Analysis of Effectiveness of Two Cushions in the Prevention of Heel Pressure Ulcers Study - Essay Example

?Introduction The study "Effectiveness of Two Cushions in the Prevention of Heel Pressure Ulcers" intends to determine if the rate of effectiveness in utilizing two cushions for the geriatric population as a means to prevent heal pressure ulcers. The introduction of the study delved on the key problem prevalent in the nursing practice, which are heel pressure ulcers. Although the researchers of the study were able to provide preventive measures in acquiring heel pressure ulcers among the geriatric population, the effectiveness of various types of cushions were not thoroughly elaborated (Heyneman, Vanderwee, Grypdonck and Defloor, 2009). At the beginning of the introduction, the researchers presented the facts as to why conducting a study about heel pressure ulcers was important. It is considered as a common problem in clinical practice and is deemed burdensome on both human and financial terms. The manifestation of heel pressure ulcers affect the patient both physically and mentally, inclusive of the fact that it adds to the expenses in clinical treatment. Thus, the researchers chose to assess two different cushions in terms of effectiveness in preventing heel pressure ulcers (Braden and Blanchard, 2007). The study has also defined what pressure ulcers are, including the means on how it can be prevented. In general, these measures are to reduce the duration or reduce the magnitude of pressure and shearing forces. In that regard, the researchers analyzed that the reduction of the duration of shear and pressure can be carried out through repositioning the patient or through the use of alternating pressure air mattresses (Heyneman, et. al, 2009). Since both variables can be reduced through the utilization of a tool that would increased the contact surface of the patient with the underlying support surface. The researchers then elaborated on the products with varying pressure reducing capacity in terms of effectiveness. Heel pads and heel boots were mentioned, although the researchers were also able to conclude that both products are not completely effective in removing heel pressure. As advised by the Royal College of Nursing (2005), clinical practice entails managing heel pressure in immobile patients, which was usually executed through raising the heels of the patients off the bed. This can be done through putting a pillow under the patient's legs, so that the heels would be suspended above the mattress. This method is deemed viable as the heel zone would not be subjected to any pressure, and the pressure is distributed accordingly in the lower leg, as supported by the pillow. The study cited five studies they have acquired in PubMed in reference to the pressure reducing qualities of pillows, as well as each of the product's effectiveness in terms of removing heel pressure ulcers. The studies included were from Smith (1984), De Keyser et al. (1994), Tymec et al. (1997), Cheney (1993) and Collins et al. (2002). The studies were mostly descriptive in nature. The information presented in the introduction were all in accordance with the study's focus. The researchers provided sufficient data in regards to the definition of heel pressure and its causes. In addition, the study also delved on the guidelines in clinical practice wherein nurses are advised to manage heel pressure, especially among geriatric patients. In that regard, the study indicated several methods on how heel pressure can be managed, as supported by descriptive studies that support the purpose of the study. In general, the study employs a quantitative research design with the aim to assess the effectiveness of two cushions in managing heel pressure ulcers. The two cushions are: a standard pillow and a wedge-shaped, bed-wide, viscoelastic foam cushion. The introduction of the study provided the necessary information to give constructive insights in regards to the research being undertaken. The message of the article was clearly written. The presentation was concise and direct to the point. In that regard, the content is comprehensible and easy to understand. In addition, the research aim is specific and well defined. Search process The research question is “Among geriatric bed-ridden patients, will the use of wedge-shaped cushion decrease the incidence of heel pressure ulcers better than standard pillows?” P Patient Geriatric Patients I Intervention Leg elevation using pillows C Comparison Standard pillow or wedge-shaped cushion O Outcomes Decreased incidence of heel pressure ulcers The search parameter of the study was specific. Although the problem area dealt with the management of heel pressure ulcers among the geriatric population, the researchers focused on the effectiveness of two cushions that can be used by geriatric patients to help in reducing heel pressure ulcers. The study selected contributes significant information in clinical practice. Since the acquisition of heel pressure ulcers is prevalent in nursing practice, especially among geriatric patients, it is important to determine the most ideal means to manage this concern. The management of heel pressure ulcers, especially among immobile patients that are on bed rest, is an important clinical intervention that can be applied in health care practice. The study employed a quantitative research design as it aimed to compare data through statistics. It involved the observation of two control groups in order to determine the effectiveness of the two variables used. The methodology used is appropriate to the study being undertaken. They researchers were able to analyze and evaluate the data through the use of standardized tests. The limitations of the methodology the researchers have applied in the study is that the sample were derived from a hospital and nursing homes alone. The variance among medical units was not included. Critical Appraisal of the Selected Study Sampling The sample of the study included 162 patients that are beyond 75 years old. Initially, the participants were pooled from randomized controlled trial carried out by Vanderwee et al. (2005; 2007) based on a specific inclusion criteria. The first study that was performed in 2005 focused on the investigation of preventing heel pressure ulcers through alternating pressure air mattress. This particular study had 447 patients that were admitted in 19 surgical, internal or geriatric wards in seven Belgian hospitals. The inclusion criteria were employed randomly through the Braden scale of the presence of NBE (nonblanchable erythema). Patients that were observed at risk for NBE with a Read More