Nursing Home Quality and Pressure Ulcer Prevention and Management Practices
The research question for the study is finding out the causes, incidence and outcomes associated with pressure ulcers between the 1st of January, year 1996 and the 31st of December, year 2004. The other question was to find out whether registration of pressure ulcer could be utilized as a way of determining the quality of health care services provided for pressure ulcers (Willem, Ladenoye, Jean and Paul, 2009).Dependent variables that have been used in this research study are pressure ulcers development measurements. Other complications arising as a result of pressure ulcers were also used as dependent variables. The independent variables used include patient care and management procedures and patient co-morbidity. Demographic variables were also used and these include age and sex of the participants. These were also independent variables (Willem et al, 2009).
The research is non-experimental since there are no control groups. In an experimental research study, a researcher tries to control various factors that may have an impact on the outcome of the study. Through controlling, the researcher is able to make predication concerning the expected results. In this case, no variables were controlled and hence, the study is non-experimental.The study design is within subjects since each and every participant took part in the study. Pressure ulcer registration was carried out for each and every participant in order to identify the incidences, causes and outcomes of the complication. Only those participants with pressure ulcer took part in the research study and this further proves that the study was conducted within subjects (Willem et al, 2009).
This research study is quantitative since it makes use of statistically numerical data. The number and percentage of recorded readings from different variables was recorded. For examples the total number of patients with pressure ulcers within the period of the research study has been identified. There is the use of numerical data collection tools in the study. An example of such a tool is a registration system that was used to register the number of pressure ulcer complications.
The research study was prospective due to the fact that the researchers used participants with different variables. The participants in this case were patients with pressure ulcers. These patients were of different ages and sexes. Since age and sex were the demographic variables associated with subjects or participants, it can be presumed that the study was prospective (Willem et al, 2009).A random assignment was not used to control experimental variables. Instead all the pressure ulcers patients and their conditions were registered and recorded. There was a standard registration program that was used to take note of all the participants or patients. Moreover, the program categorized the outcomes and causes of each pressure ulcers complication observed.
There was attrition in the research study. This is because an indication of a decrease in the number of ulcers pressure patients in consecutive years. The loss or attrition of participants could be as a result of succumbing to the condition or due to a reduction in the incident of the disease. Some participants got well and ceased taking part in the research study (Willem et al, 2009).Attrition which is defined as the loss of subjects of participants may pose a threat to the internal validity of a research study. In this case, the loss of subjects or pressure ulcers patients could affect the internal validity. It is also possible for the non-random selection to pose as a threat to internal validity.
The research question of the research study is finding out the extent of the indicator of quality of pressure ulcers. Various types of assessment were also to be determined and these include pressure ulcer risk assessment and skin integrity assessment. The researchers wanted to find out whether pressure ulcers could be used as a key indicator of the quality of health care setting such as nursing homes (Deidre, Williams, Rantz, Popejoy and Vogelsmeier, 2004).The dependent variable that was used in this research study was the prevalence of pressure ulcers. The independent variables were health care facilities responses
The study was non-experimental since there was no use of control samples or placebos. Instead, only patients with pressure ulcers were used as the sample (Deidre et al, 2004).The study was done between subjects since it only involve the use of health care facilities and the prevalence of pressure ulcers. The prevalence and risk assessment of pressure ulcers in the long-term care facilities was also determined.The study design is quantitative since numerical data was used. The use of surveys is also an indication that the research study was quantitative. There was the use of statistical data was then analyzed using statistics software. The use of numerical statistical data is the key aspect of quantitative research design. Data collection and assessment tools such as the standardization instruments were also used for monitoring the quality of health care facilities (Deidre et al, 2004).
The study was prospective since it involves constant monitoring of the health facilities in order to determine prevalence of pressure ulcers as well as assess the risks. Data was not gathered at a single instant but it took a given period of time. There was a monthly, weekly and daily assessment of quality (Deidre et al, 2004).
There was neither random assessment nor random group formation. Both non-profit and profit making health facilities were assessed. However, there was attrition since some health facilities failed to respond to the survey questions and it was therefore impossible to collect data from such facilities. The prevalence of pressure ulcers also varied due to loss of participants. It is clear that pressure ulcers, is a medical condition that could be fatal and hence there is a possibility of losing participants as a result of the condition. Consequently, attrition could pose a threat to the internal validity of the research study in addition to non-randomization of samples (Deidre et al, 2004).
Though non-random design is cheap, this method of study design has been known to affect he internal validity. It decreases the internal validity as well as the external validity. It is extremely difficult to generalize the findings obtained using this study design because the sample used can not be representative samples.An alternative research design that could be used is the random research design. Under this design, the participants would be selected randomly based on different independent and demographic variables. This research design is appropriate since it minimizes internal and external validity threats. Moreover, it is possible to generalize findings obtained by using random design since they can act as representatives for the entire population.
Willem, J, H., Ladenoye, M., Jean A. J. & Paul, J. (2009). Assessment of Incidence, Cause and Consequences of Pressure Ulcers to Evaluate Quality of Provided Care. Dermatological surgery 3(5), 1797-1803
Deidre D., Williams D. A., Rantz, M. J., Popejoy, L. L., & Vogelsmeier, A. A. (2004). Nursing Home Quality and Pressure Ulcer Prevention and Management Practices. Journal o American Geriatrics Society, 52(4), 583-588