture patients treated in tertiary health care facilities, followed by a summary of the research and important findings concerning these issues.

Research question for the Rich et al. (2011) study

Citing the conventional intervention for the prevention of pressure ulcers in bed-bound patients and current clinical guidelines for the prevention of pressure ulcers which prescribe manual repositioning at least every 2 hours, the research question of interest in the Rich et al. study was based on the dearth of timely and relevant research concerning optimal frequency of manual repositioning as part of a pressure ulcer prevention program.

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In order to develop new data collected by nursing staff from patient charts that can be used to identify optimal manual repositioning rates among a group of elderly (i.e., 65 years and older) hip fracture patients who were confined to bed based on a cohort study from nine Pennsylvania and Maryland hospitals for the period between 2004 and 2007.

Description of the research design of this study

This was a retrospective, observational study that relied on data from patient chart reviews and follow-up assessments of the incidence of pressure ulcers among the study participants.

How the sample was selected and number of participants

Out of 1,055 potentially eligible participants, a total of 269 participants were ultimately determined to be eligible for inclusion in the retrospective Rich et al. study. Approximately 2.5 million patients develop pressure ulcers in the United States each year (Preventing pressure ulcers in hospitals, 2016). Given the difficulties in studying human beings and the specificity of the guiding research question, the sample size used in the Rich et al. study was deemed adequate for the purposes of developing an informed and timely answer to its guiding research question concerning optimal manual repositioning rates for bedridden elderly patients notwithstanding its limitations (which are discussed below).

Data collection method(s) including who collected data, what tools were used, and other pertinent information

The manual repositioning data and follow-up assessments for stage 2+….....

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