Nursing Research: Enhancing Patient Outcomes Through Research

This report delves into two critical areas of nursing research: selecting the optimal mattress for preventing pressure injuries in elderly patients and determining the most effective hand hygiene method to prevent infection spread. The paper critically analyzes various mattress options, contrasting dynamic pressure-relieving mattresses with air-infused bead beds based on strength, relevance, reliability, validity, and currency, ultimately recommending dynamic pressure-relieving mattresses for their proven effectiveness. Additionally, the report explores hand hygiene practices, comparing alcohol-based hand sanitizers with traditional soap and water, considering factors like germ-killing efficacy, side effects, and the development of antibiotic resistance, concluding that soap and water are generally preferable due to their broader effectiveness against microorganisms. The research highlights the importance of ethical considerations, cultural sensitivity, and interdisciplinary collaboration in delivering effective patient care, emphasizing the need for ongoing education and training for healthcare professionals.

Running head: NURSING RESEARCH
NURSING RESEARCH
Name of the Student:
Name of the University:
Author Note:

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Introduction:
Research plays an important role in the nursing profession. The research studies
critically reflect the efficacy of the evidence based practices that are implemented while
devising nursing intervention strategies for the patients in order to yield positive patient
outcomes. This research paper would present an elaborate discussion on the two important
research topics that include the choice of best mattress for the prevention of pressure injuries
among the elderly patients and the choice of best hand hygiene method in order to prevent the
progression of infection.

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Paper I: What’s best mattress for pressure sores?
Discuss how this research may support and improve your work practice.
While dealing with elderly patients, it is important to take into consideration the
complex nature of the disorder and the decreased pace of recovery. Also, it is important to
understand that the healthcare industry is dynamic in nature and it is important to
continuously upgrade the knowledge, skills and intervention strategies so as to render
effective care to the patients. In this context, it should be mentioned that critical research and
implementation of the best evidence based practice can help in acquiring maximum patient
satisfaction. Therefore, conducting an elaborate research on the concerned research topic
would help in accumulating the best evidence based practices which could be positively
implemented to acquire positive patient outcomes.
Provide a brief summary of your findings and develop a research question
As mentioned by Chou et al. (2013), inclusion of pressure relief mattresses for the
treatment of old age patients with pressure pain, who are confined to bed for long period of
time is highly recommended. In this regard, it should be mentioned that, bedridden patients
who are partially or completely immobile are at a high risk of developing pressure ulcers
which are also known as bedsores. The use of pressure relief mattresses at an initial stage can
prevent the progression of small ulcers to becoming infected wounds and blisters. Research
studies reveal that, a total of seven, low-priced mattresses are widely used for the patients
(Bergstrom et al., 2014). These include, the alternating pressure (AP), constant low pressure
(CLP), Preventix, Modular propad (Contoured foam), large cell ripplebed, surgicgoods,
hollowcare matress pad (Fibrefill) and ardo watersoft: spenco. Out of the enlisted mattresses
the AP mattress has been studied to yield the best effect (Manzano et al., 2013). On the other
hand, the contoured foam had also generated effective results compared to the fibrefill. As
mentioned by Grothier and Bradley (2014), alternating pressure mattresses have been highly

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effective in providing pain relief to patients and at the same time prevent the progression of
injuries. Studies reveal that the use of standard foam mattress, higher specification pressure
reducing foam mattress, nom-dynamic overlays, dynamic pressure reliving mattress, air-
fluidised bed and support surfaces are highly recommended to offer assistance to elderly
people within healthcare setting.
The research question that can thus be formulated after reviewing the literary sources
can be stated as: What are the considerations that can facilitate the effective choice of an
appropriate mattress to treat bedsores?
Compare and contrast two recommended options for pressure injury prevention:
The dynamic pressure relieving mattress and the air infused beads bed are most
widely recommended for the prevention of pressure injury. The following sections would
compare the mattresses based on the five parameters of strength, relevance, reliability,
validity and currency.
On the basis of the evidence collected from the research studies, it can be said that the
Dynamic pressure relieving mattress is ideal for patients experiencing Grade 1,2, 3 and 4
pain and is also effective for overweight patients. The strength of the information collected
from the research studies can be considered of high impact value pertaining to the
presentation of the information in a precise and articulate manner (Chou et al., 2013). At the
same time, the research studies referred in the paper are peer reviewed which indicates that
the validity of the information cannot be questioned. The findings collected from the studies
are relevant and fit perfectly with the purpose of the research topic to investigate the best
quality mattress to treat pressure ulcers. Further, the power unit adjusts according to the
patient’s body weight and ensures that the correct level of pressure is maintained, thereby
determining the reliability of the product (Manzano et al., 2013). Also, the product guidelines

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published by NICE to facilitate best quality pressure relieving devices ensures currency of the
product (NICE, 2019).
Air Infused Beads Bed is relatively a new technology that lacks substantial evidence
in the form of high impact factor value research journals to determine its strength. Further,
the few papers that talks about the effectiveness of the mattress are not peer-reviewed which
doubts the validity of the product. On the other hand the handful of papers that talk about the
effectiveness of the product focus more upon Air Infused Beads Pillows which questions the
relevance of the product (Cushing & Phillips, 2013). Although, the product specification
suggests the use of a premium air-floating technology, but the lack of substantial evidence
questions the currency and the reliability of the product.

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Summarize conclusion based on findings:
While caring for geriatric patients with the problem of pressure ulcers, it is
exceedingly important to select the correct type of mattress (McInnes et al., 2015). On the
basis of the findings, it can be said that alternating overlays and dynamic pressure relieving
mattress subtype could be appropriately used to provide relief to Mrs. Smith.
Identify potential areas for change in current practice:
On critically analysing the available research studies it can be said that the literatures
reviewed highlighted a major research gap which serves as interesting areas for future
research. It can be said that the studies did not focus on the inclusion of risk assessment
pertaining to the use of the pressure mattresses which is ideally important for the care
professionals to make appropriate selection of mattresses.

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Identify issues that require further research:
Issues that require further research includes the investigation of factors for the lack of
awareness among the patients for the choice of right type of mattresses. On the other hand,
research studies evaluating the perception of the fresh nursing graduates towards the type of
mattresses and their specification can help in the development of training materials to
promote education and awareness among the professionals.
Develop actions to address the outcomes of research. Actions must include cultural,
ethical considerations and interdisciplinary involvement.
In order to deliver effective care, nursing professionals must comply with the ethical
considerations and act in the best interest of the old age patients. Also, the professionals must
critically take care of the cultural and religious preferences of the patients and accordingly
render a culturally safe care delivery (McInnes et al., 2013). In addition to this imparting
education and awareness among the multidisciplinary healthcare teams about the best
practices for treating pressure pain can help in acquiring positive patient outcomes (Manzano
et al., 2013). In addition to this, implementation of training workshops to train professionals
to accurately select pressure mattresses can help in reinforcing positive care delivery to the
patients.

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Paper II: What’s best for hand washing soap and water or alcohol sanitizer?
Discuss how this research may support and improve your work practice:
Conducting a research on the above mentioned research topic would equip the nursing
professionals to ideally explain to the family members of the patient the significance of
observing hand hygiene. At the same time, it should also be noted that the care professionals
would be able to study about the varied properties of hand soap and alcohol based sanitizers
and their effect in controlling the transmission of infection. It would also train the patients to
effectively answer the concern of patients in a confident manner.

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Provide a brief summary of findings and develop a research question:
According to Wolfe and Lantagne (2017), hands have been identified as the most
common vehicle that facilitates the transmission of microorganisms. Effective hand hygiene
has been identified as the most important procedure that can prevent the probability of
transmission of infectious agents to a great extent. Hospital Acquired Infection is caused due
to poor compliance with effective hand hygiene technique. As mentioned by Smiddy et al.
(2015), care providers must observe the five important moments of hygiene in order to reduce
the probability of infection transmission. According to the report published by the World
Health Organization, the five moments of hand hygiene includes, before touching a patient,
before performing aseptic procedures, after exposure to body fluid, after touching a patient
after contact with the belongings of the patient (Ellingson et al., 2014). The two widely
recommended hand hygiene technique includes the use of alcohol based hand sanitizer and
hand washing with the use of soap and water (Ellingson et al., 2014). However, despite the
proven importance of observing hand hygiene, care providers fail to comply with the HH
routine primarily due to, lack of awareness, prioritizing patient care and lack of easy access to
resources (de ACEITUNO et al., 2015). As mentioned by Boyce (2013), alcohol based
sanitizers comprising at least 70% ethyl alcohol has been studied to kill 99.9% bacteria
effectively. However, ABHS has also been studied to elicit side-effects such as giving rise to
antibiotic resistant strain and stripping the natural oil from the skin. In addition to this, it also
results in the killing of the healthy bacteria from the skin surface (Birnbach et al., 2015). On
the other hand, the effectiveness of hand wash is only equivalent to 90% and studies have
also shown that use of soap and water also makes the skin deprived of the natural oil balance
(Birnbach et al., 2015).

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Therefore, the research question that can be formulated on the basis of the reviewed
literatures can be mentioned as: What selection parameters determine the choice of an
effective hand hygiene method?
Compare and contrast two recommended options:
Studies recommend the use of ABHS and soap and water to be the effective agents for
observing proper hand hygiene. The sections below would compare the two options on the
basis of parameters such as strength, relevance, reliability, validity and currency.
A large number of research studies talk about the efficacy of soap and water in
controlling the prevalence of infection which confirms the strength of the method. On the
other hand, the published research studies considered in the paper are mostly peer-reviewed,
which determines the validity of the paper (Allegranzi et al., 2013). Further, the method fits
perfectly fine with the purpose of this research paper and hence soap and water can be
considered as a relevant infection control method that helps in killing 98.45% of the
microbial germs (myVMC 2019). In addition to this, the Infection Control Guidelines and
recommendations determine the reliability and currency of using soap and water as hand
hygiene method.
On the other hand, research papers published in reputed journals such as BMJ
determine the strength of using ABHS as effective hand hygiene method. The published
papers are mostly peer-reviewed which ensures the validity of the product. Further, the
effectiveness of the product to kill 90.01% of microbes predicts the relevance of the product
with the research question. However, recent findings about developing antibiotic resistance
indicate the lack of reliability and currency of the product to ensure infection control over
broad spectrum microorganisms (de ACEITUNO et al., 2015).

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Summarize conclusion based on findings:
On the basis of the research findings, the use of soap and water for hand hygiene is
widely recommended, predominantly on account of increased effectiveness against killing
microorganisms. Also, the use of ABHS is only recommended if the percentage of alcohol is
at least 70% (de ACEITUNO et al., 2015). However, the use of ABHS deprives the skin of
natural oil balance which has not been backed with adequate scientific evidence in case of
soap and water (Boyce, 2013). Hence, effective HH is extremely important for the prevention
of the transmission of nosocomial infections.
Identify potential areas for change in current practice:
The main reason attributed for the transmission of nosocomial infection has been
studied to be contaminated hands. Visitors coming to visit patients often overlook the
importance of observing hand hygiene while entering the hospital premises. Therefore,
installation of hand washing stands at the entrance of different storeys with informative
signboards can help in conveying the message to the visitors. In addition to this, distribution
of informative flyers highlighting the properties of the ABHS and soap and water can help in
making people aware about the importance of the techniques.