Qualitative Descriptive Study

Understanding of research, its role and its influence on the development of evidence-based practice in health care

Pressure Ulcer Prevention is an innovative strategy for patient’s safety so that it is possible for the nurses to provide acute care to the patients, where it is a bundle of targeting the patient’s participation in their care so that they can take active part in developing effective care plan. Personalise decision making practice in this regard is one of the main factors where the team members and health care professionals as well as social workers try to empower the patients in the decisions making practice so that the patients can express their thoughts and preferences and participate in developing effective patient care plan. It is further helpful for meeting the expectation of the patients and fulfilling their basic needs and preferences at the health care institutions. Hereby, the research focuses on the Pressure Ulcer Prevention practice, through which cooperation between the patients and the health care professional can be developed that helps in maximising the standard of patient care (Roberts et al., 2016).

The nurses have active role in developing Pressure Ulcer Prevention bundle where most of the hospitals are preferring the Pressure Ulcer Prevention for providing the best posisbel care and treatment to the patients at affordable cost of treatment so that the patient’s safety and security as well as wellbeing can be maximised (Roberts et al., 2016). The team members give priority in developing the Pressure Ulcer Prevention Care Bundle (PUPCB) where both the patients and the nurses are engaged, and the leader and managers try to encourage them to take active part for increasing patient’s participation. Introducing A Care Bundle To Prevent Pressure Ulcer (INTACT) is also another initiative of the health care professionals through which they can develop Pressure Ulcer Prevention planning where the health promotional practice such as providing message through posters and advertisement related to keep moving, eat healthy diet ad look after your skin are effective initiatives for the health care professionals to raise patient’s safety and encourage them to active part in developing appropriate care plan as per their needs and preferences (Roberts et al., 2016).

The paper highlights the participation of the nurses in intervening in the care plan and through team based practice in the health and social care institutions, enhancing communication and improving cooperation at the workplace, it is possible for the nurses to intervene in the health and social care service by which it is easy for them to maximise the quality standard of the care and deliver quality are and support the patients by ensuring greater intervention and participation. It is beneficial for the health and social care practitioners to engage with all the patients and build strong relationship with them so that it is easy to communicate with them and acknowledge their actual health needs and preferences. For team base working approach, it is the responsibility of the care givers to make healthy relationship and develop suitable organisational culture with respect and transparency where the patients can be feeling free to express their needs and preferences (Roberts et al., 2016). The patient’s role in this regard is necessary where the individuals themselves need to be cooperative in the health care institutions and interact with the care givers for developing effective care plan. In this context, the patients take active parts in the decision making practice and share their views and understanding with the care givers and in addition to these, the patients also try to exchange their information for sharing their personal data with the care givers so that the health care professionals can develop the Pressure Ulcer Prevention plan with proper cooperation and participation of the patients and acknowledge their actual preferences (Roberts et al., 2016).

Evaluating of research methodologies used in healthcare settings and ethical considerations

Methodology plays a crucial role in this research where the researcher selects appropriate methods for collecting the relevant and valid data and information related to the above mentioned research topic as well as use appropriate tools for analysing the gathered information efficiently so that the aim of the research and be fulfilled where the aim of the study is to analyse the nursing perception regarding the Pressure Ulcer Prevention where the nurses can influence the patients to increase their participation in the decision making plan for patient’s safety where the patients can get proper care and treatment as per their health needs and personal preferences. It is a qualitative descriptive study with semi structured interview with the nursing staff where the PUPCB was implemented and the research is conducted among four acute care hospitals across two Australian states. The researcher in this research considers the nurses who are permanent full time or part time employees and the employees during the implementation of INTACT trial where the nurses take active part in contributing successful implementation of INTACT at the workplace. As per the sampling, there are four to five nurses at each site who answered the questions in written version and the researcher disqualifies the answer with new information so that it is possible to avoid data saturation where appropriate data and information can be gathered well (Roberts et al., 2016). Considering the data collection method, the researcher focuses on semi structured interview where the questions are structure in different domain such as,

Perceptions of the intervention Perceived impact of the intervention Utility of the PUPCB in usual practice In this research, the researcher focuses on searching appropriate literatures so that it is possible to gather valid information related to the research topic. Hereby, secondary data collection method is utilised here where the secondary data and information is collected through secondary sources of information such as Books, Journals, News articles and online published articles which provides a scope to the researchers to collect appropriate information related to Pressure Ulcer Prevention that enhances the intervention of the nurses and the patients in developing effective care plan (Roberts et al., 2016). Moreover, after collecting the information, the researchers use the strategy of thematic analysis for analysing the information where there are different themes through which the researchers are able to represent the collected information and evaluate it proficiently. Hereby, thematic analysis is utilised in this research to analyse the gathered data collected through semi-structured interview process. the themes and subthemes are such as,

Understanding the PUPCB Comparing the PUPCB and the current practice in the health care settings Theme 2: Improving awareness, communication and participation with the PUPCB Subthemes: Increasing awareness of PUP Enhancing nurse and patient communication about PUP Active participation in PUP Theme 3: Appreciating the positive aspects of patient participation in care Subthemes: Understanding and supporting patient participation in care Realising the benefits of patient participation Theme 4: Perceived barriers to engaging patients in the PUPCB Subthemes: Cognitive impairment restricts participation in PUP Taking a passive approach to health care Undervaluing of PUP by patients Theme 5: Partnering with nursing staff to facilitate PUPCB implementation Subthemes: Communication and dissemination Leadership and influence Keeping the PUPCB simple

Ethical code of conduct in the health and social care system is one of the important practices so that it is possible to avoid any unethical practice and develop the standard of the health and social care service. Data Protection Act 2018 is also another code of ethics where the data can be secured and protected well. It is effective for improving trust and loyalty among the patients and collect valid and relevant in-depth information from the patients through communication and in this context, all the health and social care professionals need to follow the Data Protection Act for keeping the collected data secured.

Critical discussion of the research article

As per the findings of the collected information, it can be stated that partnership working is helpful for the nurses in implementing successful Pressure Ulcer Prevention plan through which it is posisbel for the health care professionals to encourage the patients for taking active part and increasing their participation in the care plan. In developing PUPCB, it is necessary to develop partnership working between the nurses and the painters and it further helps to increase patient’s involvement I a more collaborative manner. The health and social care professionals increase awareness about the PUPCB and Pressure Ulcer Prevention through improving communication and health promotional activities so that every patient can access the adequate information and contribute and engage with the nurses for getting better treatment and care. Patient’s participation in this regard is beneficial for them to get better treatment and care according to their requirements and expectations. It is useful to develop partnership care where all the practitioners, social care workers, health care professionals, nurses, doctors, other staff members, physicians and others need to be cooperative and share their views and experience to treat a patient. PUPCB and Pressure Ulcer Prevention in this regard is helpful for working together and develop an appropriate care plan for the patients for improving the wellbeing and health status of the individuals with proper medication, treatment and quality care and support (Roberts et al., 2016).

It is also necessary to enhance partnership in decision making about treatments and care where the partnership between the patients and the health care professionals is necessary in which the patients can express their views and share their needs and preferences with the care givers and the care professionals also can acknowledge the actual needs of the individuals and empower the patients for making effective care plan. Patient proactivity and personalise responsibilities are also effective in this context to implement PUPCB and Pressure Ulcer Prevention, where the patients need to be cooperative and share their views and understanding and, in this regard, the responsibility of the care givers is to create friendly atmosphere and improve trust and loyalty so that the individuals can feel free to express their understanding. Through this study, it is possible to understand that, developing coordinated care is also beneficial, that considers the patient as a whole person and in this regard, cooperation with the patients, building strong relationship and maximise their values through meeting their expectations are helpful for enhancing the quality standard of the health and social care service (Roberts et al., 2016).

The nurses also focus on enhancing communication that is personalise and convenient where under this practice, the nurses need to build trust and convince the patients to share their needs and preferences and the health professionals ensure that the collected personalise information are kept secured. These practices are helpful for developing the PUPCB and Pressure Ulcer Prevention approach where all the health care professionals, nurses and the patients are cooperative, and they share their views and understanding for successful empowerment of the patients and the nurses in the health care practice by ensuring developing patient centric care as well as implementing the PUPCB and Pressure Ulcer Prevention (Roberts et al., 2016). Partnership working between the care professionals and the patients are helpful to enhance communication, increase the satisfaction of the patients, create values for the social communities as a whole, minimise cost of treatment and maximise the quality of the health and social care service (Roberts et al., 2016).

In order to implement the PUPCB and Pressure Ulcer Prevention, the health and social care professionals face certain barriers where this program is not good for cognitive impairment which restricts the patients in taking active part in the PUPCB approach. Patients with dementia, delirium or confusion are considered as having high risk and it is risky for the nurses to encourage the patients for taking active part in the PUPCB and Pressure Ulcer Prevention program (Roberts et al., 2016). In addition to these, negative attitude of the patients is another barrier where the nurses failed to interact with them and this further raises the issue of lack of communication, non-cooperation, misunderstanding and lack of trust and loyalty among the patients. It is difficult for the nurses in this case scenario to improve engagement with the patients as well as their families al.so as they are not interactive and there is lack of trust and loyally for which the patients and their families cannot rely on the decision made by the nurses (Roberts et al., 2016). Hereby, poor empowerment of the patients, non-cooperation and lack of communication are the major barriers in developing team based working practice with collaboration between the patients and the care givers. In addition to these, isolation of the physicians, poor team cohesion and poor leadership style are other barriers for which the issue of internal conflicts and resistance to change arise, which in turn deteriorates the quality standard of the health care service where the staff members and the health care professionals fail to cooperate with the patients and develop PUPCB and Pressure Ulcer Prevention at the health and social care institutions.

On the other hand, there is non-cooperation between the patients and the health care professionals for which the issue of poor empowerment of the patients, lack of communication and disrespecting the patient’s preferences arose. Non-cooperation is one of the serious barriers in the health and social care context where the staff member, practitioners, health care professionals, physicians and social workers do not want to cooperate with each other and this in turn deteriorates the quality standard of the health care service. In order to develop effective PUPCB and Pressure Ulcer Prevention program at the health and social care institutions, it is necessary for the nurses to mitigate the above-mentioned barriers and develop some suitable solutions through which it is easy to implement the PUPCB and Pressure Ulcer Prevention where patient’s involvement can be enhanced (Roberts et al., 2016). In order to resolve the issues or barriers and increase involvement and participation of the patients in the PUPCB and Pressure Ulcer Prevention, the possible solutions are such as,

Communication and dissemination Leadership and influence Keeping

Communication is one of the effective ways to resolve the existing issue and encourage the nurses and the patients as well to take active part in the PUPCB program. Importance of providing adequate information enhances dissemination where all the nurses and the painters are able to access all the relevant information related to the PUPCB and Pressure Ulcer Prevention. Leadership and influence are also another factor that would imporve the scenario and encourage the patients for involving themselves in the PUPCB and Pressure Ulcer Prevention program which is being helpful for INTACT trial, where intervention of the nurses and other staff as well as the patients will be beneficial for developing effective PUPCB. Making the PUOCB simple by providing relevant and valid information as well as providing effective messages through television advertisement on the screen at the hospitals at different times are also helpful to motivate the patients and gather proper knowledge and understanding about the benefits of PUPCB where they are also encouraged in participating in the implementation process of PUPCB.

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Reference List

• Roberts, S., McInnes, E., Wallis, M., Bucknall, T., Banks, M. and Chaboyer, W., 2016. Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study. BMC nursing, 15(1), pp.64.