Applying in Practice - Research Paper Example

Applying research in practice May 20, Applying research in practice Discrepancy from the guideline and possible solution The National Institute for Health and Care Excellence developed guidelines for management and prevention of pressure ulcers. Patient assessment for risk of pressure ulcers, further assessment of patients’ skin for patients at high risk, alteration of patients’ positions, and appropriate dresses for the patients are some of the guidelines recommendations for management of pressure ulcers.

Other recommendations by the institution are empowerment through training and provision of information on pressure ulcers and prevention and management issues, besides use of tools for relocating pressure from specific areas (Neilson, Avital, Willock, & Broad, 2014). Evidence based research identifies practices for prevention and management of pressure ulcers that complement and support the institution’s recommendations. Continuous Bedside Pressure Mapping (CBPM) offers a basis for detecting pressures at different parts of a patient’s body and therefore helps to relocate the patient to offload pressure from the areas (Behrendt, Ghaznavi, Manhan, Craft, & Siddiqui, 2014).

The authors established that CBPM reduces patients’ risk of developing pressure ulcers. In an experimental design, results reported 0.9 percent chance of developing pressure ulcers under CBPM and 4.8 percent chance without application of CBPM. The evidence identifies the guidelines’ objective for prevention and management of pressure ulcers but with inefficiency. While the guidelines identify need for repositioning in order to alleviate pressure, it fails to provide an approach for accurate determination of pressure levels for positioning.

This means that according to the guidelines, positioning may be done when pressure is less than the threshold for causing or worsening pressure ulcers. Similarly, pressure at some point may exceed the threshold level but may not be detected for repositioning.The discrepancy between the guidelines and practice suggest inefficiency in prevention of pressure ulcers, under the guidelines, and this can be inferred to management. Nurses can resolve this by using technology to identify real time pressure at different points of a patient’s body.

With such an approach, repositioning can be effective in preventing pressure ulcers and in offloading pressure from affected regions to facilitate recovery. In addition to accurate monitoring of pressure, nurses can also collaborate with physicians and surgeons to promote surgical intervention for management of pressure ulcers (Giaquinto-Cilliers, 2014). This can facilitate healing of wounds, especially if integrated with technology-based assessment of real-time pressure and relocation of patients.

The National Institute for Health and Care Excellence recommendations do not identify use of technology for accurate assessment of pressure to inform relocation and surgical treatment. Nurses can incorporate these to resolve the discrepancy. Effects of individual patient and family needs and preferences on implementation of the changeIndividual patient and family needs and preferences influence implementation of the change by inducing moral obstacles to nurses’ intentions and authority. Informed consent and autonomy doctrines require approval of a patient, or family when a patient lack capacity, and needs and preferences influence authority that a patient or family grants a nurse (Schrems, 2014).

Needs and preferences that contradict intended change may hinder consent and with need to respect autonomy, a responsible nurse would not be able to effects a change. ReferencesBehrendt, R., Ghaznavi, A., Manhan, M., Craft, S., & Siddiqui, A. (2014). Continuous bedside pressure mapping and rates of hospital-associated pressure ulcers in a medical intensive care unit. American Journal of Critical Care 23(2), 127-133. Giaquinto-Cilliers, M. (2014). Pressure ulcers: Surgical intervention. Wound Healing South Africa 7(2), 45-52.

Neilson, J., Avital, L., Willock, J., & Broad, N. (2014). Using a national guideline to prevent and manage pressure ulcers. Nursing Management 21(2), 18-21. Schrems, B. (2014). Informed consent, vulnerability and the risks of group-specific attribution. Nursing Ethics, 21(7), 829-843.