Risk factors for pressure ulcers among elderly hip fracture patients

¶ … Art

In critiquing the study; "Risk factors for pressure ulcers among elderly hip facture patients" conducted by Mona Baumgarten et al. On the topic of pressure ulcers we find that the study's results are laid out for perusal in a clear and concise manner that allows the reader(s) to understand the study's objective, conduct and results in a simple and usable manner.

The study's jargon was not excessively overdone, and its tone and presentation were easy to follow and even a beginning nurse or nursing student would have no trouble in following its presentation.

References for the study were quite numerous and were listed at the end of the study in a numbered format that simplified use. The references were both consistent in format and style.

The material found in the research report detailing the findings of the study were quite comprehensive but were presented in such a manner that it was quite simple for the reader to discern how such findings were both relevant and conclusive in nature. Reading and studying the material provided the reader with enough information to understand how the data could be used to improve the conditions of the elderly who suffered from the ulcers, but the report was also lacking somewhat in providing the answers to those conclusions. In fact, reading the last paragraph of the report would lend more credence to the fact that the study showed the extrinsic factors were both modifiable as well as present in the incidence of pressure ulcers, but that is all it showed. The report offered very little in the way of specific recommendations on what to do with the data contained therein.

A redeeming factor in the report was that at least it did conclusively show that such incidences of pressure ulcers were the result of extrinsic as well as intrinsic factors in fracture patients. The only question a person critiquing the study might have is, was the study worth the amount of dollars and time spent on the study (ten years), or could the same results have been derived from a less comprehensive study taking far less time and costing much less.

It is not as though the problem studied by the research is a small problem, it is not. Figures show that the average cost for a hospital stay involving an individual developing pressure ulcers is approximately $10,000 more than for an individual who does not develop pressure ulcers. The pain and suffering by the patient is also extensive and ulcer development can lead to further problems. Therefore, the problem of pressure ulcers is a significant one, and a problem worthy of a study of this magnitude. This researcher, however, felt that this ten-year study could have done far more than just answer the question posed by the study in the first place, which is; do extrinsic variables affect the incidence of pressure ulcers in elderly individuals undergoing surgery?

There were a variety of strengths contained in the study not least of which was the fact that it did verify that the incidence of pressure ulcers occurred not only due to intrinsic factors but also due to extrinsic factors as well. An additional strength of the study was that it was quite comprehensive in its gathered material, especially when compared to other studies of the same type.

Many of the other studies were more concentrated in scope when compared with this study that incorporated ten years worth of data from five different sources. The critiqued study was able to take directly from patient records the information necessary to either confirm or deny the premise. Other studies were not quite as comprehensive as this one was purported to be, and compared to the results of the other studies what this study provided was not only purported to be, but was, much more comprehensive in scope and detail.

A weakness of the study was that it did not examine any patients that might have developed pressure ulcers during their hospital stay but were not reported to having them when they were released. This could have been a significant factor, but researchers will never know because the information was never looked at, nor contained in the study. An additional weakness of the study was that the researchers had to rely entirely on information and data derived from hospital reports and patient charts rather than on direct contact with the individuals involved. This could be a considerable weakness to the study, but again it is not known whether it is a weakness or not because the information is not contained therein, which makes it a weakness.

One rationale that an observer might make in regards to the criticism of this particular study and the fact that it only looked at the records of the patients rather than talking to the patients themselves was that the study was only looking for the incidences of pressure ulcers.

The study did not offer specific solutions to the problem itself. The study was attempting to verify that extrinsic factors were involved in a high percentage of pressure ulcers, not attempting to solve such incidences if they truly did exist. That is a considerable weakness according to some researchers who might use the rationale that if such a comprehensive study was to be accomplished, why not come to some specific recommendations to solve the problem if the problem was found to be justified?

A modification of the study then could be proposed and would include not only coming to some conclusions concerning the number of incidences, but also to offer up some specific recommendations to solve the problem. Additionally, the study could be modified to discover the incidences of pressure ulcer occurrence that occurred and healed during the subject's stay(s) in the hospital.

Another modification of the study could be to speak with some of the subjects involved while they were still in the hospital in order to discover any discrepancies by the observers as compared to the written reports that the study used exclusively for the obtainment of data.

The feasibility of conducting this study again is limited in its effectiveness. The study took ten years to complete and required many man-hours. Coupled with the length of time and man-hours is the cost of duplicating such an event. One consideration to duplicating this study might be to gather the records from the hospitals covering a different ten-year period to discern whether the information differs in any significant amount from what was discovered by this study.