Article critiqued
Wilson, L., Kapp, S., & Santamaria, N. (2019). The direct cost of pressure injuries in an Australian residential aged ace setting. International Wound Journal, 16(1), 64-70. https://doi.org/10.1111/iwj.12992
Critique
The article, “The direct cost of pressure injuries in an Australian residential aged ace setting”, by Lauren Wilson, Suzanne Kapp and Nick Santamaria seeks to determine the direct financial cost of pressure injuries among age patient populations in residential care settings. The research problem being addressed is how much it costs to treat pressure injuries in Australian residential aged care setting. This is based on the awareness that pressure injuries are a real concern within the care setting and population because of the prevailing factors such as poor nutrition, incontinence, altered sensory perception, reduced mobility and ageing skin, as well as reliance on health care providers to move their bodies. Towards this end, the study applied a prospective observational research approach that recruited a sample of 20 participants from the population of interest. Article Critique Essay Sample
The article’s abstract makes it clear that pressure injuries are a significant concern among the population of interest. They not only have a negative effect on health, but also attract a significant cost concern and place a burden on the health care system from additional care requirements. Although pressure injuries present a significant cost concern among aged adult patient populations in residential care settings, there has been no efforts to accurately determine the associated costs. In fact, much of the attention to the issue is based on cost estimates that carry an element of uncertainty. In fact, incidences of pressure injuries within the population are estimated at between 6.4% and 11.7%, with the annual cost estimated at about AUS$13.61 million (±SD AU$5.02 million). However, the results of the study reveal that the overall cost of treating a pressure injury is between AU$98,489.22 and AU$104,510.41 with the cost increasing to about AU$116,552.79 at 42 days. The average daily costs of care vary dependent on the stage of injury with stage 1 pressure injury attracting an average daily cost of AU$26.42, stage 2 pressure injury attracting an average daily cost of AU$37.17, stage 3 pressure injury attracting an average daily cost of AU$30.01, and unstageable pressure injury attracting an average daily cost of AU$10.22. Based on the quantified costs of treating pressure injuries among aged patients in residential settings, the authors conclude that this is a significant cost burden, and recommend that effective strategies be developed to reduce the economic burden.
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The article’s introduction describes the occurrence of pressure injuries and why aged adults in residential care settings present a concern for occurrence of pressure injuries. In addition, it notes that there is a high occurrence of pressure injuries among the population at between 6.4% and 11.7%. However, the authors report that different sources have presented different cost estimates for treating pressure injuries. With this awareness, the authors note that while there is a high incidence of pressure injuries among aged patients in residential care settings, the costs of treating pressure injuries are not accurately articulated. Given this awareness, the research is justified as intended to accurately articulate the direct cost of treating pressure injuries in residential aged care setting in Australia. This will be useful for supporting appropriate investment in prevention and treatment efforts.
The article’s methods section describes the research approach applied in collecting data and the justification for the approach. The study sought to develop a costing tool for quantifying the direct cost of treating pressure injuries in residential aged care setting as incurred by patients and health care system in dressing changes, nutritional supplies and mediation, medical equipment, external clinicians, and staff time. The development of a costing tool involves quantifiable costs, and as such the study was justified in applying a quantitative observational longitudinal approach. This approach necessitated the recruitment of participants with the use of a probability purposive sample justified as the population of interest is small in number. The focus was on calculating the average costs of treating pressure injuries with the data collected from electronic health records that accurately presented the costs to present the actual practice treatment costs, evidence-based practice model cost, and overall projected cost. The collected data is subjected to statistical analysis that investigates the trends, patterns and relationships in the quantitative data. Article Critique Essay Sample
The article’s results section presents the statistical data analysis outcomes. It first presents the sample characteristics that describe the demographic characteristics of the participants to include gender, age, pressure injury risk in Braden Scale, and incontinent of urine and feces. Second, it characterizes the pressure injuries in terms of anatomical location, stage and duration. Third, it describes the treatment applied for the pressure injuries. Fourth, it quantifies the treatment costs. Fifth, it presents an evidence-based practice model cost. Fifth, it presents the overall projected cost beyond the study period.
The article’s discussion section explores the implications of the results in terms of issues that contribute to the costs and how they compare to other cost estimates. It specially notes that the calculated costs are higher than previous estimates, a difference justified as the result of financial/economic and time influences. The cost of care increases over time.
The article’s strengths and limitations section outlines want was done well in the study and what can be improved. The primary research approach is a strength as it allows the study to collect data directly from the primary source so that it presents current data. Still, the study only recruited 20 participants and this is a limitation since this is a small sample when compared to the population. Also, the study was conducted for stages 1 to 3 while stage 4 injuries and deep tissue injury were ignored so that the collected data is not complete.
The article’s conclusion presents the inferences made from the study. It notes that daily cost of treating pressure injuries is AU$26.42 for a Stage 1 injury, AU$37.17 for a Stage 2 injury, AU$30.01 for a Stage 3 injury, and AU$10.22 for an unstageable pressure injury. This reveals that the cost of treating pressure ulcers is considerable. Also, it is noted that the cost of treatment can be reduced by applying evidence-based treatment.
Overall, the study offers a model for calculating the cost of treating pressure ulcers among older adults in a residential care setting. This is validated by the traditional research approach with model being practically tested. In addition, the model is supported by logical arguments with significant evidence from other publications. Referencing other publications is good as it adds credibility to the research. This article is very straightforward in describing the problem in determining cost estimates, proposing a cost model, and logically arguing for the model. Once the readers explore the whole article, they get to understanding that applying the model is a practical solution for an otherwise complex problem. It is a good, well-written article with an important message that supports efforts to counter pressure ulcers within the population. Taken as a whole, this article is relevant and convincing as it lays down a concrete, logical argument supporting the use of the model for determining the direct cost of pressure injuries.
The article to be critiqued
Wilson, L., Kapp, S., & Santamaria, N. (2019). The direct cost of pressure injuries in an Australian residential aged ace setting. International Wound Journal, 16(1), 64-70. https://onlinelibrary-wiley-com.ezproxy.ecu.edu.au/doi/epdf/10.1111/iwj.12992
summary Pressure injuries have a negative effect on well-being and the cost of treatment places a significant burden on the health care system. Research has, however, tended to extrapolate or estimate the cost of pressure injuries resulting in uncertainty regarding the true cost of this condition. The aim of this prospective observational study was to quantify the cost of pressure injury treatment in the Australian residential aged care setting. An electronic health care record audit and observation of usual pressure injury treatment was undertaken with a sample of 20 participants who had 23 pressure injuries. The actual treatment cost, an evidence-based practice model cost, and a projected treatment cost were calculated. The overall cost of pressure injury treatment was AU$98,489.22. The average daily cost by pressure injury stage was AU$26.42 for a Stage 1 pressure injury, AU$37.17 for a Stage 2 pressure injury, AU$30.01 for a Stage 3 pressure injury, and AU$10.22 for an Unstageable pressure injury. The projected cost of treatment was AU$104,510.41. At 42 days this cost extended to AU$116,552.79. This study has quantified the cost of pressure injury treatment in a residential aged care setting. The study may inform future efforts to accurately calculate the cost of PIs and the effectiveness of strategies to reduce the economic burden of this condition . Article Critique Essay Sample