Competent nursing practice requires continuous improvement of skills and knowledge about the technologies, procedures, and approaches to health care based on research-informed data. The medical findings obtained using research efforts form a substantial evidential basis for nursing practice that ensures the highest quality of health care services. Thus, evidence-based practice contributes to nursing competency by improving the quality of information behind the treatment or prevention choices. Such an important and prevalent issue as hospital-acquired pressure ulcers impacts immobile patients across the country and the world. That is why, to prevent this health condition from developing and leading to comorbidities and poor life quality, evidence-based practice should be prioritized. The academic literature provides substantial evidence for the formation of a solid and effective pressure ulcer prevention program as a nursing practice approach for the identified issue.
An evidence-based approach is a nursing practice that is based on scientifically validated data applied to treatment and care. In particular, the program for lesion prevention is based on the evidence retrieved from up-to-date research on the patterns in pressure ulcer development, the most vulnerable patients, the best procedures that minimize harm, and ensure positive outcomes for patients (Sayilan, 2019). To develop evidence-based practice, a nurse should establish the question first, which is how to minimize the prevalence of pressure ulcers in immobile patients. After that, the search for evidence should be initiated, found information must be critically analyzed, implemented in practice, and finally evaluated as per the effectiveness (American Association of Nurse Anesthetists [AANA], 2020). When considering the application of a pressure ulcer prevention program, the best evidence should be found from literature, it should be critically assessed against the needs of the target population, and the best evidence should be implemented (Martin et al., 2017). To ensure that evidence-based practice is thoroughly implemented, such criteria as scientifically approved data, nursing clinical expertise, and direct patient outcomes are used.
Despite the overall advantages of implementing evidence-based practice in nursing and its vital importance in incompetent patient care, numerous obstacles, and challenges impeding the development of evidence-based interventions. Firstly, given the contemporary staff shortage observed nationwide, the irrelevant nurse-patient ratio implies an increased workload for nurses related to their direct duties of patient care delivery. Therefore, time constraints might be considered one of the barriers to evidence-based practice implementation. Secondly, the lack of organizational assistance and guidance for evidence-based research might cause difficulty in nurses’ attempts to research clinical problems and apply evidence-based strategies to solve them.
Effective clinical scholarship as an intellectual process of health care workers’ engagement in scientific work is essential for evidence-based practice. Indeed, evidential data retrieved in the course of scholarship activities is the key source of scientific information that becomes an objective, reliable, and verifiable foundation for the most competent and positive result-oriented nursing care. The evidence is evaluated according to its compliance with the three components, including patient preference and values, clinical expertise, and the best research information (AANA, 2020). Evidence might be evaluated as per its effectiveness, reliability, and relevance using either quantitative or qualitative inquiry.
According to the problem presented before, a clinical question that might be addressed with evidence-based practice is as follows. In patients with impaired mobility, how effective is the use of smart hospital beds for pressure ulcer prevention, in comparison to patients subject to standard care, in pressure ulcer development minimization? An exemplar article of evidence-based nursing that addresses the presented clinical question is the research study conducted by Khaleghi (2018). The method of a non-systematic review was used to analyze the effectiveness of smart hospital beds equipped with wireless sensors in patients at risk of ulceration.
The study procedures were carried out with a high level of precision. Khaleghi (2018) reviewed 45 academic articles published between 1974 and 2014 that provided evidence concerning the outcomes and implications of smart bed utilization for bed sores prevention. Three types of sensors, the particularities of their use, advantages, and challenges were identified. The study found that sensor technologies used for smart beds are capable of significantly reducing pressure ulcers and might be effectively used for monitoring severe health conditions (Khaleghi, 2018). A sufficient number of articles, a wide time frame, and quantitative data analysis contribute to the evidence’s reliability and applicability. This example of qualitative research vividly illustrates how clinical assumptions and ideas, as per the improvement of nursing care and patient outcomes, might be analyzed by scientific means. The study’s ultimate results contribute to the scope of evidence on the clinical question and comprise a solid background for the development of evidence-based practice. However, there are knowledge gaps regarding the technical capacity of hospitals for the effective utilization of this technology since it requires an advanced information system implemented in a facility.
The implementation of such evidence-based practice would necessitate proper consideration of regulatory and ethical standards. As it has been addressed by Hahnel et al. (2020), the newly designed evidence-based practice must comply with the requirements of the hospital’s pressure ulcer prevention standards. Therefore, to implement pressure ulcer prevention care using smart hospital beds, a nurse should ensure the intervention’s compliance with regulatory issues and facilitate adherence to ethical considerations. The intersection of the medical sphere and information technology implies the necessity to address ethical considerations related to technology and healthcare. Therefore, it must be ensured that the implemented procedure is reliable, non-harmful, based on solid evidence, carried out with transparency, competence, and responsibility. Respect for patient autonomy and privacy might be challenging due to the continuous monitoring of movements and actions. Similarly, the personal data visible to third parties without the patient’s awareness might be subject to stigmatizing and psychological burden, which is to be addressed when delivering care with the help of smart bed technologies.
American Association of Nurse Anesthetists. (2020). Evidence-based practice.
Hahnel, E., El Genedy, M., Tomova‐Simitchieva, T., Haub, A., Stroux, A., Lechner, A.,… & Kottner, J. (2020). The effectiveness of two silicone dressings for sacral and heel pressure ulcer prevention compared with no dressings in high‐risk intensive care unit patients: A randomized controlled parallel‐group trial. British Journal of Dermatology, 183(2), 256-264.
Khaleghi, L. (2018). A review on equipped hospital beds with wireless sensor networks for reducing bedsores. Journal of Nursing and Healthcare, 3(3), 1-8.
Martin, D., Albensi, L., Van Haute, S., Froese, M., Montgomery, M., Lam, M.,… & Basova, N. (2017). Healthy skin wins: A glowing pressure ulcer prevention program that can guide evidence‐based practice. Worldviews on Evidence‐Based Nursing, 14(6), 473-483.
Sayilan, A. A. (2019). Evidence-based practices for the prevention of pressure ulcers. Saglık Hizmetleri ve Egitimi Dergisi, 3(1), 7-10. Web.