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What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?: - Since this article regarding stoma skin care was written for British nursing, the presented facts/statistics and products are not the same with U.S. For example, the most common type of stoma in the UK is the colostomy per this article. What about in the U.S. or even in our hospital? In order to educate myself, it's helpful for me to read this article, which started with when you need a surgically created stoma, skin physiology, and the peristomal complications caused by MASD and MARSI. Thus the advantages are their clinical facts in this paper are useful to educate nurses for peristomal skin care in our hospital. The disadvantage is that we don't use the same products they recommend in this article if FDA doesn't approve.
Discrive the method used by the author of the study: -This article was written based on the facts and statistics, which they reviewed the other research papers published in the past. Since the author didn't conduct a research for this article, this is not a research paper, but a review paper.
Hi Sakiko, I think that is a good point you mention about the FDA. Products not approved will prevent us from utilizing them in practice. I agree that products not approved by the FDA could be a disadvantage in some cases, as there is a lengthy and time consuming process to get approval for products that are safe and effective in other countries. Sometimes that could result in missed opportunities in seeing positive results.
Valarie Renaux Importance of peristomal skin protection
Describe the method used by the author of the study The method used in this article were references highlighting findings on ostomy etiology, management and findings that support their argument in using this product. For this study as there was a limited sample size of 14 neonate subjects evaluated upon their tolerance of the product. They claim all test subjects demonstrated no pain. This article was highlighting and promoting a product for wound care.
Was the correct method used? Why or why not? This article arguably is not the correct method for a research study as there are no measures discussed to minimize the bias, steps taken to avoid conflict of interest, transparency with funding of this article, and etc. The sample size was limited and potentially bias, as the reader does not know how the subjects were chosen. As this is a wound care product being sold, results may be influenced based off of lack of comorbidities, psychosocial status, demographics, family support system, nutrition, and etc. It would reasonable to assume there is bias to convince the reader to become a consumer of this product being discussed.
How does this research article compare to our practice, policy and/or procedure? It is difficult to answer this question because this was about a wound care product. We as a ministry are looking for the most cost efficient and effective and FDA approved products to utilize in practice. I did not come across a policy on ostomy management. We do have a wound ostomy nurse that will be involved in the management of the ostomy maintenance and assessment in conjunction with the bed side nurse.
References Reference List
Lacey V. Importance of peristomal skin protection. Journal of Community Nursing. 2022;36(2):44-50. Accessed September 25, 2022. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=c8h&AN=156307640&site=ehost-live&scope=site
Jennifer O'Neill How does this research article compare to our practice, policy and/or procedure? We do have a wound ostomy nurse to help create a plan for ostomy management but in regards to products we use we dont have a variety of products like adhesive remover and barrier applicator for wound care. I do not feel that we have the large amount of osteomates in this ministry.
Discuss the sample size used in the study. This article was more of an educational article about the importance of stoma care and product use. Identifying issues with medical adhesive and barrier products in order to prevent injuries. 1 in 500 people in the UK are living with a stoma.. that seems very high. So the management of preventing these injuries/cost/infection is very important for the patient.
1. How does this research article compare to our practice, policy and/or procedure?
The article emphasized the importance of skin/stoma care and some variables that require further assessments such as skin tone variation. It addition, it provided education on the products used such as adhesives, products and how to monitor for potential damage such as medical adhesive-related skin injuries (MARSI). While the practices are similar to general stoma care, the products displayed in the article differs greatly from the stoma products used at PSJMC. In my experience, we use the one piece kit applicator which consist of the new stoma collection bag, the measuring diameter guide (which allows us to accurately cut the adhesives in regards to stoma size prevent damage) and the clip that serves the purpose as a detachable valve to empty the contents.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study seems to be derived from the United Kingdom (UK) population as the article mentions a statistical study of 1 in 500 people in the UK. The limitation of the article is the purpose of the article as it is more of an educational piece. It does not have a clear sample size and criteria. Therefore there is not adequate data to compare to and use for improving stoma care and use of devices.
1) Discuss the sample size of this study The method used was a small sample size of 14 neonate subjects from an ICU. However, there is no clear sample size or criteria of the 14 neonates used and more so as an editorial rather than study.
2) How does this research article compare to our practice, policy and/or procedure?
The article is very informative, explaining the differences between MASD and MARSI. Furthermore, the creams used in the UK based study are not those used in the US. The creams that I have seen have been zinc based more so than silicone based. Furthermore, long term follow up is different from the US than UK as care differs depending on type of insurance
How does this research article compare to our practice, policy and/or procedure? First off, this is not entirely a research article. It is, however, a succinct yet thorough review of stoma physiology including indications and functions. More importantly, the article highlights considerations that need to be taken into account in the prevention of stomal and peristoma complications. While this article comes from the British healthcare system, I did find similarities in our current practice at St Joseph. To begin, an assessment is paramount to prevention and intervention no matter where in the world patients are being cared for. Second, the use of skin protectants, barrier films, and adhesive removers are commonplace at St Joes. The difference in products may simply be because the brand noted in the article is what's available in the United Kingdom. Lastly, recommendations to consider different skin tones and the way potential skin breakdown may manifest differently across skin tones should be taken into consideration regardless of where anyone is practicing healthcare. Was the correct method used? Why or why not? Again, this is not a research article per se. However, the authors cite compelling numbers to support the use of the products to protect the skin. A study comparing those using the products versus those that use a different or no product would be more substantial. However, not using any type of skin protectant or barrier when one is available may be considered unethical in this context being that there are products available on the market with well documented results. To compare one product to another would simply be an issue of brand marketing unless the materials in the products were substantially different.
1. How does this research article compare to our practice, policy and/or procedure?
This article was more of a reference article on stoma assessment and care, which was very informative. The article emphasizes on the appearance of the peristomal area, stating that it should match the rest of the abdomen. This is something that I just learned from this article. While we do assess the peristomal area as part of our nursing assessment, I always thought it was normal to have some discoloration. The article states that this is a common but underreported finding. A new practice could be to have the wound/ostomy nurse assess the skin and make recommendations based on discoloration. It’s possible that the stoma is not dressed with adequate supplies or is just being done incorrectly. More education is always key.
2. What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
The article suggests more education on stoma assessment. The advantage here is always to the patient since the article suggests that patients don’t always report what they see, nurses should be able to assess for skin complications. This is an important aspect in stoma care because complications can affect the patient’s health status and quality of life. Not necessarily a disadvantage, but a barrier in implementing this is getting the education out to nurses. At our hospital, the wound/ostomy nurses are already spread very thin so educating everyone on stoma assessment can be difficult.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias and what are the advantages and disadvantages to the proposed recommendations in the article?
The limitations on this study include a focus on only the most common types of stomas in the United Kingdom. The study lacks data from other regions, limiting the type of data being and the different types of treatments being examined and evaluated. The Advantages that this study includes a standardized way of care with detailed information on different types of treatments for different types of stoma care. The disadvantage of this study includes only research from the United Kingdom in which the products available elsewhere may not be the same. Another disadvantage is that the study focuses on the most common types of stomas in the UK where treatment due to different types of stomas elsewhere may be different.
What are the advantages and disadvantages to the proposed recommendation in the article? Advantage: The article emphasizes the importance of skin/stoma assessment , use of devices, and potential risks for complications. Disadvantage: Nurses need to be be accountable in recognizing the condition of the stoma and to implement appropriate care to ensure hi quality patient care for each individual .
How does this research compare to our practice/policy/procedure: As nurses caring for the patient with ostomies, our facility utilizes our resource ( wound consult) to initiate /implement recommended treatment for patients .
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?:
ReplyDelete- Since this article regarding stoma skin care was written for British nursing, the presented facts/statistics and products are not the same with U.S. For example, the most common type of stoma in the UK is the colostomy per this article. What about in the U.S. or even in our hospital? In order to educate myself, it's helpful for me to read this article, which started with when you need a surgically created stoma, skin physiology, and the peristomal complications caused by MASD and MARSI. Thus the advantages are their clinical facts in this paper are useful to educate nurses for peristomal skin care in our hospital. The disadvantage is that we don't use the same products they recommend in this article if FDA doesn't approve.
Discrive the method used by the author of the study:
-This article was written based on the facts and statistics, which they reviewed the other research papers published in the past. Since the author didn't conduct a research for this article, this is not a research paper, but a review paper.
Hi Sakiko, I think that is a good point you mention about the FDA. Products not approved will prevent us from utilizing them in practice. I agree that products not approved by the FDA could be a disadvantage in some cases, as there is a lengthy and time consuming process to get approval for products that are safe and effective in other countries. Sometimes that could result in missed opportunities in seeing positive results.
DeleteThis comment has been removed by the author.
ReplyDelete
DeleteValarie Renaux
Importance of peristomal
skin protection
Describe the method used by the author of the study
The method used in this article were references highlighting findings on ostomy etiology, management and findings that support their argument in using this product. For this study as there was a limited sample size of 14 neonate subjects evaluated upon their tolerance of the product. They claim all test subjects demonstrated no pain. This article was highlighting and promoting a product for wound care.
Was the correct method used? Why or why not?
This article arguably is not the correct method for a research study as there are no measures discussed to minimize the bias, steps taken to avoid conflict of interest, transparency with funding of this article, and etc. The sample size was limited and potentially bias, as the reader does not know how the subjects were chosen. As this is a wound care product being sold, results may be influenced based off of lack of comorbidities, psychosocial status, demographics, family support system, nutrition, and etc. It would reasonable to assume there is bias to convince the reader to become a consumer of this product being discussed.
How does this research article compare to our practice, policy and/or procedure?
It is difficult to answer this question because this was about a wound care product. We as a ministry are looking for the most cost efficient and effective and FDA approved products to utilize in practice. I did not come across a policy on ostomy management. We do have a wound ostomy nurse that will be involved in the management of the ostomy maintenance and assessment in conjunction with the bed side nurse.
References
Reference List
Lacey V. Importance of peristomal skin protection. Journal of Community Nursing. 2022;36(2):44-50. Accessed September 25, 2022. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=c8h&AN=156307640&site=ehost-live&scope=site
Jennifer O'Neill
ReplyDeleteHow does this research article compare to our practice, policy and/or procedure?
We do have a wound ostomy nurse to help create a plan for ostomy management but in regards to products we use we dont have a variety of products like adhesive remover and barrier applicator for wound care. I do not feel that we have the large amount of osteomates in this ministry.
Discuss the sample size used in the study.
ReplyDeleteThis article was more of an educational article about the importance of stoma care and product use. Identifying issues with medical adhesive and barrier products in order to prevent injuries. 1 in 500 people in the UK are living with a stoma.. that seems very high. So the management of preventing these injuries/cost/infection is very important for the patient.
1. How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteThe article emphasized the importance of skin/stoma care and some variables that require further assessments such as skin tone variation. It addition, it provided education on the products used such as adhesives, products and how to monitor for potential damage such as medical adhesive-related skin injuries (MARSI). While the practices are similar to general stoma care, the products displayed in the article differs greatly from the stoma products used at PSJMC. In my experience, we use the one piece kit applicator which consist of the new stoma collection bag, the measuring diameter guide (which allows us to accurately cut the adhesives in regards to stoma size prevent damage) and the clip that serves the purpose as a detachable valve to empty the contents.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study seems to be derived from the United Kingdom (UK) population as the article mentions a statistical study of 1 in 500 people in the UK. The limitation of the article is the purpose of the article as it is more of an educational piece. It does not have a clear sample size and criteria. Therefore there is not adequate data to compare to and use for improving stoma care and use of devices.
1) Discuss the sample size of this study
ReplyDeleteThe method used was a small sample size of 14 neonate subjects from an ICU. However, there is no clear sample size or criteria of the 14 neonates used and more so as an editorial rather than study.
2) How does this research article compare to our practice, policy and/or procedure?
The article is very informative, explaining the differences between MASD and MARSI. Furthermore, the creams used in the UK based study are not those used in the US. The creams that I have seen have been zinc based more so than silicone based. Furthermore, long term follow up is different from the US than UK as care differs depending on type of insurance
suzanne kang
DeleteHow does this research article compare to our practice, policy and/or procedure?
ReplyDeleteFirst off, this is not entirely a research article. It is, however, a succinct yet thorough review of stoma physiology including indications and functions. More importantly, the article highlights considerations that need to be taken into account in the prevention of stomal and peristoma complications. While this article comes from the British healthcare system, I did find similarities in our current practice at St Joseph. To begin, an assessment is paramount to prevention and intervention no matter where in the world patients are being cared for. Second, the use of skin protectants, barrier films, and adhesive removers are commonplace at St Joes. The difference in products may simply be because the brand noted in the article is what's available in the United Kingdom. Lastly, recommendations to consider different skin tones and the way potential skin breakdown may manifest differently across skin tones should be taken into consideration regardless of where anyone is practicing healthcare.
Was the correct method used? Why or why not?
Again, this is not a research article per se. However, the authors cite compelling numbers to support the use of the products to protect the skin. A study comparing those using the products versus those that use a different or no product would be more substantial. However, not using any type of skin protectant or barrier when one is available may be considered unethical in this context being that there are products available on the market with well documented results. To compare one product to another would simply be an issue of brand marketing unless the materials in the products were substantially different.
1. How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteThis article was more of a reference article on stoma assessment and care, which was very informative. The article emphasizes on the appearance of the peristomal area, stating that it should match the rest of the abdomen. This is something that I just learned from this article. While we do assess the peristomal area as part of our nursing assessment, I always thought it was normal to have some discoloration. The article states that this is a common but underreported finding. A new practice could be to have the wound/ostomy nurse assess the skin and make recommendations based on discoloration. It’s possible that the stoma is not dressed with adequate supplies or is just being done incorrectly. More education is always key.
2. What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
The article suggests more education on stoma assessment. The advantage here is always to the patient since the article suggests that patients don’t always report what they see, nurses should be able to assess for skin complications. This is an important aspect in stoma care because complications can affect the patient’s health status and quality of life. Not necessarily a disadvantage, but a barrier in implementing this is getting the education out to nurses. At our hospital, the wound/ostomy nurses are already spread very thin so educating everyone on stoma assessment can be difficult.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias and what are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe limitations on this study include a focus on only the most common types of stomas in the United Kingdom. The study lacks data from other regions, limiting the type of data being and the different types of treatments being examined and evaluated. The Advantages that this study includes a standardized way of care with detailed information on different types of treatments for different types of stoma care. The disadvantage of this study includes only research from the United Kingdom in which the products available elsewhere may not be the same. Another disadvantage is that the study focuses on the most common types of stomas in the UK where treatment due to different types of stomas elsewhere may be different.
What are the advantages and disadvantages to the proposed recommendation in the article?
ReplyDeleteAdvantage: The article emphasizes the importance of skin/stoma assessment , use of devices, and potential risks for complications.
Disadvantage: Nurses need to be be accountable in recognizing the condition of the stoma and to implement appropriate care to ensure hi quality patient care for each individual .
How does this research compare to our practice/policy/procedure:
ReplyDeleteAs nurses caring for the patient with ostomies, our facility utilizes our resource ( wound consult) to initiate /implement recommended treatment for patients .