Pressure Ulcers and Related Risk Assessment Scales

Introduction

The article was written by Araújo, Araújo, and Caetano (2011) “Comparison of risk assessment scales for pressure ulcers in critically ill patients” which discusses whether nurses can improve their performance and benefit consumers when using not only clinical judgment but also scales to predict pressure ulcers. This paper perfectly meets the framework of the PICOT question due to its focus. What is more, it was published in a journal that provides the outcomes of original research for them to be used in practice by healthcare professionals, which proves its authoritativeness.

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Main body

This research article presents quantitative data that was gathered through the exploratory and longitudinal study. The authors conducted their research in spring 2009. They referred to three intensive care units in Brazil to find those patients who would meet the needs of the study. As a result, the sample included 42 critically ill individuals. The evaluation of their condition lasted for 10-15 days, depending on their state. As this research was focused on the assessment of three different scales, three nurses were asked to maintain evaluation at the same time so that each of them could focus only on one scale.

The problem on which the discussed paper is concentrated in the incidence of hospital-acquired pressure ulcers in critically ill patients. The purpose of this research article is to compare three risk assessment tools for pressure ulcers, including the Norton, Braden, and Waterlow scales to find out which one can benefit patients the most. In this framework, the authors tried to answer such questions as 1) whether these tools ensure an accurate assessment; 2) can they really improve the clinical practice, and 3) what scale brings the most benefit.

The findings were obtained due to the research study related to the framework. They are based on the patients’ initial condition and their pre-existing diseases because they have enormous influence on the results. Then it is considered how many patients developed pressure ulcers, and their stage is identified. The daily average score for each scale is also defined.

It can be claimed that the professionals obtained the expected findings because they considered that the usage of the risk assessment scales would improve the prediction of pressure ulcers and have a positive influence on the patients’ condition. However, the researchers were not sure which of the assessed scales would be the most beneficial and did not try to predict it to avoid biases.

Still, the findings were not totally consistent with previous studies, as the authors mention that other professionals identified “Braden and Norton scales as presenting better results”, while their study revealed opposite outcomes (Araújo, Araújo, & Caetano, 2011, p. 699). However, other publications turned out to have the same conclusions as those made by the authors, which supports their findings. The professionals do not emphasize any serendipitous findings revealed during the research. Still, it can be possible to identify the prevalence of injuries as well as their severity (the stage of pressure ulcers).

The researchers report several limitations of the study, such as the absence of heel injuries division, the time of the monitoring, and the size of the sample. In their conclusions, the researchers focused on the comparison of scales and did not discuss the severity of injuries. Still, it did not prevent them from answering those questions they had. Considering their limitations, the authors offer legitimate recommendations for further research.

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Conclusion

This article can be advantageous for my practice, as it discusses the usage of the Braden and Waterlow scale in the framework of hospital-acquired pressure ulcer prediction. It allows considering the improvement of care that can be reached when being not limited to clinical judgment and define which scale is better to use.

Reference

Araújo, T., Araújo, M., & Caetano, J. (2011). Comparison of risk assessment scales for pressure ulcers in critically ill patients. Acta Paulista de Enfermagem, 24(5), 695-700.

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