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1. Describe the method used by the author of the study. The author used descriptive cross-sectional study. A cross-sectional study is a type of research design in which data is collected from different individuals at a single point in time. In a cross-sectional study, variables are observed without factors that can potentially influence them. A cross-sectional study helps to determine the prevalence of a condition, or opinion in a population, as represented by a study sample. Cross-sectional studies can be descriptive and analytic. Descriptive cross-sectional studies characterize the prevalence of outcomes or phenomena under investigation.
2. Discuss the research question or main problem discussed in the study. The main problem discussed in the study is the incidence and risk factors of medical device-related pressure injury (MDRPI) in intensive care patients. The study involved 300 patients without an MDRPI at the time of admission to the intensive care unit (ICU) of a university hospital in Turkey. The author found that factors contributing to non-device-related pressure injuries may also increase the risk of MDRPI for patients in the ICU. Additionally, pressure injury development may shorten if necessary precautions are not taken. Prophylactic dressings, timely evaluation, and early removal of unnecessary devices play crucial roles in preventing MDRPI.
1. Discuss the research question or main problem discussed in the study?:
This study sought to determine the incidence and risk factors of Medical Device-Related Pressure Injury in ICU patients. Advances in technology have increased the number of devices used on patients, but that also increases the risk for pressure injuries related to those devices. In the ICU these devices are utilized for extended periods of time and the patients also have several risk factors for skin breakdown.
2. Discuss the sample size used in the study:
The sample size in this study was only 300 patients. There was strict inclusion criteria for the study which was only performed for a few months in a single ICU at a single hospital. This is limiting if the researchers hoped to scale this study to be representative of a larger patient population.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias Some of the limitations of the article are that it was only conducted in the ICU of one hospital, it only had 300 patients in the study, and it did not specify the location of the pressure ulcers. The results of the study showed that the fastest developing MDRPI was from the nasal cannula but it did not specify if it was around the patient's nostrils or posterior ears. How does this research article compare to our practice, policy and/or procedure? In this study the most commonly occurring MDRPI was on the patient's finger, from a pulse oximeter. At the University hospital in Turkey they use hard plastic probes. The ICU at PSJMC either uses soft disposable pulse oximetry probes made of non-woven fabric or a soft disposable plastic tape. The article mentions ways to prevent MDRPIs such as periodic checking of the site that the devices are in contact with, early removal of unnecessary equipment, and prophylactic dressings. PSJMC does this as well.
How does this research article compare to our practice, policy and/or procedure? This study found that a lot of MDRPI occurred by the use of nasal cannulas. At PSJMC we do get a lot of pressure injuries from the use of nasal cannulas as well. Our nasal cannulas differ because we have protective foams to use around the ear lobes, however, they are not always used properly which leads to pressure injuries.
what are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital? This study recommended limiting the time of use for medical devices to prevent pressure ulcers as well as using protective foams when using medical devices on pressure points. Unfortunately, in the ICU patients can't always get breaks from medical devices like nasal cannulas or ventilators, we also always have to use pulse oximetry probes. But I do agree on using foams to protect the skin from direct pressure from these devices as well as frequent skin assessments to prevent pressure injuries.
Discuss the research question or main problem discussed in the study?
The study discussed incidence and risk factors of medical related pressure injury in intensive care patients.Medical devices are common in ICU due to patient's unstable hemodynamic status, need for respiratory support, incontinence and inability to take oral nutrition. It was observed that devices used in ICU , when not necessary preventions are not taken could cause pressure injuries. Factors such as prolonged hospitalization, parental nutrition and vasopressor use are risk factors for pressure injuries.
What are the advantages and disadvantages to the proposed recommendations in the article?
Safe applications of medical devices, periodic evaluation of the area in which the devices are in contact, early or timely removal of unused devices and use of prophylactic dressing in accordance to policies play an important role in preventing MDRPI
The study consisted of patients hospitalized in the Neurology and Anesthesia ICU of a university hospital in Turkey between April 15, 2022 and September 15, 2022.
Describe the method used by the author of the study?
The study involved 300 patients who did not have an MDRPI (Medical Device Related Pressure Injury) at the time of admission to the ICU. The data was collected using the Patient Information Form, the Medical Device-Related Injury Follow-up Chart and the Jackson/Cubbin Risk Assessment Scale.
The study consisted of patients hospitalized in the Neurology and Anesthesia ICU of a university hospital in Turkey between April 15, 2022 and September 15, 2022. The data were collected from the patients meeting the inclusion criteria. Patients who are 18 years of age or older were given one medical device for 24 hours who did not have MDRPI (Medical Device Related Pressure Injury) at the time of ICU admission. Both conscious and unconscious patients who volunteered were included in the study.
Describe the method used by the author of the study?
The author used a data collection tool that included: patient information which includes the questions about the patient's age, gender, body mass index (BMI), history of chronic disease, ICU admission length, hospitalization duration, diagnosis, labs (hematocrit, hemoglobin and albumin levels), skin turgor, moisture, vital signs, and presence, location, size of the patient's non-device related pressure injuries. The study involved 300 patients who did not have MDRPI (Medical Device Related Pressure Injury) at the time of admission to ICU. The data was collected using the Patient Information form, the Medical Device-Related Injury Follow-up Chart and the Jackson/Cubbin Risk Assessment Scale.
Discuss the research question or main problem discussed in the study. The main problem in this study is risk factors of medical device-related pressure injury in the intensive care patients. Prevention of development of MDRPI can be achieved if necessary prevention are in place like prophylactic dressing are being used, evaluation, and early removal of the device.
Discuss the simple size used in the study. The study included 300 patients. The study was preformed in ICU for only few months in one hospital.
How does this research article compare to our practice, policy and/or procedure?
This journal recommends that care giver periodically evaluate the area the medical devices that are in contact with, removal of unused devices as quickly as possible, and use of prophylactic dressings play an important role in preventing MDRPI. PSJMC implements MDRPI prevention strategies. These include thoroughly inspecting the skin beneath and around oxygen administration devices at least every 8-12 hours with close attention to the back of the ears, bridge of nose and nares if applicable. Secure mask straps to minimal required pressure/tension to obtain adequate placement. Consider the application of a protective dressing (i.e., transparent film, silicone, thin foam or hydrocolloid) over the nasal bridge for prevention of friction/shear and management of skin damage. The use of split foam in patients with tracheostomy also prevents MDRPI Removal of foley catheter not only prevents MRDPI but also CAUTI. Wound care consult is ordered for MDRPI evaluation.
Discuss the research question or main problem discussed in the study?
This study aims to determine the incidence and risk factors of Medical Device-Related Pressure Injury (MDRPI) in Intensive Care Unit (ICU) patients. Medical device-related pressure injury (MDRPI) in intensive care unit (ICU) patients is a serious issue. Many risk factors, such as old age, immobility, sensory disorders, malnutrition, vasopressor drug use, circulatory disorders, poor oxygenation, edema, any moisture and slipping friction that these patients may have, also contribute to the risk of pressure injuries. ICU patients require more medical equipment or instruments due to the need for treatment and disease monitoring. They will have more opportunities to use certain specialized devices or certain specific drugs, making them more susceptible to MDRPI. Furthermore, compared with patients in the general ward, ICU patients are more likely to have problems such as limited activity, perception, and disturbance of consciousness, leading to MDRPI. It was found that MDRPI occurred most frequently in the hand-finger region due to pulse oximetry probe.
Article 1- Determination of Nurses’ Knowledge Levels on Skin Tears: A Cross-sectional Study
Q5- Discuss the research question or main problem discussed in the study.
The research question is perfect because lots of patients are at risk of skin tears and understanding how to classify, patient risk factors and ways to prevent, as well as treatment are very important in reducing length of stay and additional hospital costs. The authors felt skin tears develop from mechanical forces, so nurses play an important role in prevention and management. From a nursing education point of view, I can vouch that not much of the basic nursing education is dedicated to understanding skin tears/ injuries when there are so many other topics. I think learning never stops, a nurses’ initial education is just the beginning but when you get into practice one will need to refine it and that is why this topic is important to understand where a nurse's knowledge is and what additional information would be helpful.
Q6- Discuss the sample size used in this study.
The population of the study consisted of nurses working in Turkey. The authors calculated the required sample size of the study to be 384 participants with at least 1 year of employment. The study ended up with 346 participants, 80% (n= 279) were women, and 73.7% (n=255) had an undergraduate degree. The study group had a mean of 11.25 years of work experience in nursing. I think the size was sufficient to draw the conclusions they did which were lower amount of education corresponded to lower knowledge and the reverse was true.
1. How does this research article compare to our practice, policy and/or procedure?
Pressure injuries are common in adult ICU patients. ICU acquired pressure injuries are associated with mainly intrinsic factors and morality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important safety threat
2. Discuss the research question or main problem discussed in the study.
Inability of intensive care patients to feel pressure, friction and shear, on the skin due to a sedation, encephalopathy, neurological diseases or young age (infants and young children), being immobile, duration of medical device use, fixing devices to provide correct function and life support measures. Pressure Injuries occur with medical devices which are used more in intensive care patients are in direct or indirect contact with the skin caused focal or localized forces on the superficial or deep tissues
1. How does this research article compare to our practice, policy and/or procedure?
Pressure injuries are common in adult ICU patients. ICU acquired pressure injuries are associated with mainly intrinsic factors and morality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important safety threat. MDRPI's are a common complication that can occur in Intensive Care Unit (ICU) patients .They can happen when a medical device like a ventilator ,feeding tube ,or catheter ,applies pressure to a patients skin for an extended period of time damaging the tissue. MDRPI's cam cause Pain and discomfort ,longer hospital stays ,increased health care costs ,life threatening infections ,and wound and scars . And some risk factors for MDRPI's include old age ,immobility ,sensory disorders ,malnutrition ,vasopressor ,drug use ,circulatory disorders ,porr oxygenation and edema. Current Evidence also shows that (MDRPI ) has a high prevalance and incidence, and much research has been done to prevent MDRPI in recent years .
2. Discuss the research question or main problem discussed in the study. The sutdy aims to determine the incidence and risk factors of Medical Device Related Pressure Injury (MDRPI's) in Intensive Care Unit (ICU) patients.This descriptive cross sectioanl study invloved 300 patients who did not have an MDRPI at the time of admissions to the ICU of a Univeristy Hospital in Turkey.The data was collected using the Patient Information form ,the Medical Device Related Pressure Injury follow up chart ,and the Jackson/ Cubbin Risk Assessememt Scale Inability of intensive care patients to feel pressure, friction and shear, on the skin due to a sedation, encephalopathy, neurological diseases or young age (infants and young children), being immobile, duration of medical device use, fixing devices to provide correct function and life support measures. Pressure Injuries occur with medical devices which are used more in intensive care patients are in direct or indirect contact with the skin caused focal or localized forces on the superficial or deep tissues
1. Discuss the research question or main problem discussed in the study?
The main problem that is discussed in this study is the incidence and risk factors that contribute to medical-device related pressure injuries (MDRPI) in the setting of an intensive care unit (ICU). MDRPI’s are more common in the ICU compared to medical-surgical floors because of the increase in use of medical devices for extended periods, such as endotracheal tubes, masks, and electrocardiogram electrodes. ICU patients are more at risk for MDRPIs because of they are more hemodynamically unstable, require additional respiratory support, incontinent, and are unable to take oral nutrition. Risk factors that increase a patient in the ICU chances of developing MRRPIs include older age, immobility, sensory disorders, malnutrition, vasopressor usage, and poor oxygenation. It was discovered through research that the most common MDRPI was a stage 1 pressure injury on the finger because of the use of continuous pulse oximeters. The study suggested that frequent evaluation of the site where devices are being used, early removal of medical devices, and safe application of medical devices all help to decrease the amount of MDRPIs in ICU patients.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
The limitations of the article is the relatively small sample size. There were only 300 participants from one floor at a hospital from April 15, 2022 through September 15, 2022. The study lacks diversity as it was only from a single hospital unit, the Neurology and Anesthesia-Reanimation ICU. The article is also limited because the patients were sedated which could have possibly altered the results. Overall, the biggest limitation of the study is the lack of participants and the authors recognize this stating that the data would need to be validated in a larger multi-centric study.
1. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias. Although ICU settings are a logical place to monitor Medical Device-Related Pressure Injuries (MDRPI) given the larger number of devices used per patient, this study only used a sample size of 300 patients in one hospital in Turkey. A more robust multi-centric study in multiple unit specialties would yield more data and better validation of results. Another limitation of the study is that it does not specify whether pressure ulcer preventive dressings were used with the devices such as foam pads attached to nasal cannulas or adherent or non-adherent dressings between devices and skin, as the use and non-use of these dressings can directly affect the number of resulting skin injuries.
2. Describe the method used by the author of the study: This was a descriptive and cross-sectional study of ICU patients who had at least one medical device for more than 24 hours and had no pressure injuries at onset of the study. Relevant patient data was collected via the patient information form. Skin monitoring and documentation was performed daily. In addition, the Jackson/Cubbin Risk Assessment Scale was used. Data for approximately 1.5 years in 2022 was collected and analyzed for incidence of various MDRPI.
1) Discuss the research question or main problem in the study: The study determines the incidence and risk factors of medical device related pressure injury (MDRPI) in ICU. A few risk factors that were considered in this study are old age, mobility, malnutrition, sensory disorders, use of vasopressors, poor oxygen, circulatory disorders. Use of medical devices such as nasogastric tubes, splints, ET tube, mask, pulse ox, EKG electrodes, arteriovenous catheters may also lead to MDRPI. 2) Discuss the sample size: The study involved 300 patients in Turkey who didn't have MDRPI at the time of admission in ICU. The average age was 71.88 +/- 14.8 years old. patient population consisted of patients hospitalized in neurology and Anesthesia- reanimation ICU of a University Hospital between April 15, 2022 and Sept. 15, 2022
Methods: This study utilized descriptive and cross-sectional study methods with the STROBE checklist for cross-sectional studies. The study involved 300 patients who met the inclusion criteria. A patient information form including questions relating to history of chronic disease, skin turgor and moisture among other criteria was utilized for baseline assessment. A medical device- related pressure injury follow up chart recorded the location of the devices, duration, and severity of pressure injury and was assessed every 24 hours during the patient's ICU stay.
Research question: As technology has advanced, a gradual increase in the number of medical devices used for life support and treatment has in turn increased the risk of MDRPI. This study aimed to determine the incidence and risk factors of MDRPI in ICU patients, in this case those hospitalized in the Neurology and Anesthesia ICU of a university hospital in Turkey. Because MDRPI is one of the leading indicators of patient safety and nursing care quality in healthcare centers, a study of this nature, focusing on ICU patients, was deemed necessary.
1. Describe the method used by the author of the study.
ReplyDeleteThe author used descriptive cross-sectional study. A cross-sectional study is a type of research design in which data is collected from different individuals at a single point in time. In a cross-sectional study, variables are observed without factors that can potentially influence them. A cross-sectional study helps to determine the prevalence of a condition, or opinion in a population, as represented by a study sample. Cross-sectional studies can be descriptive and analytic. Descriptive cross-sectional studies characterize the prevalence of outcomes or phenomena under investigation.
2. Discuss the research question or main problem discussed in the study.
The main problem discussed in the study is the incidence and risk factors of medical device-related pressure injury (MDRPI) in intensive care patients. The study involved 300 patients without an MDRPI at the time of admission to the intensive care unit (ICU) of a university hospital in Turkey. The author found that factors contributing to non-device-related pressure injuries may also increase the risk of MDRPI for patients in the ICU. Additionally, pressure injury development may shorten if necessary precautions are not taken. Prophylactic dressings, timely evaluation, and early removal of unnecessary devices play crucial roles in preventing MDRPI.
1. Discuss the research question or main problem discussed in the study?:
ReplyDeleteThis study sought to determine the incidence and risk factors of Medical Device-Related Pressure Injury in ICU patients. Advances in technology have increased the number of devices used on patients, but that also increases the risk for pressure injuries related to those devices. In the ICU these devices are utilized for extended periods of time and the patients also have several risk factors for skin breakdown.
2. Discuss the sample size used in the study:
The sample size in this study was only 300 patients. There was strict inclusion criteria for the study which was only performed for a few months in a single ICU at a single hospital. This is limiting if the researchers hoped to scale this study to be representative of a larger patient population.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
ReplyDeleteSome of the limitations of the article are that it was only conducted in the ICU of one hospital, it only had 300 patients in the study, and it did not specify the location of the pressure ulcers. The results of the study showed that the fastest developing MDRPI was from the nasal cannula but it did not specify if it was around the patient's nostrils or posterior ears.
How does this research article compare to our practice, policy and/or procedure?
In this study the most commonly occurring MDRPI was on the patient's finger, from a pulse oximeter. At the University hospital in Turkey they use hard plastic probes. The ICU at PSJMC either uses soft disposable pulse oximetry probes made of non-woven fabric or a soft disposable plastic tape. The article mentions ways to prevent MDRPIs such as periodic checking of the site that the devices are in contact with, early removal of unnecessary equipment, and prophylactic dressings. PSJMC does this as well.
How does this research article compare to our practice, policy and/or procedure? This study found that a lot of MDRPI occurred by the use of nasal cannulas. At PSJMC we do get a lot of pressure injuries from the use of nasal cannulas as well. Our nasal cannulas differ because we have protective foams to use around the ear lobes, however, they are not always used properly which leads to pressure injuries.
ReplyDeletewhat are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital? This study recommended limiting the time of use for medical devices to prevent pressure ulcers as well as using protective foams when using medical devices on pressure points. Unfortunately, in the ICU patients can't always get breaks from medical devices like nasal cannulas or ventilators, we also always have to use pulse oximetry probes. But I do agree on using foams to protect the skin from direct pressure from these devices as well as frequent skin assessments to prevent pressure injuries.
Discuss the research question or main problem discussed in the study?
ReplyDeleteThe study discussed incidence and risk factors of medical related pressure injury in intensive care patients.Medical devices are common in ICU due to patient's unstable hemodynamic status, need for respiratory support, incontinence and inability to take oral nutrition. It was observed that devices used in ICU , when not necessary preventions are not taken could cause pressure injuries. Factors such as prolonged hospitalization, parental nutrition and vasopressor use are risk factors for pressure injuries.
What are the advantages and disadvantages to the proposed
recommendations in the article?
Safe applications of medical devices, periodic evaluation of the area in which the devices are in contact, early or timely removal of unused devices and use of prophylactic dressing in accordance to policies play an important role in preventing MDRPI
Describe the sample size used in the study?
ReplyDeleteThe study consisted of patients hospitalized in the Neurology and Anesthesia ICU of a university hospital in Turkey between April 15, 2022 and September 15, 2022.
Describe the method used by the author of the study?
The study involved 300 patients who did not have an MDRPI (Medical Device Related Pressure Injury) at the time of admission to the ICU. The data was collected using the Patient Information Form, the Medical Device-Related Injury Follow-up Chart and the Jackson/Cubbin Risk Assessment Scale.
Describe the sample size used in the study?
DeleteThe study consisted of patients hospitalized in the Neurology and Anesthesia ICU of a university hospital in Turkey between April 15, 2022 and September 15, 2022. The data were collected from the patients meeting the inclusion criteria. Patients who are 18 years of age or older were given one medical device for 24 hours who did not have MDRPI (Medical Device Related Pressure Injury) at the time of ICU admission. Both conscious and unconscious patients who volunteered were included in the study.
Describe the method used by the author of the study?
The author used a data collection tool that included: patient information which includes the questions about the patient's age, gender, body mass index (BMI), history of chronic disease,
ICU admission length, hospitalization duration, diagnosis, labs (hematocrit, hemoglobin and albumin levels), skin turgor, moisture, vital signs, and presence, location, size of the patient's non-device related pressure injuries. The study involved 300 patients who did not have MDRPI (Medical Device Related Pressure Injury) at the time of admission to ICU. The data was collected using the Patient Information form, the Medical Device-Related Injury Follow-up Chart and the Jackson/Cubbin Risk Assessment Scale.
Discuss the research question or main problem discussed in the study.
ReplyDeleteThe main problem in this study is risk factors of medical device-related pressure injury in the intensive care patients. Prevention of development of MDRPI can be achieved if necessary prevention are in place like prophylactic dressing are being used, evaluation, and early removal of the device.
Discuss the simple size used in the study.
The study included 300 patients. The study was preformed in ICU for only few months in one hospital.
How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteThis journal recommends that care giver periodically evaluate the area the medical devices that are in contact with, removal of unused devices as quickly as possible, and use of prophylactic dressings play an important role in preventing MDRPI. PSJMC implements MDRPI prevention strategies. These include thoroughly inspecting the skin beneath and around oxygen administration devices at least every 8-12 hours with close attention to the back of the ears, bridge of nose and nares if applicable. Secure mask straps to minimal required pressure/tension to obtain adequate placement. Consider the application of a protective dressing (i.e., transparent film, silicone, thin foam or hydrocolloid) over the nasal bridge for prevention of friction/shear and management of skin damage. The use of split foam in patients with tracheostomy also prevents MDRPI
Removal of foley catheter not only prevents MRDPI but also CAUTI. Wound care consult is ordered for MDRPI evaluation.
Discuss the research question or main problem discussed in the study?
This study aims to determine the incidence and risk factors of Medical Device-Related Pressure Injury (MDRPI) in Intensive Care Unit (ICU) patients. Medical device-related pressure injury (MDRPI) in intensive care unit (ICU) patients is a serious issue. Many risk factors, such as old age, immobility, sensory disorders, malnutrition, vasopressor drug use, circulatory disorders, poor oxygenation, edema, any moisture and slipping friction that these patients may have, also contribute to the risk of pressure injuries. ICU patients require more medical equipment or instruments due to the need for treatment and disease monitoring. They will have more opportunities to use certain specialized devices or certain specific drugs, making them more susceptible to MDRPI. Furthermore, compared with patients in the general ward, ICU patients are more likely to have problems such as limited activity, perception, and disturbance of consciousness, leading to MDRPI. It was found that MDRPI occurred most frequently in the hand-finger region due to pulse oximetry probe.
Article 1- Determination of Nurses’ Knowledge Levels on Skin Tears: A Cross-sectional Study
ReplyDeleteQ5- Discuss the research question or main problem discussed in the study.
The research question is perfect because lots of patients are at risk of skin tears and understanding how to classify, patient risk factors and ways to prevent, as well as treatment are very important in reducing length of stay and additional hospital costs. The authors felt skin tears develop from mechanical forces, so nurses play an important role in prevention and management. From a nursing education point of view, I can vouch that not much of the basic nursing education is dedicated to understanding skin tears/ injuries when there are so many other topics. I think learning never stops, a nurses’ initial education is just the beginning but when you get into practice one will need to refine it and that is why this topic is important to understand where a nurse's knowledge is and what additional information would be helpful.
Q6- Discuss the sample size used in this study.
The population of the study consisted of nurses working in Turkey. The authors calculated the required sample size of the study to be 384 participants with at least 1 year of employment. The study ended up with 346 participants, 80% (n= 279) were women, and 73.7% (n=255) had an undergraduate degree. The study group had a mean of 11.25 years of work experience in nursing. I think the size was sufficient to draw the conclusions they did which were lower amount of education corresponded to lower knowledge and the reverse was true.
1. How does this research article compare to our practice, policy and/or procedure?
ReplyDeletePressure injuries are common in adult ICU patients. ICU acquired pressure injuries are associated with mainly intrinsic factors and morality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important safety threat
2. Discuss the research question or main problem discussed in the study.
Inability of intensive care patients to feel pressure, friction and shear, on the skin due to a sedation, encephalopathy, neurological diseases or young age (infants and young children), being immobile, duration of medical device use, fixing devices to provide correct function and life support measures. Pressure Injuries occur with medical devices which are used more in intensive care patients are in direct or indirect contact with the skin caused focal or localized forces on the superficial or deep tissues
1. How does this research article compare to our practice, policy and/or procedure?
ReplyDeletePressure injuries are common in adult ICU patients. ICU acquired pressure injuries are associated with mainly intrinsic factors and morality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important safety threat. MDRPI's are a common complication that can occur in Intensive Care Unit (ICU) patients .They can happen when a medical device like a ventilator ,feeding tube ,or catheter ,applies pressure to a patients skin for an extended period of time damaging the tissue. MDRPI's cam cause Pain and discomfort ,longer hospital stays ,increased health care costs ,life threatening infections ,and wound and scars . And some risk factors for MDRPI's include old age ,immobility ,sensory disorders ,malnutrition ,vasopressor ,drug use ,circulatory disorders ,porr oxygenation and edema. Current Evidence also shows that (MDRPI ) has a high prevalance and incidence, and much research has been done to prevent MDRPI in recent years .
2. Discuss the research question or main problem discussed in the study.
The sutdy aims to determine the incidence and risk factors of Medical Device Related Pressure Injury (MDRPI's) in Intensive Care Unit (ICU) patients.This descriptive cross sectioanl study invloved 300 patients who did not have an MDRPI at the time of admissions to the ICU of a Univeristy Hospital in Turkey.The data was collected using the Patient Information form ,the Medical Device Related Pressure Injury follow up chart ,and the Jackson/ Cubbin Risk Assessememt Scale
Inability of intensive care patients to feel pressure, friction and shear, on the skin due to a sedation, encephalopathy, neurological diseases or young age (infants and young children), being immobile, duration of medical device use, fixing devices to provide correct function and life support measures. Pressure Injuries occur with medical devices which are used more in intensive care patients are in direct or indirect contact with the skin caused focal or localized forces on the superficial or deep tissues
1. Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main problem that is discussed in this study is the incidence and risk factors that contribute to medical-device related pressure injuries (MDRPI) in the setting of an intensive care unit (ICU). MDRPI’s are more common in the ICU compared to medical-surgical floors because of the increase in use of medical devices for extended periods, such as endotracheal tubes, masks, and electrocardiogram electrodes. ICU patients are more at risk for MDRPIs because of they are more hemodynamically unstable, require additional respiratory support, incontinent, and are unable to take oral nutrition. Risk factors that increase a patient in the ICU chances of developing MRRPIs include older age, immobility, sensory disorders, malnutrition, vasopressor usage, and poor oxygenation. It was discovered through research that the most common MDRPI was a stage 1 pressure injury on the finger because of the use of continuous pulse oximeters. The study suggested that frequent evaluation of the site where devices are being used, early removal of medical devices, and safe application of medical devices all help to decrease the amount of MDRPIs in ICU patients.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
The limitations of the article is the relatively small sample size. There were only 300 participants from one floor at a hospital from April 15, 2022 through September 15, 2022. The study lacks diversity as it was only from a single hospital unit, the Neurology and Anesthesia-Reanimation ICU. The article is also limited because the patients were sedated which could have possibly altered the results. Overall, the biggest limitation of the study is the lack of participants and the authors recognize this stating that the data would need to be validated in a larger multi-centric study.
1. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
ReplyDeleteAlthough ICU settings are a logical place to monitor Medical Device-Related Pressure Injuries (MDRPI) given the larger number of devices used per patient, this study only used a sample size of 300 patients in one hospital in Turkey. A more robust multi-centric study in multiple unit specialties would yield more data and better validation of results. Another limitation of the study is that it does not specify whether pressure ulcer preventive dressings were used with the devices such as foam pads attached to nasal cannulas or adherent or non-adherent dressings between devices and skin, as the use and non-use of these dressings can directly affect the number of resulting skin injuries.
2. Describe the method used by the author of the study:
This was a descriptive and cross-sectional study of ICU patients who had at least one medical device for more than 24 hours and had no pressure injuries at onset of the study. Relevant patient data was collected via the patient information form. Skin monitoring and documentation was performed daily. In addition, the Jackson/Cubbin Risk Assessment Scale was used. Data for approximately 1.5 years in 2022 was collected and analyzed for incidence of various MDRPI.
1) Discuss the research question or main problem in the study:
ReplyDeleteThe study determines the incidence and risk factors of medical device related pressure injury (MDRPI) in ICU. A few risk factors that were considered in this study are old age, mobility, malnutrition, sensory disorders, use of vasopressors, poor oxygen, circulatory disorders. Use of medical devices such as nasogastric tubes, splints, ET tube, mask, pulse ox, EKG electrodes, arteriovenous catheters may also lead to MDRPI.
2) Discuss the sample size:
The study involved 300 patients in Turkey who didn't have MDRPI at the time of admission in ICU. The average age was 71.88 +/- 14.8 years old. patient population consisted of patients hospitalized in neurology and Anesthesia- reanimation ICU of a University Hospital between April 15, 2022 and Sept. 15, 2022
Methods: This study utilized descriptive and cross-sectional study methods with the STROBE checklist for cross-sectional studies. The study involved 300 patients who met the inclusion criteria. A patient information form including questions relating to history of chronic disease, skin turgor and moisture among other criteria was utilized for baseline assessment. A medical device- related pressure injury follow up chart recorded the location of the devices, duration, and severity of pressure injury and was assessed every 24 hours during the patient's ICU stay.
ReplyDeleteResearch question: As technology has advanced, a gradual increase in the number of medical devices used for life support and treatment has in turn increased the risk of MDRPI. This study aimed to determine the incidence and risk factors of MDRPI in ICU patients, in this case those hospitalized in the Neurology and Anesthesia ICU of a university hospital in Turkey. Because MDRPI is one of the leading indicators of patient safety and nursing care quality in healthcare centers, a study of this nature, focusing on ICU patients, was deemed necessary.