Pressure ulcer occurs due to the forces of friction, pressure, and shear that affect the integrity of the skin tissues. It is common among patients, who have minimal mobility, poor posture, impaired nutrition, and obesity (McInnes, Jammali-Blasi, Bell-Syer, Dumville, Cullum, 2014). The prevention of pressure ulcers involves the use of support surfaces such as cushions, mattresses, chairs, and overlays, which relieve the pressure on bony prominences of the body.
Although the use of support surfaces is a known intervention, the effect of using support surfaces regularly is unknown. The use of support surfaces regularly is applicable among bedridden patients, who have diverse chronic conditions. The selected articles are relevant because they are peer-reviewed articles from CINAHL, Elsevier, NCBI, and The Cochrane Library. A pressure ulcer, prevention of pressure ulcer, and support surfaces are keywords used in the selection of the three articles.
Since bed-bound patients are prone to pressure ulcers, the essay hypothesizes that the use of support surfaces regularly will decrease the chances of a bed-bound patient developing pressure ulcers. The null hypothesis is that the use of support surfaces regularly will not decrease the chances of a bed-bound patient developing pressure ulcers.
The important points of the article are that the use of support surfaces plays a central role in the prevention and treatment of pressure ulcers among predisposed patients and/or those already suffering from it. According to Colin, Rochet, Ribinik, Barrois, Passodori, and Michel (2012), support surfaces such as beddings, seating cushions, transport trolleys, operating tables, positioning accessories, and protection accessories are effective in the prevention and treatment of pressure ulcers among patients.
These support surfaces alleviate pressure on vulnerable parts of the body, and thus, prevent the development of pressure ulcers among patients. Colin et al. (2012) recommend that the use of support surfaces should complement other preventive and curative strategies such as nutritional and postural care. In this view, the use of support surfaces alone cannot prevent and treat pressure ulcers among predisposed patients and sick patients.
As a research question, the study sought to identify the best support surfaces, which are effective in the prevention and treatment of pressure ulcers. The findings show that structured foam mattresses, alternating pressure mattresses, low-air-loss beds, overlays, and air-fluidized beds are the best support surfaces in the prevention and treatment of pressure ulcers.
The design of the study is meta-analysis because it entailed systematic analysis of literature review articles dated from 2000 to 2010 obtained from various databases such as The Cochrane Library, PubMed, and Pascal Biomed. Colin et al. (2012) state that, “a systematic review of literature, a compendium of prevailing professional practices, and validation by a multidisciplinary panel of experts” are three major steps that the study employed in the meta-analysis method (p. 467).
In the collection of data, the populations of the study were patients at risk of developing pressure ulcers in various healthcare settings. The population targeted had undergone randomized clinical trials; hence, their data are appropriate for the study of pressure ulcers (Colin et al., 2012). In the sampling procedure, the study employed the purposive sampling method.
Out of 430 research articles obtained from online databases, 145 research articles met the criteria for selection and were used in the meta-analysis. Data collection strategies involved systemic classification support surfaces, which are applicable in the treatment and prevention of pressure ulcers among patients.
The findings hold that support surfaces are effective in the prevention and treatment of pressure ulcers among bedridden patients. According to Colin et al. (2012), structured foam mattresses, alternating pressure mattresses, low-air-loss beds, overlays, and air-fluidized beds are the best support surfaces that prevent the occurrence of pressure ulcers.
However, these findings have limitations because the numbers of clinical trials are few, and corporate bodies have not conducted such research. Since the use of support surfaces is effective in the prevention and treatment of pressure ulcers, the study recommends the application of nutritional and postural interventions to boost the efficacy of support surfaces.
The important points of the article are that pressure ulcers are common among immobile patients and the elderly and the use of support surfaces is effective in preventing their occurrence and treatment of patients, who have already developed pressure ulcers. The findings of the study reveal that the standard foam mattress, alternating pressure mattress, seat cushions, and limb protectors are the best support surfaces, which reduce the occurrence of pressure ulcers (McInnes, Jammali-Blasi, Bell-Syer, Dumville, & Cullum, 2014).
In establishing these findings, the first question used is to what extent can cushions, mattress overlays, beds, and mattress replacements decrease the prevalence of pressure ulcers when compared to standard support surfaces? The second question is that what is the effectiveness of different support surfaces in the prevention of pressure ulcers?
The design of the study is a meta-analysis of various articles of randomized controlled trials, which entailed comparative analysis of different support surfaces. The populations of the study were patients, who were at risk of developing pressure ulcers owing to their chronic conditions. To obtained accurate information, the study employed a purposive method of sampling, which ensured that all research articles meet the inclusion criteria.
McInnes et al. (2014) state that the articles comprised of randomized controlled trials and compared the incidences of pressure ulcers in support surfaces such as beds, cushions, and mattresses. In data collection strategies, the study selected 31 research articles from MEDLINE, EMBASE, CINAHL, and CENTRAL databases. To retrieve important data, data extraction and management entailed analysis of inclusion criteria, care settings, demographic attributes, interventions, and outcomes.
The findings of the study revealed that some support surfaces are more effective in the prevention and treatment of pressure ulcers than others are. Specifically, the standard foam mattress, alternating pressure mattress, seat cushions, and limb protectors are effective to support surfaces, which decrease the incidences of pressure ulcers among predisposed patients (McInnes et al., 2014).
However, these findings have limitations because the sample sizes in various researchers are small, and the lack of blinding increases biases. The study recommends the use of advanced foam mattresses, seat cushions, beds, and overlays as support surfaces because they are effective in the prevention of pressure ulcers among patients at risk.
The important points of the article are that the incidences of pressure ulcers in the United Kingdom continue to increase among the elderly, and thus, there is a need to prevent their occurrence using designed mattresses as effective support surfaces. In a comparative study to establish an effective form of a mattress, Rafter (2012) finds out that the Dyna-Form Mercury Advance mattress is more effective than the Softform Premier Active mattress in the prevention of pressure ulcers among patients.
The Dyna-Form Mercury Advance mattress fits patients, who are highly predisposed to pressure ulcers because it comprises alternating and static systems. Hence, the study recommends the use of this form of mattress among patients, who have a high risk of developing pressure ulcers. To establish these findings, the research questions aimed at determining the effect of the two forms of mattresses on the incidences of pressure ulcers and finding out the opinions of patients and healthcare providers about the efficacy of the mattresses.
The design of the study is case-control because it entails the assessment of patients and nurses in a healthcare environment. The populations of the study were patients, who are at risk of developing pressure ulcers, and nurses attending to these patients. In a sampling of patients, the study employed a convenience method of sampling and selected 10 patients.
The study then assigned five patients randomly to the Dyna-Form Mercury Advance mattress and the remaining five to the Dyna-Form Mercury Advance mattress (Rafter, 2012). Using convenience sampling, the study also selected 14 nurses. The data collection strategies involved examination of the prognosis and incidences of pressure ulcers. Moreover, the data collection involved the use of questionnaires, which measure the satisfaction level of patients and usability of the mattresses by nurses.
The findings indicate that the Dyna-Form Mercury Advance mattress is more effective than the Dyna-Form Mercury Advance mattress. According to Rafter (2012), the Dyna-Form Mercury Advance mattress reduced incidences of pressure ulcers and both nurses and patients gave positive remarks about their usability and conformability respectively.
Hence, it is evident that the nature of the mattress determines its effectiveness in the prevention and treatment of pressure ulcers among patients. The limitations of the study are that these findings have low external validity because the sample size is very small and the duration of the study is short. These limitations reduce the extrapolation of the findings and their application as evidence-based findings. Overall, the study recommends healthcare providers use cost-effective support surfaces such as the Dyna-Form Mercury Advance mattress.
The literature review of the three articles supports the hypothesis that the use of support surfaces regularly will decrease the chances of a bed-bound patient developing pressure ulcers. The first article identifies the best support surfaces that are effective in the prevention of pressure ulcers.
Colin et al. (2012) state that structured foam mattresses, low-air-loss beds, alternating pressure mattresses, overlays, and air-fluidized beds are the best support surfaces that are applicable in the prevention of pressure ulcers among patients at risk. In this view, clinical guidelines should incorporate these findings in the prevention of pressure ulcers among patients at risk. The article also supports the use of support surfaces in the prevention of pressure ulcers among predisposed patients.
McInnes et al. (2014) hold that the standard foam mattress, alternating pressure mattress, seat cushions, and limb protectors are effective to support surfaces in the prevention of pressure ulcers. Hence, it implies that the design of the support surfaces determines their effectiveness in reducing the incidences of pressure ulcers.
The third article compares the efficacy of two forms of mattresses and reveals that the Dyna-Form Mercury Advance mattress is effective in reducing incidences of pressure ulcers, is comfortable for patients, and is usable among nurses. Generally, the use of support surfaces regularly requires postural and nutritional care for it to be effective in the prevention of pressure ulcers.
References
Colin, D., Rochet, J., Ribinik, P., Barrois, B., Passodori, Y., & Michel, J. (2012). What is the best support surface in prevention and treatment, as of 2012 for a patient at risk and/or suffering from pressure ulcer sore? Developing French guidelines for clinical practice. Annals of Physical and Rehabilitation Medicine, 55(7), 466-481. Web.
McInnes, E., Jammali-Blasi, A., Bell-Syer, M., Dumville, C., & Cullum, N. (2014). Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews, 4(CD001735), 1-62. Web.
Rafter, L. (2012). Evaluation of patient outcomes: Pressure ulcer prevention mattresses. British Journal of Nursing, 20(11), S22-S28. Web.