Pressure Ulcers Study: Literature Review


There is a wide range of academic research devoted to the investigation of pressure ulcers (PU) and the methods of their prevention in a health care unit. The problem of hospital-acquired PUs is a critical subject of modern medical research due to the complexity of comorbidities associated with this condition. Bedridden patients hospitalized in a health care unit are predisposed to a variety of risks leading to a particular level of PU severity. Therefore, it is essential to collect and analyze the information about the current methods of PU prevention, treatment, and management to ensure the necessity of the study. In this paper, available research literature will be reviewed; research questions, sample populations, and limitations will be compared to validate the gap in research which the study aims to address.

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A Comparison of Research Questions

The scope of research purposes formulated in the research questions of the reviewed articles embraces several significant issues related to PU acquisition. The study by Bly, Schallom, Sona, and Klinkenberg (2016) focuses on the examination of the variables contributing to PU development and the comorbidities associated with them. The risk factors identified as variables were limited to the health conditions of the patients, use of medical devices, and bed surfaces (Bly et al., 2016). In their article, Qaseem, Mir, Starkey, and Denberg (2015) aim to identify the benefits and disadvantages of the utilization of PU risk assessment tools and preventative measures. The researchers question how effective the existing assessment instruments are and if they vary depending on the particularities of a patient’s condition.

Similarly, Black et al. (2015) investigate a specific measure of PU prevention. The researchers pose a research question initiating the identification of wound dressing effectiveness as a way to minimize PU in patients assisted with medical devices. This research, as well as the study by Bly et al. (2016), concentrates on the physical contact of tissue with other surfaces but does not include microclimate as one of the determinants of PU acquisition. Thus, the research questions of the reviewed articles primarily address standardized measures of prevention, their analysis, and the identification of a range of risk factors.

A Comparison of Sample Populations

The patient populations chosen for each of the analyzed articles are alike. Bly et al. (2016) concentrate on critically ill adult patients. Qaseem et al. (2015) addressed the needs of “all adults at risk for pressure ulcers” (p. 360). Finally, the research by Black et al. (2015) investigated the preventive measure of wound dressings for patients in critical care units. The comparison of the sample populations identified in the reviewed literature shows that the issue of Pus is commonly researched within critically ill bedridden individuals. Therefore, it is important to concentrate research on a more specific group of patients depending on the level of their predisposition in relation to the risk factors.

A Comparison of the Limitations of the Studies

Apart from a significant contribution to the scope of information about the prevention of PU development, the sources have their limitations imposed by the conditions of research. Firstly, the article by Qaseem et al. (2015) does not provide any clear justification of the efficacy of every proposed evaluation or prevention tool due to the limitation of the findings to one study. The efficacy of such preventative interventions as “nutritional supplementation, lotions, cleansers, and dressings” was not proven for the reason of the lack of evidence (Qaseem et al., 2015, p. 364). Black et al. (2015) found that it is essential to eliminate the usage of dressing under tight medical devices; however, the research does not provide evidence indicating the effect of thick dressing on PU prevention.

Besides, both Qaseem et al. (2015) and Black et al. (2015) identified the problems of staff coordination under PU management procedures. However, the researchers did not introduce any specific measures aimed at the organization of health care workers’ actions in response to the factors contributing to PU development. As for the research by Bly et al. (2016), this research concentrated primarily on the repositioning of a patient and his or her blood characteristics. The study’s limitations were associated with the lack of evidence about the effect of nutrition on PU development (Bly et al., 2016). These limitations form a significant gap in the research of PU and provide an opportunity to address the unexplored issues in the current study.

Conclusion and Recommendations for Further Research

Considering the research questions, populations, and limitations of the reviewed sources, one might emphasize the need for substantial research on PU management and prevention methods. None of the analyzed studies addressed hospital microclimate as a risk factor for PU acquisition. The sample population was too broad, which generalized the findings. Therefore, the current study aims at addressing the literature gaps. The implementation of techniques capable of addressing risk factors specific for a particular patient is required to eliminate a standardized approach to PU management and ensure patients’ safety and comfort when hospitalized. The population needs to be identified precisely with a focus on the particularities of the health conditions, level of predisposition to PU development, and microclimate of the hospital environment. As a result of the research, a concise practical, PU preventive tool for nurses’ application in the acute care setting needs to be introduced.

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Black, J., Alves, P., Brindle, C. T., Dealey, C., Santamaria, N., Call, E., & Clark, M. (2015). Use of wound dressings to enhance prevention of pressure ulcers caused by medical devices. International Wound Journal, 12(3), 322-327.

Bly, D., Schallom, M., Sona, C., & Klinkenberg, D. (2016). A model of pressure, oxygenation, and perfusion risk factors for pressure ulcers in the intensive care unit. American Journal of Critical Care, 25(2), 156-164.

Qaseem, A., Mir, T. P., Starkey, M., & Denberg, T. D. (2015). Risk assessment and prevention of pressure ulcers: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 359-369.

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