Case Studies: Research Based Practice in Nursing - HLT54115

This assignment presents two case studies focused on nursing practices. The first case study investigates the use of foam mattresses in preventing and managing pressure injuries, highlighting their advantages over standard mattresses in distributing pressure and reducing friction. The second case study examines hand hygiene protocols, comparing the efficacy of hand sanitizers and hand soaps in a hospital setting, emphasizing the superior germ-killing properties of sanitizers. Both case studies include detailed analyses of the current practices, potential areas for improvement, and ethical considerations. The document also discusses the importance of awareness and education for patients and healthcare staff to improve outcomes and prevent infections. It stresses the need for ongoing research to enhance the effectiveness and durability of medical products and practices.

Running head: Research based practice in nursing
Research based practice in nursing
Name of the student:
Name of the university:
Authors notes:

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Case study: 1
1. Pressure injuries in the underlying tissue and can lead to pressure ulcers. For
speedy recovery, it is required to provide a comfortable mattress which can decrease the risk
factors. The special foam mattresses help to distribute the pressure evenly and not restricting
to a single area reducing the pressure on vulnerable parts (Poppe 2016). This research would
help in similar practices and helpful for those diagnosed with pressure injuries. Using special
or foam mattresses can help in prevention of ulcers and their risk factors. Non-dynamic
overlays are best suited to reduce the risks of pressure ulcers.
2 Foam mattresses has been showing the best properties of reducing the pressure on a
single area. The foam mattresses reduces the amount of friction and sheer thus reducing the
pressure. Foam mattresses helps in making the person comfortable and the pressure points are
suited to evenly distribute for all parts of the body. A standard mattress does not aid in
distributing the pressure and with friction the pressure gets accumulated to one part of the
body. The legs are most vulnerable part for accumulated pressure. The accumulated pressure
is not suited for any patient as it impairs the function and sensory perception. Therefore
normal mattresses must be changed with foam mattresses to prevent the incidence of pressure
injuries.
3a Compared to the normal mattresses foam mattresses have more efficient properties
in managing the pressure injuries in the patients. Foam mattresses prevent friction against the
skin and stretching of blood vessels due immobility. There are many mattresses which
ensures that there are regular inflation and deflation so that sores are relieved but it fails to
deliver in the given area. Therefore such specialised foam mattresses are not efficient in
placing pressure in injured area. Cost wise foam mattresses are costlier than normal
mattresses due to its properties. Foam has additional properties like better quality that often

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enhances the price. Air mattresses are sometimes designed with high technology of inflation
and are highly priced but the properties of foam mattresses are most efficient in dealing with
pressure injuries. Foam mattresses can be used for many days compared to the normal
mattresses as they holds great frictional property (Edsberg et al. 2016). Strength wise foam
mattresses are durable and can be used for a long time. Foam mattresses made up of latex is
preferred due to its material. Normal mattresses are also durable and is suited for all
conditions. In this case the lady has a swollen feet and to prevent the swelling foam
mattresses are the best option.
4b Based on findings it can be concluded that the best mattresses to cure the pressure
injuries and swelling of the leg is foam mattresses that minimises the friction and less
pressure is accumulated in a single body part. In case of pressure injury it is required that
there is less pressure subjected to the healing point but the simple mattress does not have any
such function. In case of normal mattress the friction increases and durability decreases with
daily usage and this can increase the risk factors for ulcer. The air pressure mattress have the
properties of inflating and deflating and may help but in most cases it is seen that it may not
be very useful and has no use in decreasing the pain. Therefore, it can be concluded that foam
mattresses are best suited for people injured with ulcer or having pain out of pressure injury.
5a There are many potential areas for change in practise of determination of the
suitable mattress. In hospitals the general mattress are mostly used in beds for the patient.
Through the following findings it can be said that in cases of pressure injury to the patients,
the patient must be shifted to bed with foam mattress. Foam mattress has suitable features to
stop the risk of ulcer and pain. Normal mattresses can also be modified with foam mattresses
as it has advanced properties of reducing the friction and less pressure is accumulated in
single body parts.. Air pressure mattresses have inflating function but are not suited for

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normal every day use. Therefore advanced features in foam mattresses are the best option and
has the potential for further research in minimising the pressure injury.
5b There are certain areas of research in foam mattresses like the quality and
durability. The longevity of foam materials depend on the products and must contain more
natural products. Foam mattresses must also be designed with inflating and deflating air cells
that can look after the needs of patients. In case of leg ulcer or swelling in the leg due to
pressure injury the air cells must be helpful in decreasing the pain. With advanced durability
it can be ensured that the properties have longer longevity (Jackson et al. 2016). More
consistent in air flow is desired to reduce sweating and friction which can worsen the
condition of ulcers.
5c It is important in ethical grounds to inform the hospital staff about the research
outcome so that they can consider the facts and make necessary arrangements. Many patients
may not be comfortable in foam mattresses therefore in such cases they must be educated and
let know of the effects of foam mattresses in minimising pressure injury. There must be
ample awareness made to the patients about how to minimise the effect by sleeping in foam
mattresses even when at home and not in the hospital. Therefore it can be said that with
proper awareness the findings may be made known to everyone so that it can be used to
decrease the effects of pressure injury.

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Case study: 2
1. It is very important to maintain cleanliness in hospitals especially when
encountering a patient. In this case study the family members of the patients develop a
routine of washing hands before and after meeting the patient. The topic of concern here is
the best choice of hand wash and in which form. This research would help to ascertain the
best practise of washing hands and ensure cleanliness. Through this research it would be clear
to us that which practice is best for killing the germs. The research would help to throw light
on the best way to kill the bacteria (Blackwell, Goya-Tocchetto and Sturman 2017).
2. In the case study we get to know how the patients family develop cleanliness by
washing hand with soap but they enquire about the best method of washing their hands. Both
soap and hand sanitizers are used but the most effective method can be understood through
analysis. Hand sanitizers are more popularly used these days due to ease of use and are made
up of alcohol. On the other hand normal soap bars can remove the germs but do not kill them
and works for a very short time (Wagner et al. 2019). Hand sanitizer generally consists of
around 60% alcohol content that helps in killing the germs in a short time. In hospitals it is
best to opt for the hand sanitizers because it is more effective than hand soaps (Deshpande et
al. 2017).
3a. The normal hand soaps and hand sanitizers are used to wash and clean hands.
Both work effectively against killing the bacteria but to see that the infection is not rampant
we must ensure the best product out of the two. According to my understanding, hand
sanitizers are best way of washing hands as they kill the bacteria more effectively compared
to the normal hand soaps. Sanitizers are more safe in using as they are provided with nozzle
and ensures cleanliness for use of different person. In turn of hand soaps once it is used the
soap gets wet and not fit for individual use (Fan 2017). This way more infection may be
spread which is not good for both the patients and their family members.

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Hand sanitizers have important relevance in killing the germs by 70%. In busy areas
like hospitals hand sanitizers are mostly preferred due to ease of its usage. Many times the
ingredient consist of isopropyl alcohol but if it is below 60%, it is not effective to kill the
germs. Alcohol and isopropyl alcohol is known to show antiseptic properties and thus can
ensure that hand sanitizers are not harmful (Greenaway et al. 2017). According to typical
industry standards the validity or the expiry date of a common sanitizer ranges from 2-3 years
in particular. There is not much difference in the currency of hand sanitizers and soaps and is
economic for daily use. Therefore it can be used daily by the hospital staffs. Hand sanitizers
generally come in medium sized bottles and can be used for more than hundred washes. The
best part of hand sanitizers are that it comes in a bottle and ensures individual use. (Kampf
2016)..
4b Based on information got from the action and ingredients of both hand sanitizers
and hand soap it can be concluded that hand sanitizers are more effective in hospitals for the
use of its visitors. It will be wrong to say that hand soap is ineffective as it can kill some
germs and ensure some level of protection but it is its mild properties that make the patient
more vulnerable to infections (Rai et al. 2019). The presence of alcohol more than 60% is
effective for killing the germs and therefore it is more preferred than the normal hand soaps.
Hand soaps are generally multidisciplinary in action and does not ensure any single property
of killing particular germs as hand sanitizers are designed to kill the germs and prevent it to
grow. Hospitals are sensitive place where there must be strict cleanliness maintained
otherwise there may be breeding grounds of microorganisms which can lead to infection
among both patients and their family members.
5 a The current practise is best suited to curb the menace of germs causing infection.
There should be more education to people visiting hospitals regarding the basic practice of
washing hands before meeting their family members admitted. There is not much education

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about how the germs get transmitted and how a patient is more vulnerable in getting
infection. In many hospitals use of hand soap is still practised but it must be noted that hand
soaps are not suitable for individual use and through touching the same soap there can be
transmission of germs. There must be stricter norms in practice of hand wash. It is required
for the members of the patient to wash their hands both during and after the visit. There must
be habit of washing the hands regularly as many disease can be controlled by stopping the
transmission of germs. It should be known to people that hand soaps are not used for any
specific reason so the usage of hand soaps must be limited (Song and Heacock 2016).
5d Hand sanitizers and other sterile solutions work effectively against the microbes
but on subsequent use the bacteria tend to develop machinery against the product. Slowly this
may prove to be fatal for the efficacy of the product. Therefore there must be research to
control the microbes so they do not get any machinery to fight against the product. This
cannot be controlled as the bacteria on subsequent use develops mechanism to fight against
the products. The research must be aimed on developing advanced products with ingredients
over time so that the effectiveness of the hand sanitizers may be controlled. There may be
further research on making it more convenient in usage like less usage of water making it dry.
Many times alcohol can prove to be having drying effect on skin so further research can see
that there are no adverse effects in skin like allergic reactions or redness of skin (Ripabelli et
al. 2016).
5e There must be considerate action to look after the outcomes of future. As per the
research it is clear that hand sanitizers are better in function than the normal hand soaps.
Therefore being a nurse it is my responsibility to educate people about the effects of healthy
washing. Taking all ethical considerations I must personally interact with the patients and
families to let them know about healthy habit of washing hands and how effective is the
practice of washing by hand sanitizers (King et al. 2016). This research was based on my

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observation among the patients and my nursing practice. There must be awareness among the
patients and their family members visiting the hospital to know the effect of washing hand
through hand sanitizers. There may be many of them who would not like to believe and leave
their age old practice of washing through general soaps. In such cases there must not be strict
implementation of my research outcomes but they may be understood by holding logical
views.

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