This paper is the first part critique of Bergquist-Beringer and Daley (2011)’s article on pressure ulcer (PU) prevention for use in home health care environments. It explores the following subsections.
Problem Statement
According to Grove and Burns (2011), a good problem statement describes the clinical and research problem as well as the study significance. These two elements introduce readers to the significance of the topic under analysis. It ensures a clear reader orientation to the problem as well as the framework that will be useful in the inference stage. Notably, Bergquist-Beringer and Daley (2011) have a clear clinical and research problem statement. The authors describe the occurrence of hospital acquired pressure ulcers (PUs) as an issue that affects patients across all clinical settings including home-based healthcare.
According to Bergquist-Beringer and Daley (2011), patients that acquire P.Us often experience intense pain and discomfort. Also, they are characteristic of isolation and may most likely develop other critical complications that require hospitalization. Thus, the authors acknowledge the existence of adequate literature on the prevention of PU for patients under inpatient care. However, they identify a research gap in the appropriateness of similar guidelines in home healthcare environments.
The article also contains a clear description of the study significance based on the following pointers. First, the authors approximate the current annual national expenditure on PU treatment to be USD 11 billion. Such statistics make PU an almost prevalent yet expensive healthcare problem. Second, they consider PU as preventable especially among care providers who desire to reduce its incidence. Third, current clinical guidelines for preventing PU occurrence offer adequate recommendations for practice. However, these studies base their inference on evidence collected from long-term and acute care clinical environments. Finally, there exists limited research to explore how practitioners can adapt such prevention guidelines for utilization in home care environments. The gap overlooks an up to 17 percent PU incidence rate among such patients (Bergquist-Beringer & Daley, 2011).
Purpose and Research Question
Russell and Gregory (2003) asserts that readers should always look out for clear purpose and research questions before reviewing the main study. This move offers insight on the relevance of the article to clinical practice. Excellent study reports are those with clear documentations of the study purpose and research questions. Bergquist-Beringer and Daley (2011) provide a clear statement and description of the purpose of the study. Ideally, the study aims at delineating interventions and activities that can be useful in the prevention of PU in home health care.
However, they do not have an explicitly provide the research questions. Thus, the paper explores the following roughly drafted research questions. First, what activities and interventions are useful in the prevention of PU in home health care? Second, can the study findings offer clear guidance on the adoption of clinical guidelines on PU prevention in home health care environments? Finally, is there a difference in complexity between clinical and home healthcare PU prevention measures?
Nonetheless, they relate the research questions and study purpose to the problem at hand. The description in the introductory segment helps provide a link between the two components. According to Grove and Burns (2011), it is the researchers’ role to offer multiple vantage points that relate their research question to the said methodology. Thus, qualitative studies look into finding the breadth within an area of interest. Notably, their qualitative research method offers an appropriate way of answering the research question.
In this case, the researchers look at sampling practitioners working in various kinds of home health areas. They also note that their choice of participants depends on the breadth and depth of experience as stated in the research question. The research question concentrates on finding different perspectives and recommendations from participants on how to prevent the occurrence of PU in home care environments (Bergquist-Beringer & Daley, 2011).
Literature Review
Grove and Burns (2011) note some reasons for conducting a relevant and exhaustive literature review. For instance, they state that good reviews help justify the reasons for research. Reviews provide strength to the study and help in the identification the gap from existing studies. They also allow researchers to establish a theoretical and methodological focus that would help relate existing studies to new knowledge.
Bergquist-Beringer and Daley (2011) use both qualitative and quantitative studies as part of their literature review. The journal articles include Allam et al. (1999), Dallam et al. (1995), Hopkins et al. (2006), and Langemo et al. (2000) among others. Other review contents include books, reports, and organizational websites. Some of the books include House and Howe (1999), Bernard (2006), and Morgan (1998). All these material is relevant to the study topic. They talk touch on relevant issues such research methodologies, PU incidence, PU prevention, and home health care.
Bergquist-Beringer and Daley (2011)’s retrospective analysis uses literature that spreads from 1993 to 2010. Most of these studies provide an updated analysis of the subject and a strong foundation that is significant to PU prevention. Notably, the researchers identify a weakness in a biased focus on clinical settings as opposed to home health care. Nonetheless, the researchers identify and compare various methods used in others studies on the topic. Eventually, they can provide a critical summary of the current knowledge on PU prevention in home health care settings.
Conceptual/ Theoretical Framework
Grove and Burns (2011) states that is vital that researchers use a suitable conceptual or theoretical framework as a way of providing a structure that will help guide their research. These frameworks offer the background required to support an investigation and give a justification for the significance of exploring a research question. It encompasses the variables the researcher intends to measure and understand. Notably, the framework presents a theory that helps explain an issue (Grove & Burns, 2011).
Bergquist-Beringer and Daley (2011) use the Henriksen et al. (2009)’s conceptual model dubbed the human factors of home health care. This model is useful in examining the quality and safety concerns of patient management in non-clinical settings. It proposed that care in such environments rely on reimbursement guidelines, availability of community resources, the nature of the task at hand, as well as caregiver and patients’ characteristics. The model also assumed that adverse events can fall to a minimum low upon the interaction and collaboration of basic model components. Their application of this model to PU prevention and care suggested that practice guidelines would encompass directions for helping implement the ancillary that is vital to home care.
The Bergquist-Beringer and Daley (2011)’s framework are a summary of their theory regarding PU as a problem developed through a review of tested variables. Through this model, the researchers identify a plan for data interpretation and investigation. It presents an adequately supported rationale organized in a way that assists readers to assess and understand various viewpoints. The primary purpose of this model is for the authors to demonstrate that the relationships are not personal rather informed of scientific facts.
References
Bergquist-Beringer, S., & Daley, C. (2011). Adapting Pressure Ulcer Prevention for Use in Home Health Care. Journal of Wound, Ostomy and Continence Nurses Society, 38 (2), 145-154.
Grove, S., & Burns, N. (2011). Understanding Nursing Research. Maryland Heights, MO: Elsevier.
Russell, C. K., & Gregory, D. M. (2003). Evaluation of qualitative research studies. Journal of Evidence Based Nursing, 6 (2), 36-40.
