1PICOT STATEMENT Table of Contents PICOT statement.............................................................................................................................2 Patient population (P)..................................................................................................................2 Intervention (I).............................................................................................................................2 Comparison (C)...........................................................................................................................3 Outcome (O)................................................................................................................................3 Time Frame (T)............................................................................................................................4 References........................................................................................................................................5
2PICOT STATEMENT PICOT statement “In patients with long illness (P), how does good skincare (I) compared to the use of pressure reducing cushions mattresses (C) affects the recovery from HAPI- Hospital Acquired Pressure Injuries (O) within one year.” Patient population (P) The selected patient population is a group of people aged above 70 years associated with skin damages and mobility problems by dehydration and various other factors. These factors include illnesses associated with bed and post-surgery conditions. This population has been detected to have inabilities in moving and to be suffering from obesity or paralysis. According to the epidemiological reports 700,000 people have been found to be affected by pressure ulcer every year in various healthcare settings which include own home patients and the vulnerable patient who are aged over 75 years (Lachenbruch et al., 2016). This is the overall patient population of the PICOT analysis. Intervention (I) Patient skin must be kept clean and dry in order to avoid any injuries associate with pressure. Products or drugs, which dries out the human skin, should be avoided in order to prevent the occurrence of pressure ulcer in patients. A doctor or nurse must always take care of the fact that there are no physiological changes in patient skin. These changes mainly include swelling, soreness and redness (Bale et al., 2018). Regular bathing with soap and water will prevent the occurrence of pressure ulcers in the selected patient population. This intervention has been found to be related to building skin tolerance that is a gradual but effective process for the
3PICOT STATEMENT reduction of pressure ulcer prevalence among the patients. Use of foam pads and pillows are also associated with the protection of skin and bony areas. Two skin surfaces must not be allowed to rest against each other while sleeping (Hernandez, 2019). This factor has been spotted in various research studies associated with HAPI. Comparison (C) On comparing the interventions strategies, pressure-relieving mattresses, beds and seat cushions that are widely used in both non-institutional and institutional settings. This strategy has been studied in various research studies involving randomized controlled trials (RCT) (Bassinger, Kistler & Soule, 2016). According to various observations, Drive Medical deluxe gel wheelchair cushion and Wondergel Original Gel seat cushion has been identified as the best mattresses and cushions for the reduction of pressure ulcers. Memory foam has been used in regular nursing practices to envelop a steep and well-distributed pressure all over the body. Thus, it can be stated that a single part of the body is never pressurized after the use of mattresses for the patients. This is the main reason for foam mattress being the best mattress for bedsore preventions. Thus, it can be stated that although the use of cushions and mattress are more effective than skin cleaning in the prevention and treatment of HAPI, the first process is more costly than the process of skin cleaning. Outcome (O) The target outcome of this PICOT question is the prevention and recovery of patients from HAPI. Pressure ulcers have been found to affect a large number of long-term patients and inpatients in the hospital settings. These two strategies have been found to be effective in the reduction of pressure ulcer prevalence among various health care institutes where both short term and long term patients are admitted. According to various research studies, it can be stated that
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4PICOT STATEMENT even if healing does not take place immediately after the introduction of the strategies, skin and tissue damage rates is reduced (Elsabrout et al., 2018). Severe pressure ulcers have been observed to health within a week after the introduction of proper treatment, however, surgery is needed for serious wounds (Penoyer et al., 2019). Mattresses and dressings have been found to prevent the infection by dead tissue dissolving process. This is the overall outcome of this PICOT question talking about pressure ulcers and hospital-acquired pressure infections. Time Frame (T) Patients suffering from HAPI will be found to have recovered from their suffering condition after the use of mattresses and skin-cleaning process for the prevention of hospital- acquired pressure infections. The normal recovery time for stage 2 pressure ulcer infection is 4 weeks. However, the complete recovery rate is one year for pressure ulcer infections. This is the overall discussion about the PICOT statement stated above “In patients with long illness (P), how does good skincare (I) compared to the use of pressure reducing cushions mattresses (C) affects the recovery from HAPI- Hospital Acquired Pressure Injuries (O) within one year."
5PICOT STATEMENT References Bale, S., Cameron, J., Meaume, S., & Ingegneri, A. (2018). Skin care. InScience and practice of pressure ulcer management(pp. 111-124). Springer, London. Bassinger, A., Kistler, K., & Soule, M. (2016). Preventing Pressure Ulcers in Adults: An Integrative Review. Elsabrout, K., Orbacz, E., McMahon, L. A., & Apold, S. (2018). Large‐Scale Hospital Mattress Switch‐Out Leads to Reduction Hospital‐Acquired Pressure Ulcers: Operationalization of a Multidisciplinary Task Force.Worldviews on Evidence‐Based Nursing,15(3), 161-169. Hernandez, M. J. (2019).Pressure ulcer prevention: A quality improvement project(Doctoral dissertation, Bradley University). Lachenbruch, C., Ribble, D., Emmons, K., & VanGilder, C. (2016). Pressure ulcer risk in the incontinent patient.Journal of Wound, Ostomy and Continence Nursing,43(3), 235-241. Penoyer, D., Britt, C., Wilkinson, L., Arwood, L., & Sole, M. (2019). 687: A CRITICAL CARE- SPECIFIC PUP BUNDLE REDUCES HOSPITAL-ACQUIRED PRESSURE ULCERS IN THE ICU.Critical Care Medicine,47(1), 324.