Matrix Worksheet Template
Use this document to complete Part 2 of the Module 2 Assessment, Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies
| Full citation of selected article | Article #1 | Article #2 | Article #3 | Article #4 |
| Yap, T. L., Kennerly, S. L., Horn, D. S., Bergstrom, N., Datta, S., & Colon-Emeric, C. (2018). TEAM-UP for quality: A cluster randomized controlled trial protocol focused on preventing pressure ulcers through repositioning frequency and precipitating factors. BMC Geriatrics, 18-54. https://doi.org/10.1186/s12877-018-0744-0.
| Whitty, J. A., McInnes, E., Bucknall, T., Gillespie, B. M., Banks, M., Thalib, M.,… & Chaboyer, W. (2017). The cost-effectiveness of a patient-centered pressure ulcer prevention bundle: Findings from the INTACT cluster randomized trial. International Journal of Nursing Studies, 75, 35-42. Doi: 10.1016/j.ijnurstu.2017.06.014. | De Myer, D., Van Damme, N., Van De Bussche, K., Van Hecke, A., Verhaeghe, E., & Beeckman, D. (2016). PROTECT – trial: A multicentre prospective pragmatic RCT and health economic analysis of the effect of tailored repositioning to prevent pressure ulcers – study protocol. Journal of Advanced Nursing, 73(2), 495–503. doi: 10.1111/jan.13166. | Omura, Y., Yamagami, Y., Hirota, Y., Nakatani, E., Tsujimoto, T., & Inoue, T. (2019). Evaluation of the effectiveness of the sliding sheet in repositioning care in terms of working time and subjective fatigue: A comparative study with an experimental design. International Journal of Nursing Studies, 99. Doi:10.1016/j.ijnurstu.2019.103389. | |
| Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest) | This article was selected since it is an empirical study relating to advances in pressure ulcer prevention studies through the turning and repositioning of patients. The study involved the use of human subjects, making their safety, dignity, and privacy a key priority. The study also sought to maximize benefits by increasing knowledge about the clinical issue reviewed and minimizing harms and risks caused by frequent patient disturbance.
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| This article was selected as it explores the effectiveness of a pressure ulcer prevention bundle. The care program under review comprises nurse training and patient education on best practice strategies such as repositioning and skin inspection. The research required patients’ sensitive personal health and financial data to fulfill its objectives. Patient and institutional consent was therefore sought based on guarantees to minimize harmful exposures. | This paper is selected for review because it discusses tailored repositioning as the best practice to reduce pressure ulcer incidences. Current recommendations propose patient repositioning based on an individual’s condition and the support surface. In contrast, the best practice offered in the paper entails the use of an algorithm to calculate a patient’s ideal repositioning frequency. | This article is selected since it presents empirical support for the use of sliding sheets, which are a best practice, compared to standard practices of manually turning at-risk patients. The study gives rise to an ethics of research challenge of minimizing risk since it involves the use of elderly patients to simulate patients with impaired mobility. Turning such patients may expose them to risks of falling. Consequently, the researchers had to acquire the subjects’ informed consent. |
| Brief description of the aims of the research of each peer-reviewed article | Using their TEAM-UP (Turn Everybody and Move for Ulcer Prevention) study, the researchers sought to establish whether the use of viscoelastic high-density foam support-surfaces can enable an extension of repositioning intervals from the current recommended 2 hours to between three and four hours without increasing the risk of new ulcer development. | Patient-centered care bundles often have the potential to improve a patient’s safety and quality of care. The researchers in this paper therefore seek to determine the cost-effectiveness of a pressure ulcer prevention bundle (PUPB) by comparing its direct costs and effects to the standard care programs offered at healthcare facilities. | Despite the availability of recommended repositioning frequencies, pressure ulcers continue to affect many patients due to nursing failures to adhere to the stipulations. The current study thus aims to improve nurses’ adherence to recommended repositioning frequencies and reduce incidences of pressure ulcers and incontinence-associated dermatitis (IAD). | Many nurses in healthcare facilities often decline to use sliding sheets when repositioning their patients due to perceptions of excessive time wastage compared to manual repositioning. The researchers in this study aimed to compare the levels of subjective fatigue and working time differences between the use of sliding sheets for patient turning and repositioning, compared to non-assisted techniques. |
| Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific. | The study employed a quantitative research methodology in the form of a cluster-randomized clinical trial. Here, the researchers created three nursing home (NH) clusters, each comprising three nursing homes. Every facility was after that randomly assigned an NH-wide repositioning interval at either 2, 3, or 4 hours, implemented during four weeks of intervention.
| The study employed a quantitative research methodology consisting of randomized clinical trials across eight tertiary hospital sites in Australia. The researchers stratified the sites by pressure ulcer incidence rates and randomly assigned patients to either receive the PUPB or standard care, measuring the occurrence of Hospital Acquired Pressure Ulcers. | The study implemented a quantitative research methodology through a multicenter, cluster, three-arm, randomized controlled pragmatic trial and cost-effective analysis. | The study employed a quantitative research methodology, in the form of a comparative experimental study design. Each of the 30 participant nurses was randomly assigned to one of three types of repositioning sequences to measure the time used and subjective fatigue experienced. |
| A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected. | The randomized methodology is beneficial since it is precise and controlled, helping to overcome various forms of bias, such as observer and patient bias, along with confounding resulting from unequal distribution. Such randomization also enhances the reliability of the results since they can be reproduced/replicated. Randomization of intervention intervals ensures research’s validity by obtaining different results from the different intervention intervals.
| The method is advantageous since it overcomes selection bias and confounding. It is also precise and controllable in its application and measurements, making it reliable ideal for the current study. The random application of the PUPB interventions enhances the reliability of the test and its results since it can be applied to any other set of subjects. The random application of either PUPB or standard care increases the study’s validity since a clear difference exists in the interventions | The study’s reliability is strengthened through cluster randomization and unannounced visits to the healthcare facility for data collection. The use of a pragmatic trial ensures validity by measuring the effectiveness of the intervention. | The random assignment of different interventions to different participants is beneficial to the research since it helps to overcome participant bias and strengthen reliability. The external validity of the study is, however, restricted due to the experimental environment of the study. |
| General Notes/Comments | According to the researchers, pressure ulcers are expensive to treat, costing between $21,000-152,000, thereby highlighting the importance of prevention research.
| The cost-effective analysis was measured through avoidance of hospital-acquired pressure ulcers. | The study is still ongoing. | Sliding sheet repositioning generally takes more time compared to manual repositioning. However, the method is more active while taking into account total personnel time and subjective fatigue. |