Pressure Ulcers Assignment Paper

Pressure Ulcers Assignment Paper


This literature review compares the research questions, population samples, and study limitations of literature review articles and the capstone project’s PICOT statement. The PICOT question aims at preventing Pressure Ulcers (PU) among hospitalized middle-aged post-surgical and stroke patients through educational programs. It also discusses the recommendations for future research to advance knowledge and nursing practice. PU are damaged tissue areas that occur because of excess shearing forces and pressure.Pressure Ulcers Assignment Paper

Pressure sores impact negatively on a patient’s QoL, prolong hospitalization, increase morbidity, mortality, the workload of healthcare personnel, and health-associated costs. This literature review will be guided by the following PICOT question; Among hospitalized middle to late adulthood stroke and post-surgical inpatients in the Inpatient Rehabilitation Center (P), can evidence-based practice educational intervention (I) linked to treatment and preventing PU, in comparison to the absence of formal education (C), result in enhancing the confidence and knowledge of nurses when taking care of patients with PU/at risk of acquiring Pus within 3 months (T)?

Currently, existing evidence suggests that educating healthcare providers is a vital component of preventing pressure ulcers as it is directed towards behavior change and inspiring preventive practices with the ultimate goal of decreasing the incidences of developing pressure ulcers.Pressure Ulcers Assignment Paper

Comparison of Research Questions

The research questions on how to prevent PU ranged from the effect of educating healthcare providers on PU prevention and the successful factors of preventing PU in the inpatient setting, to determining the level of knowledge about PU prevention among healthcare personnel. For instance, Porter‐Armstrong et al. (2018) assessed how educating healthcare providers impacted the prevention of PU. This research question was similar to that of Karimian et al (2020) and the PCOT question that purposes to determine how education of healthcare personnel impacts the knowledge of ICU nurses about preventing PU. Although Porter‐Armstrong et al. (2018) found many uncertainties, which prevented them from making a conclusive recommendation; Karimian et al (2020) suggested that an educational intervention improves the attitude and knowledge of nurses and other healthcare providers on PU prevention.

Other research questions evaluated the impact of an education program on preventing PU in other populations other than healthcare providers as required by the PICOT question. For instance, Cross, Hindley & Carey (2017) evaluated how educating formal care workers in the community helped to prevent PU. Formal care workers can easily recognize and inform health staff about patients at high risk of developing PU. Similarly, Robineau et al. (2019) assessed how educating spinal cord injury patients influenced the prevention of PU. Baron et al. (2016) and Tallier et al. (2017) examined if knowledge of PU prevention among nurses is a predictor of PU prevention behavior. However, while the former compared the knowledge scores of teams that took part and did not take part in PU educational interventions, the later established if the use of a staging tool by nurses could impact the prevention of PU.


Comparison of Sample Populations

Most articles incorporated healthcare personnel and patient education programs as the primary intervention in different settings and population samples. For instance, Porter‐Armstrong et al. (2018) conducted a systematic review of RCTs that included five RCTs about preventing PU by frontline healthcare providers (healthcare assistants, nursing and medical staff, and allied health professionals). The studies took place in either outpatient, inpatients, domiciliary home care, or community-based clinics. Karimian et al (2020) and Baron et al. (2016) sampled and interviewed ICU nurses. The former interviewed 67 ICU nurses while the later interviewed 71 RNs from three ICUs. Since these studies used a small population sample, the applicability of their findings to larger populations is limited.

Some studies focused on patient population samples. For instance, Gunningberg et al., (2017) and Robineau et al. (2019) sampled 190 and 26 adult patients respectively. However, the population sample in the study by Gunningberg et al., (2017) were aged 52 years and older admitted in the internal medical or geriatric ward. In contrast, the population sample in the study by Robineau et al. (2019) had a mean age of 52 years with a spinal cord injury.Pressure Ulcers Assignment Paper

Studies by Hommel et al. (2017) and Tallier et al. (2017) were specific to acute hospital settings involving healthcare personnel.  Hommel et al. (2017) conducted focused groups interviewed healthcare personnel in six acute care hospitals while Tallier et al. (2017) interviewed 62 nurses from 10 acute care settings. Other studies included formal care workers working in community settings (Cross, Hindley & Carey, 2017) since formal care workers are well-positioned to assist in identifying and informing healthcare providers about high-risk patients of pressure ulcers.

Comparison of Limitations of Studies

A major limitation across all the studies was the use of education programs as the specific intervention without reapplying a knowledge test a third time to determine if the participants consolidated knowledge. As a result, it is difficult to determine if the participants maintained and applied the acquired knowledge in the long term and if the findings could be the same thereafter. Besides, instead of involving all the healthcare personnel in a setting, the researchers’ sampled either nurse technicians, RNs, or ICU nurses. For instance, Karimian et al (2020) and Baron et al. (2016) interviewed ICU nurses while Tallier et al. (2017) interviewed peri-operative RNs in 10 acute care settings. This increases the risk of selection error and bias.

It is also worth mentioning that most studies used small population samples. Karimian et al (2020) and Baron et al. (2016) sampled and interviewed 67 and 71 ICU nurses respectively. Tallier et al. (2017) interviewed 62 nurses from 10 acute care settings while Robineau et al. (2019) used a sample of 26 adult patients. A small population sample affects the reliability of findings, increases variability, and limits the generalizability of outcomes.

Conclusion and Recommendations for Further Research

PUs impact negatively on patient’s QoL, prevent full functional status, increases morbidity, mortality, and healthcare-related costs. It also prolongs hospitalization, increases the workload of healthcare providers, causes pain and suffering. Existing evidence suggests that educating healthcare providers is a vital component of preventing pressure ulcers as it is directed towards behavior change and inspiring preventive practices with the ultimate goal of decreasing the incidences of developing pressure ulcers.

This literature review compared the research question, population samples, and study limitations of literature review articles and the capstone project’s PICOT statement. The review reveals many similarities between the population samples and research questions in the literature articles and the project’s PICOT statement. It also reveals unique factors specific to PU education as a prevention strategy in inpatient settings. It is, therefore, safe to conclude that these articles recommend the education of healthcare providers as an effective intervention to prevent PU among adult middle-aged post-surgical and stroke patients. Further studies should use larger population samples and measure the long-term impact of the acquired knowledge.Pressure Ulcers Assignment Paper


Baron, M. V., Reuter, C. P., Burgos, M. S., Cavalli, V., Brandenburg, C., & Krug, S. B. F. (2016). An experimental study with nursing staff related to the knowledge about pressure ulcers. Revista Latino-Americana de Enfermagem.

Cross, C., Hindley, J., & Carey, N. (2017). Evaluation of a formal care worker educational intervention on pressure ulceration in the community. Journal of clinical nursing

Gunningberg, L., Sedin, I. M., Andersson, S., & Pingel, R. (2017). Pressure mapping to prevent pressure ulcers in a hospital setting: A pragmatic randomized controlled trial. International journal of nursing studies.

Hommel, A., Gunningberg, L., Idvall, E., & Bååth, C. (2017). Successful factors to prevent pressure ulcers–an interview study. Journal of Clinical nursing.

Karimian, M., Khalighi, E., Salimi, E., Borji, M., Tarjoman, A., & Mahmoudi, Y. 2020. The effect of educational intervention on the knowledge and attitude of intensive care nurses in the prevention of pressure ulcers. International Journal of Risk & Safety in Medicine.

Porter‐Armstrong, A. P., Moore, Z. E., Bradbury, I., & McDonough, S. (2018), Education of healthcare professionals for preventing pressure ulcers. Cochrane Database of Systematic Reviews.

Robineau, S., Nicolas, B., Mathieu, L., Duruflé, A., Leblong, E., Fraudet, B., & Gallien, P. (2019). Assessing the impact of a patient education programme on pressure ulcer prevention in patients with spinal cord injuries. Journal of Tissue Viability.Pressure Ulcers Assignment Paper

Tallier, P. C., Reineke, P. R., Asadoorian, K., Choonoo, J. G., Campo, M., & Malmgreen-Wallen, C.,(2017). Perioperative registered nurses’ knowledge, attitudes, behaviors, and barriers regarding pressure ulcer prevention in perioperative patients. Applied Nursing Research.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

  1. Title page
  2. Introduction section
  3. A comparison of research questions
  4. A comparison of sample populations
  5. A comparison of the limitations of the study
  6. A conclusion section, incorporating recommendations for further research

An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.Pressure Ulcers Assignment Paper