Nursing Assignment 5: Clinical Question on Pressure Injuries

This nursing assignment addresses the critical clinical problem of pressure injuries in elderly patients, a significant comorbidity increasing morbidity and mortality. The student formulates a research question using the PICOT framework, focusing on the effectiveness of a walking intervention (10 minutes every two hours) in preventing pressure injuries among elderly residents of aged care facilities. The assignment provides a detailed description of the clinical problem, its significance, and the rationale for the chosen clinical question, supported by relevant literature. The student aims to use CINAHL and Medline databases to find research evidence to compare the intervention to other methods. The paper highlights the importance of evidence-based nursing research in improving the quality of life for elderly patients and preventing critical health complications. The assignment emphasizes the need to identify effective interventions that can reduce the risk of pressure injuries, considering the limitations of existing interventions like patient repositioning.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the student
Name of the university
Author note

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Introduction
Increasing age has always been observed with critical health complications among
elderly population due to which their morbidity and mortality increases (Chaboyer et al., 20-
16). Pressure injuries (PIs) has been considered as one of the critical comorbidity that has
affected majority of the elderly patients admitted in the acute units of healthcare facility. This
is the reason their quality of life and hospitalisation duration increases. Therefore, the
primary aim of this paper is to propose a research question and identify the recent research
works that could be used as evidences in the healthcare interventions of elderly patients
suffering from pressure injuries.
Potential clinical problem
Pressure ulcer is the health complication that would be dealt with in this evidence
based nursing research as Frih et al. (2017) has mentioned that majority of the elderly patients
admitted in the healthcare wards are affected with this complication. Presence of pressure
injuries could affect the mental and physical health complications drastically and impacts the
activities of daily life as well as quality of life. Interventions of pressure injuries are
complicated to implement as it requires complete concentration of the healthcare
professionals and without this the risk of falls and other critical condition increases (Fulbrook
& Anderson, 2016). Multiple interventions associated with positioning and changing the side
of patient has been implemented among patients and has been effectively reduced the
complications of pressure injuries, however the risk of recurrence could not be denied with
such interventions. Hence, in such condition, the patient should be provided with some
interventions that would help them to restore their tissue functioning that primarily get
damaged due to the occurrence of pressure injury. Further, Järbrink et al. (2017) also
mentions that changes in patient’s positioning helps to reduce the rate of pressure injury for a

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limited time and hence, it could not be used as a permanent solution for the risk of pressure
injury among elderly patients. Hence, in such condition, need of identifying some
interventions that could effectively reduce the rate of critical health complication associated
with pressure injury among the elderly population should be discussed and implemented in
the care process. There are multiple research evidences that could be implemented among the
elderly patients to reduce their risk of critical health complications. One such intervention
that could be implemented among these patients is physical activity including light to
moderate weight training, balancing exercises and walk so that the patients could restore
effective blood circulation in their body and the area of their skin under the risk of pressure
injury could restore its activity (Mudge et al., 2017). In such condition, it should be
mentioned that weight training and balancing workouts possess minimal to moderate risk of
falls among frail elderly patients and hence application of these could increase the risk of
critical complication among their health complications (McDermott et al., 2017). Hence, in
such condition, implementation of walks could become the only effective and safe
intervention that could help the elderly patients suffering from the critical risk of health
complication relief. However, prior to implement this effective intervention it is important to
analyse the effectiveness through the analysis of recent research articles (Amir, Lohrmann,
Halfens & Schols, 2017). Hence, this would be the aim of this so that through the conduction
of evidence search in databases such as CINAHL recent and accurate research evidences
could be collected that would help to understand the effectiveness of the intervention among
the patients. Further, with the help of this search strategy the impact of its application and the
strength and limitations of the interventions would be obtained effectively (Ricci, Bayer &
Orgill, 2017).
Clinical question
Population Intervention Comparison Outcome TimeLine

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Elderly
population
living in the
aged care
facilities
Walking for 10
minutes
everyday
Compared to
other
interventions
Prevents the
risk of pressure
injury
Within a
specific
timeframe
The question: does the application of physical activity associated intervention
(walking for 10 minutes) reduces or prevents the risk of pressure injury among elderly
population living in the aged care facilities compared to other interventions within a specific
timeframe?
This research question has been formulated in a way so that the effectiveness of this
intervention could be effectively identified and compared to other interventions through the
help of recent and accurate research articles collected from CINAHL database. This would
further help the healthcare professionals to implement the int5evention without any hesitation
(Chaboyer, Mills, Roberts & Latimer, 2015).
Conclusion
This paper identified the health complication associated with the pressure injuries
associated health complications which is considered as one of the primary health
complication of the elderly patients. Through the application of evidence based nursing
research this [paper aims to develop a search strategy suing scientific database CINHAL and
search the key terms related to proposed research question. Further, this paper aims to
identify the effectiveness of walk for 10 minutes among the elderly patients that are suffering
from the risk of critical health complications.

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References
Amir, Y., Lohrmann, C., Halfens, R. J., & Schols, J. M. (2017). Pressure ulcers in four
Indonesian hospitals: prevalence, patient characteristics, ulcer characteristics,
prevention and treatment. International wound journal, 14(1), 184-193. DOI;
https://doi.org/10.1111/iwj.12580
Chaboyer, W., Bucknall, T., Webster, J., McInnes, E., Gillespie, B. M., Banks, M., ... &
Cullum, N. (2016). The effect of a patient centred care bundle intervention on
pressure ulcer incidence (INTACT): A cluster randomised trial. International journal
of nursing studies, 64, 63-71.DOI: https://doi.org/10.1016/j.ijnurstu.2016.09.015
Chaboyer, W., Mills, P. M., Roberts, S., & Latimer, S. (2015). Physical activity levels and
torso orientations of hospitalized patients at risk of developing a pressure injury: An
observational study. International Journal of Nursing Practice, 21(1), 11-17. DOI;
https://doi.org/10.1111/ijn.12188
Frih, B., Jaafar, H., Mkacher, W., Ben Salah, Z., Hammami, M., & Frih, A. (2017). The
effect of interdialytic combined resistance and aerobic exercise training on health
related outcomes in chronic hemodialysis patients: the Tunisian randomized
controlled study. Frontiers in physiology, 8, 288. DOI;
https://doi.org/10.3389/fphys.2017.00288
Fulbrook, P., & Anderson, A. (2016). Pressure injury risk assessment in intensive care:
comparison of inter‐rater reliability of the COMHON (Conscious level, Mobility,
Haemodynamics, Oxygenation, Nutrition) Index with three scales. Journal of
advanced nursing, 72(3), 680-692. DOI; https://doi.org/10.1111/jan.12825

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Järbrink, K., Ni, G., Sönnergren, H., Schmidtchen, A., Pang, C., Bajpai, R., & Car, J. (2017).
The humanistic and economic burden of chronic wounds: a protocol for a systematic
review. Systematic reviews, 6(1), 15. DOI: https://doi.org/10.1186/s13643-016-0400-8
McDermott, M. M., Leeuwenburgh, C., Guralnik, J. M., Tian, L., Sufit, R., Zhao, L., ... &
Anton, S. D. (2017). Effect of resveratrol on walking performance in older people
with peripheral artery disease: the RESTORE randomized clinical trial. JAMA
cardiology, 2(8), 902-907. DOI:10.1001/jamacardio.2017.0538
Mudge, A. M., Banks, M. D., Barnett, A. G., Blackberry, I., Graves, N., Green, T., ... & Lim,
K. (2017). CHERISH (collaboration for hospitalised elders reducing the impact of
stays in hospital): protocol for a multi-site improvement program to reduce geriatric
syndromes in older inpatients. BMC geriatrics, 17(1), 11. DOI:
https://doi.org/10.1186/s12877-016-0399-7
Ricci, J. A., Bayer, L. R., & Orgill, D. P. (2017). Evidence-based medicine: the evaluation
and treatment of pressure injuries. Plastic and reconstructive surgery, 139(1), 275e-
286e. DOI: 10.1097/PRS.0000000000002850
Rivers, C. S., Fallah, N., Noonan, V. K., Whitehurst, D. G., Schwartz, C. E., Finkelstein, J.
A., ... & Ho, C. (2018). Health conditions: effect on function, health-related quality of
life, and life satisfaction after traumatic spinal cord injury. A prospective
observational registry cohort study. Archives of physical medicine and
rehabilitation, 99(3), 443-451. DOI; https://doi.org/10.1016/j.apmr.2017.06.012