Case Study 1
1) In the present case study the nurse personnel decided to take care to the patient named Mr. Smith regarding the prevention of the pressure injury after the surgery. In order to prevent the progression of the pressure injury the nurse had decided to use the general mattress or the air mattress as in various studies the effectiveness of these mattresses in prevention of the pressure injury is well documented (van Leen et al. 2011). In case of pressure injury prevention, the use of the normal mattress cannot be recommended at all as it is not associated with the prevention of the pressure injury (Sauvage et al. 2017). Henceforth the nurse personnel should opt for the air mattress or the foam mattress for prevention of the pressure injury prevention. The air mattress is mainly a bed that is also used as an effective treatment tool for the pressure ulcer prevention among the patients. However, in some cases, this type of bed also uses water as a floating bed. According to the study of Garg et al. (2015), it was reported that the use of the air mattress is more beneficial in terms of injury prevention compared to the use of the general mattress. In this study the authors included 57 participants comprised of both air mattress user (42 patients) and the general mattress user (15 patients). The study result stated that the after the detection of the ulcer the immediate treatment protocol was initiated among the participants of both groups. The participants of the air mattress group showed full recovery (100%; n=5) and on the other hand the 2 out of 5 people in the general mattress group showed recovery.
The foam mattress is made of the polyurethane and it is often named as viscoelastic polyurethane for its higher density and viscosity. This type of mattress mainly creates matrix through which the air can move and thus allows the improvement of the pressure ulcer injury among the patients as well (Ozyurek and Yavuz 2015). In another study by Park and Park (2017) it was reported that the use of the foam mattress was effective compared to the standard mattress used in the hospital care setting.
2. Therefore, from the above discussion it can be concluded that the both the air mattress and the foam mattress are beneficial for the prevention of pressure ulcer injury among the patients. However, in this case study the nurse can choose the air mattress prior to the foam mattress.
3. a) The main potential area of change in the hospital care setting should be associated with the mandatory use of the air mattress or the foam mattress instead of the general mattress in prevention of the pressure ulcer.
b) The comparative analysis of the foam mattress and the air mattress in prevention of the pressure injury can be recommended as further area of research.
c) As a part of the actions to address the outcomes research, the hospital care authorities must consider the cultural and ethical believes of the patients and prior to the implementation consent of the patients must be collected as a part of the ethical considerations.
Case Study 2
1. The present case study addresses the two areas of the hand washing technique such as the hand soap and the hand sanitizer among the nurses. The hand sanitizer practices are recommended by WHO and it can be replaced by hand washing technique by using soap as well. The hand sanitizer contains mainly isopropyl alcohol, glycerol, and hydrogen peroxide and on the other hand, soap does not contain such type of components. The study of Nasution et al. (2019) it was reported that use of the hand sanitizer is beneficial for the prevention of the hand acquired infections in the hospital care setting. In this study the researchers reported that the researchers were able to include only 16 nurses in the study and they were divided into two groups. Although the study reported about the WHO recommendation, the study failed to show any significant differences in between the hand sanitizer group and the hand soap group.
The soap based method in the hospital care setting was also supported by the researchers. In this regard, it can be stated that Singh et al. (2020) reported about the effectiveness of the hand soap compared to the use of the hand sanitizer based on alcohol. In this study the researchers performed a literature search in the online databases by using the relevant keywords. Therefore, the researchers finally included 17 articles in the final review study. The study result stated that the washing hands with the soap is beneficial and more practical to maintain the hand hygiene compared to the alcohol based sanitizer on greasy and soiled hands. However, the alcohol-based sanitizer can help to kill bacteria colony if used appropriate volume.
2. From the above analysis of the above finding, it can be stated that the two articles described the effectiveness of the soap based hand hygiene practice and alcohol based hand sanitizer in preventing the hospital acquired infections in the hospitals. However, the use of alcohol based hand sanitizer was recommended in both the articles for preventing the hospital acquired infections among the nurses and patients. Furthermore, it is also evident that the WHO also recommends the use of the alcohol based hand sanitizer in place of the soap based hand washing method.
3. a) Considering the present case study or the scenario, it can be stated that the potential area of change is associated with the use of both the hand sanitizer recommended by WHO and the soap based hand washing method for providing better protection.
b) Considering the present condition, it can be stated that the researchers should concentrate on the formulation of the soap and hand sanitizer to examine the effectiveness of the different formulations used in the hand sanitizer in the hospital care setting. Moreover, the perception of the nurses towards the different method can also be assessed as a part of the future research.
c) As a part of the actions to address the outcomes research, the hospital care authorities must consider the cultural and ethical believes of the nurses and prior to the implementation consent of the nurses must be collected as a part of the ethical considerations.
References
Garg, P., Patel, R., Taraporvala, RJ., and Pispati, A., 2015. The efficacy of Air Mattress in bedsore prevention and treatment. Sch. J. App. Med. Sci., 2015; 3(3H):1602-1604
Nasution, T.A., Yunita, R., Pasaribu, A.P. and Ardinata, F.M., 2019. Effectiveness Hand Washing and Hand Rub Method in Reducing Total Bacteria Colony from Nurses in Medan. Open Access Macedonian Journal of Medical Sciences, 7(20), p.3380.
Ozyurek, P. and Yavuz, M., 2015. Prevention of pressure ulcers in the intensive care unit: a randomized trial of 2 viscoelastic foam support surfaces. Clinical Nurse Specialist, 29(4), pp.210-217.
Park, K.H. and Park, J., 2017. The Efficacy of a Viscoelastic Foam Overlay on Prevention of Pressure Injury in Acutely Ill Patients. Journal of Wound, Ostomy and Continence Nursing, 44(5), pp.440-444.
Sauvage, P., Touflet, M., Pradere, C., Portalier, F., Michel, J.M., Charru, P., Passadori, Y., Fevrier, R., Hallet-Lezy, A.M., Beauchêne, F. and Scherrer, B., 2017. Pressure ulcers prevention efficacy of an alternating pressure air mattress in elderly patients: E²MAO a randomised study. Journal of Wound Care, 26(6), pp.304-312.
Singh, P., Potlia, I., Malhotra, S., Dubey, H. and Chauhan, H., 2020. Hand Sanitizer an Alternative to Hand Washing—A Review of Literature. Journal of Advanced Oral Research, p.2320206820939403.
van Leen, M., Hovius, S., Neyens, J., Halfens, R. and Schols, J., 2011. Pressure relief, cold foam or static air? A single center, prospective, controlled randomized clinical trial in a Dutch nursing home. Journal of tissue viability, 20(1), pp.30-34.
