In Sprakes and Tyrer’s (2010) research article entitled “Improving Wound and Pressure Area Care in a Nursing Home”, the effectiveness of wound and pressure ulcer management was examined. The rate of wounds and pressure ulcers in a nursing home is often an indicator of the quality of care received as these injuries can lead to illness and a decreased quality of life (Sprakes & Tyrer, 2010). Sprakes and Tyrer have identified gaps in overall management of wound and pressure ulcers. They have also identified a large volume of referrals regarding advice and support for wounds and pressure ulcers.
For these reasons the authors’ research was aimed toward whether utilization of a new wound and pressure ulcer management system in the nursing home would decrease rate and severity of these injuries (Sprakes & Tyrer, 2010). The reason this article was selected for critique was due to personal encounters with pressure ulcers in the nursing home setting and first-hand observations of the debilitating effects they can have on an individual. Summary Research took place in a nursing home that was selected due to observations of poorly managed wounds and pressure ulcers.
The authors’ overall aim of the research was to “improve outcomes for patients requiring wound and pressure ulcer management” (Sprakes & Tyrer, 2010, p. 47). The authors planned on meeting this goal through improving staff knowledge, improving documentation, and finally encouraging owners to uphold the proper standards of care. Before implementing their management framework, the authors obtained data to establish a control. The authors collected data over a six month period regarding frequency of wounds and pressure ulcers and regarding the number of times additional support nurses were contacted to aid with wounds/pressure ulcers.
Next, staff knowledge was assessed regarding wound and pressure ulcer assessment and management (Sprakes & Tyrer, 2010). The authors then created a unique competency-based framework. This competency-based framework served as the standard of care to be used throughout the project. It also served as an evaluating tool when measuring staff performance. From there the authors then went on to discuss the project with the staff. Concerns, barriers, and benefits were all discussed as the authors felt “if staff understand why change is occurring, they are more likely to implement the required change” (Sprakes & Tyrer, 2010, p.
47). When implementing their competency-based framework the authors selected four nurses to be supported through the program. Only four were chosen due to the amount of time required to support each individual member. The four nurses then received two theoretical training sessions with a day on wound assessment and a day on pressure ulcer prevention and management (Sprakes & Tyrer, 2010). Once complete, the nurses worked alongside one of the authors in implementing the framework in the clinical setting. Completion of the process took an average of six weeks per nurse (Sprakes & Tyrer, 2010).
After completion of the program the four nurses had their knowledge reassessed and another set of data was collected over a six month period to allow time for the nursing staff to incorporate the framework into practice (Sprakes & Tyrer, 2010). After analyzing the data, the authors found a 77% decrease in the number of wounds and a 57% decrease in the number of pressure ulcers. The data also revealed a significant increase in wound and pressure ulcer documentation and a decrease in the number of contacts to supportive nurses. When reassessed the staff demonstrated an increase in knowledge and skill.
Overall the authors came to the conclusion that both the nursing staff and patients considerably benefited from the project. Based off the results, they encourage the implementation of similar projects in other nursing homes (Sprakes & Tyrer, 2010). Analysis of the authors’ references affirms their appropriateness to the study; however, 66% of the references used are not current as indicated by a publication date greater than 5 years. Critique Based on the article, the authors’ purpose of the study was apparent and the results were conclusive.
The authors’ decision to implement an evidenced-based wound assessment tool was a great choice as it significantly benefited documentation rates as one was not being used in the nursing home prior. Through this choice it was evident that the authors were able to help the nursing staff to “ensure the credibility of their profession and provide accountability for nursing care” (North Carolina Concept-Based Learning Editorial Board, 2011, p. 2324). When analyzing the study it clearly demonstrates the impact that proper guidelines and education can have on wound and pressure ulcer management.
Through education the authors were able to aid the nursing home in preventing the occurrence of more wound and pressure ulcers as “prevention is the goal for the clients at risk for pressure ulcers” (NCC-BLEB, 2011, p. 1918). Although this article is a good resource for information and statistics on wound and pressure ulcers, it is not recommended for individuals looking for particular nursing interventions used for wound and pressure ulcers. While the authors did broadly explain their competency-based framework, they lacked depth in explaining specific information and interventions taught and used throughout the project.
In conclusion, this work greatly contributes to the nursing profession because it created a unique quality management plan that has the potential to better numerous nursing homes and improve the lives of many patients. References North Carolina Concept-Based Learning Editorial Board. (2011). Nursing: A concept-based approach to learning (Vols. 1-2, pp. 1915-1926, 2324, 2425). Upper Saddle River, NJ: Pearson Education, Inc. Sprakes, K. , & Tyrer, J. (2010). Improving wound and pressure area care in a nursing home. Nursing Standard, 25(10), 43-49. Retrieved from http://search. ebscohost. com/login. aspx? direct=true&db=rzh&AN=2010893921&site=