The Evidence-Based Medicine Research Paper

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In long term resident with pressure ulcer comparing nutrition intervention plus standard skin care with standard skin care only?

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The utilized clinical peer reviewed articles as well as Journals’ development is done by or in association with well informed health practitioners particularly those specialized in pressure ulcer area. Most of these articles are backed by firmly founded recommendations derived from utilization of literature reviews as well as actual field research studies that is rather exhaustive. These resourceful peer reviewed articles include of the American Geriatrics as well as Critical Care Journals that are reviewed by different authors in a specified span of time. In these articles a comparison is carried out regarding the role of skin care practiced in a standardized manner to nutritional intervention aspect with regards to pressure ulcer care and management.

The various methods of analysis as depicted in each of the articles are diverse and include trials that are rather randomly controlled as well as statistical analysis of secondary sources. Other articles utilized include; health practitioners manuals from where the analyzed study statistics are derived and integrated accordingly.

The resultant understanding from this review is that as much as both practices are effective in their distinct ways of actual pressure ulcer management there is need to have them integrated for complementary purpose. Some authors argue that nutritional intervention may not have much positive impact on the already suffered ulcer but when complimented with skin care of a certain standard the results are promising.

Finucane, T. E. (1995). Malnutrition, tube feeding and pressure sores; Journal of the American Geriatrics Society, 43, 447-451”

This particular peer reviewed journal covers a literature search involving articles whose field research was conducted from 1985 all the way to 1994 regarding pressures sores as related to malnutrition. The research also featured tube feeding application in the actual pressure ulcer management. The author notes that in this whole process, a total of twenty two studies were complied for review whereby important information regarding nutritional intake as linked to pressure ulcer was yielded. The results realized in this type of nutrient intervention as a beneficial contribution to pressure ulcer management is said to be inconclusive. According to the author, reviews brought forth specific contradictory results that led to a conclusion that nutrition intervention in form of tube feeding does not form efficient therapy. This article’s analysis points out that poor health suffered by particular pressure ulcer patients may be resulting from improper dietary that would not be improved by any form of complementary nutrient intake. The author also notes that there are a number secondary impacts affecting tube feeding which have a capability of worsening pressure ulcers situation. Therefore it occurs that for nutrition intervention to show effectiveness some of levels of skin care need to be applied to complement its deficiencies.

LaMantia, J. G., Hirschwald, J. F., Goodman, C. L., Wooden, V. M., Delisser, O., & Staas, W. E. (1987). A program design to reduce chronic readmissions for pressure sores. Rehabilitation Nursing Journal, 12(1), 22-25.”

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The authors of this particular article bring out the necessity of success realised in standard skin care practice as a means of managing pressure without any integration of nutrient intake considerations. This case study was conducted in order to evaluate impact of a certain modification program that is expected to bring forth improvement on pressure ulcer situations. The authors also point out that positive results of the study were to be applied in more or less related situations involving spinal cord damage management whereby skin care is integrated. Therapy sessions were set forth and each of the forty participants was expected to adhere to the laid down rules and regulations of which upon completion; results in terms of their health were analysed. The statistical analysis in this particular study was carried out in such a way the percentages of successful and unsuccessful participants were calculated from the beginning of the evaluation to the end. Although the percentage of successful participants kept dropping from the initial 78% to 20%; it occurred that consistency and proper following of required directions to skin care resulted to recovery of intact skin. On the other hand, the group that went against the laid down skin care procedures ended up suffering skin reopening. This article shows that a well strategized skin care management plan is bound to register effectiveness in pressure management as compared to integration of nutrition in the entire process.

Thompson C. & Fuhrman P. Nutrients and Wound Healing: Still Searching for the Magic Bullet. American Journal of Critical Care, 2, 26-29”

The author of this article points out the necessity of nutrition intervention in the entire aspect of pressure ulcer management. In this article, it is argued that although nutrition intervention is recommended as a compliment of skin care, clinicians involved in impacting this practice are normally faced with some tough challenges. Among those mentioned by the author are delayed as well as improper wound healing. The author admits that nutritional intervention plays a considerably important role in the entire healing process but also points out the controversy realized in inclusion of the nutrition regimen. This study also features compilation of limitations characterizing research studies involving nutrition recommendations as some form of pressure ulcer management strategy. The author concludes with an invitation of further research studies towards the same as he argues that available clinical studies tend to be deficient of firm founded evidence that would be used on formulating outstanding guidelines regarding the entire aspect of nutrition support.

Cereda, E., Gini, A., Pedrolli, C. and Vanotti, A. (2009), Disease-Specific, Versus Standard, Nutritional Support for the Treatment of Pressure Ulcers in Institutionalized Older Adults: A Randomized Controlled Trial. Journal of the American Geriatrics Society, 57: 1395–1402”

This journal’s author puts forth a study that tends to compare the important of standard diet as well as skin care as compared to one where particular disease nutritional perspective is utilized with regards to pressure ulcer treatment. A number of elderly patients living in randomly selected institutions are engaged in a controlled trial. The group on trial is divided such that part of it is administered with some standard diet as well as skin care while the other is accorded particular disease nutritional care. In both case, the rate of ulcer management as well as healing was observed and results measured with a specific scale for gauging Ulcer healing process. It occurs that nutritional intervention constituting proteins, vitamin C as well as some zinc supplements had better healing process outcomes hence the recommendation of this kind of intervention as a complement of skin care for Ulcer management.

Bell L. Evaluation of and Caring for Patients with Pressure Ulcers; American Journal of Critical Care. 2008; 17: 348

The author points out the risk associated with pressure Ulcer occurrence suffered by hospitalized patients who are in rather critical conditions. The author notes that among the factors influencing these occurrences are complication of multiple diseases, long and extended bed rest periods as well as adoption of improper body positioning. In order to reduce these fateful instances, the author points out the increased commitment by nurses practicing in this particular area to engage in prevention of hospital associated injury as well as management of already existing ones.

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The study has therefore come forth with a number of things that needs to be observed and implemented accordingly including the proper identification of necessary skin care recommendations as well as products. According to the author, this practice ought to be a routine whose results are considerably promising even without engaging in any nutritional intervention since apart from being a management strategy, skin care also serves as an efficient preventive measure.

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