If not automatically directed on the PDF file just click Download PDF file on the Headings tab.
For documents located in SharePoint Site (CA SJ Wound and Ostomy) look for the article and click it to open. April 2026 - Assessing Knowledge among Endoscopy Nurses. Don't forget to write your name with each posting.
-The endoscopy department of 427 bed suburban community hospital served as a setting for the evidence- based skin tear prevention quality improvement project. Patients in endoscopy may originate from out patient ,inpatient, emergency room or ICU.The inclusion criteria for the study included registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ) Nursing experience averaged 14.7 years for theses endoscopy nurses.
Describe the method used by the author of the study
- A multidisciplinary approach was implemented to create an endoscopic specific STPP Skin Tear Prevention Protocol, including review of current literature and collaboration with wound care nurse, physical therapists and endoscopy staff. Appropriate prevention measures identified for endoscopy included staff education on best practice, identification of at risk patients, and using a skin tear prevention bundle. For 12 weeks of study, a paper copy of the STRAT ( skin tear risk assessment tool) was placed in patient’s medical chart.If patient was identified at risk , the nurse initiated appropriate STPP ( skin tear prevention protocol).It was then communicated between admitting and procedural nurse.The procedural nurse is responsible for continuing the STPP.The procedural nurse then communicated the risk assessment to recovery nurse who then continued the STPP. The admitting, procedural and recovery nurse are all responsible for verifying that documentation has been completed and that any new skin tear have been appropriately reported.
Research Question: Between spring and summer of 2022, a noticeable increase in skin tears was identified in the endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ. The goal of this evidence-based quality improvement project and feasibility study with a pre/post-timed series survey design had three main goals: to design and implement an evidence-based skin tear prevention protocol for endoscopy, evaluate this protocol for usability and effectiveness, and assess endoscopy nurse's skin tear prevention knowledge. A literature review revealed that no studies on skin tear incidents or prevention in the endoscopy setting could be found leaving the question related to best practices for skin tear prevention in endoscopy unanswered. A multidisciplinary team approach was needed. One survey revealed a concerning lack of knowledge among nurses regarding skin tear risk assessment, prevention and treatment regardless of their educational background and experience. A systematic review found that implementing a skin tear bundle, regardless of the individual components, leads to decreased skin tear incidence, and early identification of at-risk patients is key. Additional studies regarding safe patient handling to prevent tears from friction and sheering, the use of limb coverings and best practice adhesive removal strategies in settings other than that of endoscopy were reviewed.
Methods: A feasibility study with a pre/post-timed series survey design was developed and conducted over three months to assess nursing knowledge and the effectiveness of the STPP on skin tear prevention. The authors developed a Skin Tear Prevention Intervention Questionnaire (STPIQ) in collaboration with wound care nurses. A scoring tool was utilized to evaluate the STPIQ content for validity and reliability, and questionnaire was then utilized with endoscopy nurses at baseline, one month and three months. A PowerPoint presentation summarizing skin tear prevention measures specific to the endoscopy setting was provided to staff via work emails, presented at staff meetings and discussed in walking rounds. The Skin Tear Risk Assessment Tool (STRAT) was adapted for the endoscopy setting and was completed on all patients ages 65 or older upon admission and included a list of skin tear risk factors, suggested interventions based on the risk assessment, and a reminder to complete all documentation. The admitting, procedural, and recovery nurses were all responsible for completing the STRAT and implementing the appropriate STPP interventions. The endoscopy nurses implemented 911 skin tear prevention interventions and there was a 66% reduction in skin tears over the three months of the study.
How does this research article compare to our practice, policy, and procedure? In this article the staff took a multifaceted approach that included teaching, assessing patients for risk factors, and skin tear prevention protocol implementation. In our practice I feel that although during our assessment we identify patients at risk for shearing and skin tear injuries, that all to often we rush and do not implement proper prevention such as proper lifting equipment or using adhesive remover even though these tools are readily available. I feel that with more education and reinforcement of policies and procedures the hospital as a whole might be able to cut down on skin tear injuries, much like was done in this study.
What are the advantages and disadvantages to the proposed recommendations in the article? The advantages to the proposed recommendations in the article would be to reduce the number of skin tears suffered during the hospital stay. This would greatly improve patient satisfaction and outcomes and also reduce costs in extra resources, time, diagnostics, and treatment and law suits that may arise from skin tears that arise from improper care. The disadvantages of the recommendations proposed in this article is the extra cost of educating the staff and the time it would take to implement even more policy and procedure into an already cramped schedule. Overall I believe the benefits outweigh the costs of implementing the recommendations of the skin tear prevention interventions.
April article: Assessing Knowledge Among Endoscopy Nurses With Implementation of a Skin Tear Prevention Intervention
Question #1: Discuss the sample size used in the study.
The endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ, served as the setting for this evidence-based skin tear prevention quality improvement project. Endoscopy is a fast-paced and vibrant patient care area that serves high and low- acuity patients of all ages. Patients in endoscopy could have originated as outpatients, inpatients, from the emergency room, or the ICU. The inclusion criteria for the study involved registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ). Nursing experience averaged was 14.7 years for theses endoscopy nurses.
Question #2: What are the advantages and disadvantages to the proposed recommendations in the article?
The article proposed Skin Tear Prevention Protocol Design. The proposal included on educating staff on best practices, identifying at-risk patients, and using a skin tear prevention bundle that includes skin preparation wipes, stockinette limb coverings, safe patient handling techniques, and adhesive remover wipes. The form of education included a power point presentation summarizing the skin tear prevention measures to endoscopy setting, printed educational materials, rounds discussion.
Skin Tear Prevention Bundle included applying skin prep before using adhesives, using adhesive remover wipes, for all tape and dressing removal, placing stockinette sleeves on the upper extremities if proning or turning the patient, and employing proper techniques while moving and repositioning patients.
I see these proposals as more advantageous not just in the endoscopy settings but wherever & whenever it is necessary, especially while a patient is hospitalized. The advantages can comprise of providing better if not excellent care to patients, improve nursing skills competence, lesser number of hospitalizations days related to complications, etc.
What I see as a disadvantage is the cost. Although it is projected as less than $ 2 per patient with cumulative cost, it will an additional expenditure.
March article: Leaving Slings and Other Transfer Devices Under Patients: A Clinical Decision Support Quality Improvement Project
Question # 1: Discuss the research question or main problem discussed in the study?
The article's evidence suggested that sling and transfer device use is a cause of hospital-acquired pressure injuries, and therefore skin protection must be considered when using these devices. The Veterans Health Administration facilities utilize fabric slings with safe patient handling and mobility equipment for patient transfers. Knowledge or best practice regarding the safety of leaving slings under patients' skin has not been established. To address this evidence gap, the Veterans Integrated Services Network (VISN) Patient Safety Center of Inquiry (PSCI) conducted a quality improvement project to develop guidance regarding leaving slings and other transfer devices under patients and potential for skin or pressure injury risk. The purpose of this report is to describe current use of slings and transfer devices at VHA facilities and introduce a guidance document that may be used to facilitate best practices in use of transfer equipment
Question #2: Describe the method used by the author of the study
Quality improvement project activities were conducted from October 2019 to September 2021 using a mixed-methods rapid assessment approach. The objectives were to collect data about common practices at VHA facilities related to leaving slings under patients, examine reported patient transfer practices and associations with rates of inpatient pressure injuries, and evaluate current practices against best available evidence to develop guidance about safely using slings to reduce pressure injury and skin injury risk. The data collection techniques were cross-sectional surveys, electronic health record review, and qualitative interviews. This project was determined to be quality improvement (QI) by the James A. Haley Veterans’ Hospital Research and Development Committee and therefore exempt from additional Institutional Review Board. The feedback on practices and perceptions related to leaving slings and other transfer devices was evaluated using online cross-sectional surveys and interviews with VHA staff. Secondary data for VHA inpatient rates of pressure injury were used to examine associations with staff-reported sling and other transfer device practices.
February article: Intensive Care and Operating Room Nurses’ Knowledge Regarding Skin Tears
Question #1 Discuss the research question or main problem discussed in the study?
Skin tears are common injuries, especially in hospital-based settings such as intensive care and operating rooms. These injuries usually occur as a result of skin vulnerability and incorrect use of medical devices. Nurses have an important role in the prevention, early detection and management of skin tears. Previous research has shown that nurses' knowledge of skin tears varies and is sometimes inadequate. There are a limited number of studies comparing the knowledge levels of operating room and intensive care nurses. The questions that were addressed in this study were the level of knowledge of operating room and intensive care nurses regarding skin tear and the factors that are affecting their level of knowledge.
Question #2: Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several limitations which should be taken into consideration when interpreting the findings. The sample of the study was limited to nurses in a specific institution, and the generalizability of the results to the entire population of nurses is limited. Data were collected through self-report, and nurses' preventive interventions for skin tears and the accuracy of their implementation could not be assessed through direct observation. Therefore, additional research is recommended to determine the factors that prevent the dissemination of accurate knowledge and practices and the underlying causes of these factors.
January article: Predictors of Patient Participation in Pressure Injury Prevention: An Observational Sub study
Question #1 Discuss the sample size used in the study
The parent trial inclusion criteria were adults admitted in the previous 36h to medical and surgical units of three large metropolitan hospitals, whose expected hospital length of stay was greater than 24h and who were at high risk for a pressure injury. In the state where the study took place, hospitals used the Water low scale as a risk assessment tool. Therefore, patients at risk of pressure injury were defined as either a Water low score of ≥10 or patients who had limited mobility. Patients were excluded if they were unable to be turned, had an existing sacral pressure injury or other lesion in the sacral area at the time they were recruited, had urinary or fecal incontinence , or were unable to speak or understand English if no interpreter was present. When individuals are incontinent, the dressing manufacturer recommends a different process for dressing application, which introduces a difference in the way the dressings are applied within the intervention group. Therefore, the parent trial excluded patients with Incontinence. All participants in the parent trial were included in this analysis. A power analysis showed that with eight predictors, a sample size of 766 would have >95% power to detect a small effect (0.03) with an alpha of p<0.05 [27]. This sample size also allows us to assess the scale's psychometric properties
Question #2 Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several strengths, including its large, adequately Powered sample, providing confidence in the study's results. They also used an instrument that had previously been shown to be valid and reliable. While most fit statistics were met in their study, and were similar to those previously reported for this scale, two were not. However, given the chi-square is sensitive to large samples, this was not unexpected. Additionally, room mean square error of approximation values of 0.05 to 0.08 are generally considered acceptable, with values 0.0.08–0.1 marginally acceptable, thus some use the criteria of <0.10 [29, 36] which was met in their study. Thus, we conclude the PPPIP scale is valid and reliable. This research also has some limitations. First, because participants were part of a larger clinical trial with strict inclusion and exclusion criteria, the findings may not be generalizable to patients not at pressure injury risk, not incontinent, or not in a pressure injury study. Second, they did not have data on patients' current health status. They used the number of comorbidities as a proxy for health status, but recognize the two are not the same. Third, we they not measure actual PIP behavior; patient participation was self-reported. Finally, their model predicted a very small amount of variance in scale scores.
Bethany Sobesto 5/16/26 Discuss the limitations of the article: limited sample size, design flaws, and/or author bias The sample size was small and they only included patients in the GI endoscopy area. More studies need to be done to see if is feasible to do the skin tear risk assessments on other floors in the hospital. Also, the number of skin tears reported relied on nurses reporting of them. This self reporting may not have been accurate or reliable since some nurses are not honest about the number of skin tears they assess or they are too busy to do a thorough assessment of the patients. What are the advantages and disadvantages to the proposed recommendations in the article? The advantages would be a decrease in the number of skin tears in patients and potentially a higher patient patient satisfaction score. As more nurses are educated on how to prevent skin tears, they can do things such as use adhesive remover when removing a dressing, use no sting barrier to protect skin before applying an IV tegaderm dressing, and be careful not to quickly/aggressively rip off tape from the patient's skin. A disadvantage is the time it takes to educate nurses on skin tear prevention and the increase in cost associated with having to use extra supplies. Although, the increase in cost was only $2 per patient in this research study, so I believe the increase in cost is worth it to help protect the patient's skin.
Discuss the sample size used in the study A feasibility study was used to measure nursing knowledge on skin tear prevention in endoscopy and nurse satisfaction with the skin tear prevention protocol .A pre/post survey was used to measure nursing knowledge at baseline ,one month ,and three months post protocol implementation.Over the three month study 537 endoscopy patients >65 years old were identified to be at risk for skin tears .Endoscopy nurses implemented 911 skin tear prevention nursing interventions.This project demonstrated an 88% gain in nursing knowledge and a 66% skin tear reduction in endoscopy .The findings provide an optimistic outlook for skin tear prevention in endoscopy settings . For assessing endoscopy nurses during new protocol or checklist implementations ,a sample size of 60-120 participants (or about 30 to 60 per group )is typical for experiment or pilot studies Endoscopy patients >65 years old who often present with the risk factor for skin tears ,e.g advanced age ,chronic health issues ,limited mobility, and compromised integumentary ,were the focus of a skin tear prevention intervention .This evidence -based quality improvement project and feasibility study with a pre/post timed series survey design had three main goals to design and implement an evidence based skin tear prevention protocol for endoscopy ,evaluate this protocol for usability and effectiveness and assess endoscopy nurses skin tear prevention knowledge .
What are the advantages and disadvantages to the proposed recommendations in the article? Implementing a skin tear prevention and management protocol in an endoscopy setting offers significant clinical and operational benefits ,primarily by reducing patient and injury ,but requires navigating some practical challenges like additional staff documentation .Advantages such as Fewer Injuries and less pain by utilizing risk assessment tools and safety equipment
.Cost Efficiency by preventing tears translates directly to lower material usage ,shorter patient turnaround times and reduced health care cost
..Improved knowledge and Satisfaction by education initiatives yields substantial gains in nursing confidence, enabling staff to handle acute wounds quickly and effectively.Better Patient Experience by avoiding traumatic wounds protects patient dignity and satisfaction
While the Disadvantages are as follows Increased initial workload by admitting and procedural nurses must take the time to complete risk assessments and communicate per patient skin tear risk
Documentation Burden by which nurses face the added task or detailed clinical documentation -classifying the wound and recording the exact cause and treatment pathway
Learning curve by which adapting to modern wound management techniques
Fast Paced Constraints wherein taking time to precisely reapproximate tiny ,fragile skin flaps can be challenging during busy quick turn around lists .
Discuss the sample size used in the study
ReplyDelete-The endoscopy department of 427 bed suburban community hospital served as a setting for the evidence- based skin tear prevention quality improvement project. Patients in endoscopy may originate from out patient ,inpatient, emergency room or ICU.The inclusion criteria for the study included registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ) Nursing experience averaged 14.7 years for theses endoscopy nurses.
Describe the method used by the author of the study
- A multidisciplinary approach was implemented to create an endoscopic specific STPP Skin Tear Prevention Protocol, including review of current literature and collaboration with wound care nurse, physical therapists and endoscopy staff. Appropriate prevention measures identified for endoscopy included staff education on best practice, identification of at risk patients, and using a skin tear prevention bundle. For 12 weeks of study, a paper copy of the STRAT ( skin tear risk assessment tool) was placed in patient’s medical chart.If patient was identified at risk , the nurse initiated appropriate STPP ( skin tear prevention protocol).It was then communicated between admitting and procedural nurse.The procedural nurse is responsible for continuing the STPP.The procedural nurse then communicated the risk assessment to recovery nurse who then continued the STPP. The admitting, procedural and recovery nurse are all responsible for verifying that documentation has been completed and that any new skin tear have been appropriately reported.
Research Question: Between spring and summer of 2022, a noticeable increase in skin tears was identified in the endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ. The goal of this evidence-based quality improvement project and feasibility study with a pre/post-timed series survey design had three main goals: to design and implement an evidence-based skin tear prevention protocol for endoscopy, evaluate this protocol for usability and effectiveness, and assess endoscopy nurse's skin tear prevention knowledge. A literature review revealed that no studies on skin tear incidents or prevention in the endoscopy setting could be found leaving the question related to best practices for skin tear prevention in endoscopy unanswered. A multidisciplinary team approach was needed. One survey revealed a concerning lack of knowledge among nurses regarding skin tear risk assessment, prevention and treatment regardless of their educational background and experience. A systematic review found that implementing a skin tear bundle, regardless of the individual components, leads to decreased skin tear incidence, and early identification of at-risk patients is key. Additional studies regarding safe patient handling to prevent tears from friction and sheering, the use of limb coverings and best practice adhesive removal strategies in settings other than that of endoscopy were reviewed.
ReplyDeleteMethods: A feasibility study with a pre/post-timed series survey design was developed and conducted over three months to assess nursing knowledge and the effectiveness of the STPP on skin tear prevention. The authors developed a Skin Tear Prevention Intervention Questionnaire (STPIQ) in collaboration with wound care nurses. A scoring tool was utilized to evaluate the STPIQ content for validity and reliability, and questionnaire was then utilized with endoscopy nurses at baseline, one month and three months. A PowerPoint presentation summarizing skin tear prevention measures specific to the endoscopy setting was provided to staff via work emails, presented at staff meetings and discussed in walking rounds. The Skin Tear Risk Assessment Tool (STRAT) was adapted for the endoscopy setting and was completed on all patients ages 65 or older upon admission and included a list of skin tear risk factors, suggested interventions based on the risk assessment, and a reminder to complete all documentation. The admitting, procedural, and recovery nurses were all responsible for completing the STRAT and implementing the appropriate STPP interventions. The endoscopy nurses implemented 911 skin tear prevention interventions and there was a 66% reduction in skin tears over the three months of the study.
How does this research article compare to our practice, policy, and procedure? In this article the staff took a multifaceted approach that included teaching, assessing patients for risk factors, and skin tear prevention protocol implementation. In our practice I feel that although during our assessment we identify patients at risk for shearing and skin tear injuries, that all to often we rush and do not implement proper prevention such as proper lifting equipment or using adhesive remover even though these tools are readily available. I feel that with more education and reinforcement of policies and procedures the hospital as a whole might be able to cut down on skin tear injuries, much like was done in this study.
ReplyDeleteWhat are the advantages and disadvantages to the proposed recommendations in the article? The advantages to the proposed recommendations in the article would be to reduce the number of skin tears suffered during the hospital stay. This would greatly improve patient satisfaction and outcomes and also reduce costs in extra resources, time, diagnostics, and treatment and law suits that may arise from skin tears that arise from improper care. The disadvantages of the recommendations proposed in this article is the extra cost of educating the staff and the time it would take to implement even more policy and procedure into an already cramped schedule. Overall I believe the benefits outweigh the costs of implementing the recommendations of the skin tear prevention interventions.
ReplyDeleteApril article: Assessing Knowledge Among Endoscopy Nurses With Implementation of a Skin Tear
ReplyDeletePrevention Intervention
Question #1: Discuss the sample size used in the study.
The endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ, served as the setting for this evidence-based skin tear prevention quality improvement project. Endoscopy is a fast-paced and vibrant patient care area that serves high and low- acuity patients of all ages. Patients in endoscopy could have originated as outpatients, inpatients, from the emergency room, or the ICU. The inclusion criteria for the study involved registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ). Nursing experience averaged was 14.7 years for theses endoscopy nurses.
Question #2: What are the advantages and disadvantages to the proposed recommendations in the article?
The article proposed Skin Tear Prevention Protocol Design. The proposal included on educating staff on best practices, identifying at-risk patients, and using a skin tear prevention bundle that includes skin preparation wipes, stockinette limb coverings, safe patient handling techniques, and adhesive remover wipes. The form of education included a power point presentation summarizing the skin tear prevention measures to endoscopy setting, printed educational materials, rounds discussion.
Skin Tear Prevention Bundle included applying skin prep before using adhesives, using adhesive remover wipes, for all tape and dressing removal, placing stockinette sleeves on the upper extremities if proning or turning the patient, and employing proper techniques while moving and repositioning patients.
I see these proposals as more advantageous not just in the endoscopy settings but wherever & whenever it is necessary, especially while a patient is hospitalized. The advantages can comprise of providing better if not excellent care to patients, improve nursing skills competence, lesser number of hospitalizations days related to complications, etc.
What I see as a disadvantage is the cost. Although it is projected as less than $ 2 per patient with cumulative cost, it will an additional expenditure.
March article: Leaving Slings and Other Transfer Devices Under Patients: A Clinical Decision Support Quality Improvement Project
ReplyDeleteQuestion # 1: Discuss the research question or main problem discussed in the study?
The article's evidence suggested that sling and transfer device use is a cause of hospital-acquired pressure injuries, and therefore skin protection must be considered when using these devices. The Veterans Health Administration facilities utilize fabric slings with safe patient handling and mobility equipment for patient transfers. Knowledge or best practice regarding the safety of leaving slings under patients' skin has not been established. To address this evidence gap, the Veterans Integrated Services Network (VISN) Patient Safety Center of Inquiry (PSCI) conducted a quality improvement project to develop guidance regarding leaving slings and other transfer devices under patients and
potential for skin or pressure injury risk. The purpose of this report is to describe current use of slings and transfer devices at VHA facilities and introduce a guidance document that may be used to facilitate best practices in use of transfer equipment
Question #2: Describe the method used by the author of the study
Quality improvement project activities were conducted from October 2019 to September 2021 using a mixed-methods rapid assessment approach. The objectives were to collect data about common practices at VHA facilities related to leaving slings under patients, examine reported patient transfer practices and associations with rates of inpatient pressure
injuries, and evaluate current practices against best available evidence to develop guidance about safely using slings to reduce pressure injury and skin injury risk. The data collection techniques were cross-sectional surveys, electronic health record review, and qualitative interviews. This project was determined to be quality improvement (QI) by the James A. Haley Veterans’ Hospital Research and Development Committee and therefore exempt from additional Institutional Review Board.
The feedback on practices and perceptions related to leaving slings and other transfer devices was evaluated using online cross-sectional surveys and interviews with VHA staff. Secondary data for VHA inpatient rates of pressure injury were used to examine associations with staff-reported sling and other transfer device practices.
February article: Intensive Care and Operating Room Nurses’ Knowledge Regarding Skin Tears
ReplyDeleteQuestion #1 Discuss the research question or main problem discussed in the study?
Skin tears are common injuries, especially in hospital-based settings such as intensive care and operating rooms. These injuries usually occur as a result of skin vulnerability and incorrect use of medical devices. Nurses have an important role in the prevention, early detection and management of skin tears. Previous research has shown that nurses' knowledge of skin tears varies and is sometimes inadequate. There are a limited number of studies comparing the knowledge levels of operating room and intensive care nurses.
The questions that were addressed in this study were the level of knowledge of operating room and intensive care nurses regarding skin tear and the factors that are affecting their level of knowledge.
Question #2: Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several limitations which should be taken into consideration when interpreting the findings. The sample of the study was limited to nurses in a specific institution, and the generalizability of the results to the entire population of nurses is limited. Data were collected through self-report, and nurses' preventive interventions for skin tears and the accuracy of their implementation could not be assessed through direct observation. Therefore, additional research is recommended to determine the factors that prevent the dissemination of accurate knowledge and practices and the underlying causes of these factors.
January article: Predictors of Patient Participation in Pressure Injury Prevention: An Observational Sub study
ReplyDeleteQuestion #1 Discuss the sample size used in the study
The parent trial inclusion criteria were adults admitted in the previous 36h to medical and surgical units of three large metropolitan hospitals, whose expected hospital length of stay was greater than 24h and who were at high risk for a pressure injury. In the state where the study took place, hospitals used the Water low scale as a risk assessment tool. Therefore, patients at risk of pressure injury were defined as either a Water low score of ≥10 or patients who had limited mobility. Patients were excluded if they were unable to be turned, had an existing sacral pressure injury or other lesion in the sacral area at the time they were recruited, had urinary or fecal incontinence , or were unable to speak or understand English if no interpreter was present. When individuals are incontinent, the dressing manufacturer recommends a different process for dressing application, which introduces a
difference in the way the dressings are applied within the intervention group. Therefore, the parent trial excluded patients with Incontinence. All participants in the parent trial were included in this analysis. A power analysis showed that with eight predictors, a sample size of 766 would have >95% power to detect a small effect (0.03) with an alpha of p<0.05 [27]. This sample size also allows us to assess the scale's psychometric properties
Question #2 Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several strengths, including its large, adequately Powered sample, providing confidence in the study's results. They also used an instrument that had previously been shown to be valid and reliable. While most fit statistics were met in their study, and were similar to those previously reported for this scale, two were not. However, given the chi-square is sensitive to large samples, this was not unexpected. Additionally, room mean square error of approximation values of 0.05 to 0.08 are generally considered acceptable, with values 0.0.08–0.1 marginally acceptable, thus some use the criteria of <0.10 [29, 36] which was met in their study. Thus, we conclude the PPPIP scale is valid and reliable.
This research also has some limitations. First, because participants were part of a larger clinical trial with strict inclusion and exclusion criteria, the findings may not be generalizable to patients not at pressure injury risk, not incontinent, or not in a pressure injury study. Second, they did not have data on patients' current health status. They used the number of comorbidities as a proxy for health status, but recognize the two are not the same. Third, we they not measure actual PIP behavior; patient participation was self-reported. Finally, their model predicted a very small amount of variance in scale scores.
Bethany Sobesto 5/16/26
ReplyDeleteDiscuss the limitations of the article: limited sample size, design flaws, and/or author bias
The sample size was small and they only included patients in the GI endoscopy area. More studies need to be done to see if is feasible to do the skin tear risk assessments on other floors in the hospital. Also, the number of skin tears reported relied on nurses reporting of them. This self reporting may not have been accurate or reliable since some nurses are not honest about the number of skin tears they assess or they are too busy to do a thorough assessment of the patients.
What are the advantages and disadvantages to the proposed recommendations in the article?
The advantages would be a decrease in the number of skin tears in patients and potentially a higher patient patient satisfaction score. As more nurses are educated on how to prevent skin tears, they can do things such as use adhesive remover when removing a dressing, use no sting barrier to protect skin before applying an IV tegaderm dressing, and be careful not to quickly/aggressively rip off tape from the patient's skin. A disadvantage is the time it takes to educate nurses on skin tear prevention and the increase in cost associated with having to use extra supplies. Although, the increase in cost was only $2 per patient in this research study, so I believe the increase in cost is worth it to help protect the patient's skin.
Discuss the sample size used in the study
ReplyDeleteA feasibility study was used to measure nursing knowledge on skin tear prevention in endoscopy and nurse satisfaction with the skin tear prevention protocol .A pre/post survey was used to measure nursing knowledge at baseline ,one month ,and three months post protocol implementation.Over the three month study 537 endoscopy patients >65 years old were identified to be at risk for skin tears .Endoscopy nurses implemented 911 skin tear prevention nursing interventions.This project demonstrated an 88% gain in nursing knowledge and a 66% skin tear reduction in endoscopy .The findings provide an optimistic outlook for skin tear prevention in endoscopy settings .
For assessing endoscopy nurses during new protocol or checklist implementations ,a sample size of 60-120 participants (or about 30 to 60 per group )is typical for experiment or pilot studies
Endoscopy patients >65 years old who often present with the risk factor for skin tears ,e.g advanced age ,chronic health issues ,limited mobility, and compromised integumentary ,were the focus of a skin tear prevention intervention .This evidence -based quality improvement project and feasibility study with a pre/post timed series survey design had three main goals to design and implement an evidence based skin tear prevention protocol for endoscopy ,evaluate this protocol for usability and effectiveness and assess endoscopy nurses skin tear prevention knowledge .
What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteImplementing a skin tear prevention and management protocol in an endoscopy setting offers significant clinical and operational benefits ,primarily by reducing patient and injury ,but requires navigating some practical challenges like additional staff documentation .Advantages such as Fewer Injuries and less pain by utilizing risk assessment tools and safety equipment
.Cost Efficiency by preventing tears translates directly to lower material usage ,shorter patient turnaround times and reduced health care cost
..Improved knowledge and Satisfaction by education initiatives yields substantial gains in nursing confidence, enabling staff to handle acute wounds quickly and effectively.Better Patient Experience by avoiding traumatic wounds protects patient dignity and satisfaction
While the Disadvantages are as follows
Increased initial workload by admitting and procedural nurses must take the time to complete risk assessments and communicate per patient skin tear risk
Documentation Burden by which nurses face the added task or detailed clinical documentation -classifying the wound and recording the exact cause and treatment pathway
Learning curve by which adapting to modern wound management techniques
Fast Paced Constraints wherein taking time to precisely reapproximate tiny ,fragile skin flaps can be challenging during busy quick turn around lists .