Assessment 2: Pressure Area Care and Evidence-Based Practice Report

This report delves into the critical aspects of pressure area care (PAC), emphasizing evidence-based practices to ensure patient safety and well-being. It begins by highlighting the three pillars of evidence-based practice: patient values, clinical expertise, and relevant research. The report then examines systematic reviews as a crucial tool for gathering unbiased knowledge and establishing best practice policies. Key concepts such as incidence, prevalence, morbidity, and mortality related to pressure injuries are thoroughly discussed, with statistical data from Australia provided to illustrate the scope of the issue. Furthermore, the report explores the characteristics of Randomized Controlled Trials (RCTs) and their significance in understanding the effectiveness of various treatments. The report underscores the importance of PAC in the context of nursing care and the need for nurses to stay informed on the latest evidence-based approaches to enhance patient outcomes. The report also provides an overview of the NMBA Codes of Conduct for Midwives and Nurses (2018), which state that “Nurses provide safe, person-centred, evidence-based practice for the health and wellbeing of people (pp.6 & 7). In addition, the NMBA Standards for Practice for Registered Nurses and Midwives specifies that nurses and midwives must “access, analyse, and use the best available evidence that includes research findings, for safe, quality practice” (pp.3 & 4).

PRESSURE AREA CARE

Three elements of evidence based practice
 Patient values
 Clinical expertise
 Relevant research on the basis of the patient’s condition (Fallon et al., 2015)
 On the basis of these three pillars the evidence based practice for the
pressure care practice (PAC) can be done which is the care for the
pressure injuries on the soft tissues or the pressure ulcers produced by
the bed shore or other injuries as it helped in the knowledge about the
disease and the treatment on the basis of the patient needs and help in the
clinical practice (Liversedge et al., 2018).
Systematic review
 Systematic review is based on the pre selected question and the critical
analysis of the findings based on that question. The critical analysis
would be helpful in setting a clear objective and help the nurses in
gathering an unbiased knowledge and the best practice policy for the
situation in this case the PAC (Saunders & Vehviläinen-Julkunen, 2016).

Hierarchy of systematic review
 Level 1 (Griffiths et al., 2016).
Meaning of systematic review
 The systematic review helps in the proper analysis of the
clinical condition on the basis of the searched evidences and
thus properly collaborates with the clinical expertise and the
patient value factor in this case the PAC(Khalil et al., 2016).

Characteristics of Randomized Controlled
Care
 Randomized selection of participants with minimized but
distinct variations
 Comparison of treatment provided to one group and the
control group without the treatment given in order to
determine the effectiveness of the treatment (Dionne-Odom et
al., 2015).
 RCT would be helpful in the knowledge gathering about the
prevalence, incidence, mortality and the morbidity rate of
pressure injuries or pressure ulcers thus a proper knowledge
about the PAC for the nurses.

Incidence
 Incidence rate is the measurement of the occurrence of disease and
other incident. Here in the context of nursing care and the evidence
based practice the incidence is the rate of new disease (Ferlay et al.,
2015).
 In case of pressure area care which refers to the care for the pressure
ulcer formed during injuries or bed shore for long time would be a very
common factor and the incidence rate for this condition is higher as the
risk of soft tissue injury is one of the basic factors for the patient.
Yearly PI incidence rate of Australia
 Ranges from 1.9% up to 59% among the aged people and
also in the paediatric patients it has been seen that 0.25% to
27% approximately. Other than these the critical patients in
critical care also showed the effects ranges from 3% to 53.4%
(Cec.health.nsw.gov.au, 2019).

Prevalence
 Prevalence rate of a disease is primarily dependent on the
incidence rate of the disease.
 Other than the disease incidence the prevalence also depends
on the factor of the duration of the disease among the
population.
 The prevalence rate of a disease is the actual number of people
alive with the disease along with the period of time with the
disease or the particular day the disease diagnosed (Ogden et
al., 2015).
 In case of pressure injuries or pressure ulcers the prevalence
rate is dependent on the disease type and the factor of the
aftermath of operation or others. The prevalence rate of
pressure injuries in Australia is up to 37% (Health Times,
2019).

Morbidity
 The association to any kind of mental or physical disease in a period
of time is termed as morbidity (Case & Deaton, 2017).
 The PI is a common aftermath of different acute diseases and also in
the operation cases.
 The timeframe of the PI is the actual morbidity rate of a population
in accordance with age and incidence rate. Thus the PAC is needed in
these cases.
Mortality
 Mortality rate is the factor which can be termed as the death rate of
people in a given population, affected by specific disease or incident
or other factors (Abs.gov.au, 2019).
 For example the mortality rate from pressure injuries in Australia is
67.6% (Health Times, 2019).

References
Case, A., & Deaton, A. (2017). Mortality and morbidity in the 21st century. Brookings
papers on economic activity, 2017, 397.
Cec.health.nsw.gov.au. (2019). Retrieved from
http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0011/361991/2015-NSW-
Pressure-Injury-Point-Prevalence-Survey-report.pdf
Dionne-Odom, J. N., Azuero, A., Lyons, K. D., Hull, J. G., Tosteson, T., Li, Z., ... &
Hegel, M. T. (2015). Benefits of early versus delayed palliative care to informal
family caregivers of patients with advanced cancer: outcomes from the ENABLE III
randomized controlled trial. Journal of clinical oncology, 33(13), 1446.
Fallon, L. M., Collier-Meek, M. A., Maggin, D. M., Sanetti, L. M., & Johnson, A. H.
(2015). Is performance feedback for educators an evidence-based practice? A
systematic review and evaluation based on single-case research. Exceptional
Children, 81(2), 227-246.
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., ... & Bray,
F. (2015). Cancer incidence and mortality worldwide: sources, methods and major
patterns in GLOBOCAN 2012. International journal of cancer, 136(5), E359-E386.

Continued..
Griffiths, P., Ball, J., Drennan, J., Dall’Ora, C., Jones, J., Maruotti, A., ... & Simon, M. (2016).
Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform
policy and practice. A review and discussion paper based on evidence reviewed for the
National Institute for Health and Care Excellence Safe Staffing guideline
development. International journal of nursing studies, 63, 213-225.
Health Times. (2019). Pressure injuries - the silent killers. Retrieved from
https://healthtimes.com.au/hub/wound-care/59/practice/bf1/pressure-injuries-the-silent-
killers/606/
Khalil, H., Peters, M., Godfrey, C. M., McInerney, P., Soares, C. B., & Parker, D. (2016). An
evidence‐based approach to scoping reviews. Worldviews on Evidence‐Based Nursing, 13(2),
118-123.
Liversedge, H. L., Bader, D. L., Schoonhoven, L., & Worsley, P. R. (2018). Survey of neonatal
nurses' practices and beliefs in relation to skin health. Journal of Neonatal Nursing, 24(2), 86-
93.
Ogden, C. L., Carroll, M. D., Fryar, C. D., & Flegal, K. M. (2015). Prevalence of obesity among
adults and youth: United States, 2011–2014.
Saunders, H., & Vehviläinen-Julkunen, K. (2016). The state of readiness for evidence-based
practice among nurses: An integrative review. International Journal of Nursing Studies, 56,
128-140.