Prevention of Pressure Ulcers Using the Medicinal Plant Aloe Vera: A Randomized Controlled Quantitative Study by Hekmatpou et al. (2018)
One of the issues that bedside nurses face in the care of patients is the occurrence of pressure ulcers. This is especially true for nurses who care for orthopedic patients or patients who are elderly and undergoing rehabilitation due to mobility problems (Gaspar et al., 2019). Pressure ulcers are a quality improvement issue that indicate a low quality of care that needs to be addressed. As a quality outcome, it can be used to measure the effectiveness of nursing care in a healthcare setting by the regulatory bodies such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The purpose of this paper is to critically analyze a published peer-reviewed scholarly article detailing a quantitative study done on the effectiveness of the complementary/ alternative medical (CAM) treatment by the plant aloe vera in the prevention of pressure ulcers. The study is a randomized controlled trial (RCT) by Hekmatpou et al. (2018). Randomized Controlled Quantitative Study Essay Example
Study Type, Level of Evidence (LOE), Purpose, and Problem Statement
The type of this study was randomized controlled trial or RCT. As a quantitative study, RCTs involve the division of the total sample of subjects into a study or intervention group and a control group. The study group receives the intervention in question (aloe vera) while the control group is given a placebo. This was a blinded trial which means that the researchers that were administering the active intervention and those giving the placebo did not know which was placebo and which was the active intervention. This is done to prevent bias in interpreting the results and also undue influence on the results. The level of evidence for RCTs is the highest at level I on the hierarchy of evidence. This is true for RCTs and systematic reviews with or without meta-analysis.
The purpose of the study was to investigate the efficacy of using aloe vera gel in preventing the occurrence of pressure ulcers in orthopedic patients undergoing rehabilitation in a facility setup (Hekmatpou et al., 2018). Orthopedic conditions often render the patient immobile for prolonged periods of time as they wait for the injured part to heal. This is because treatment of most orthopedic injuries such as fractures involves immobilization of the part. Unfortunately, this immobilization makes the bony prominences of especially the pelvis bear sustained pressure for a long time. This reduces the blood flow to these prominences predisposing the immobile patients to the development of pressure ulcers (Gaspar et al., 2019; Mitchell, 2018).
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Study Steps, Sample Size, and Variables
In this study by Hekmatpou et al. (2018) conducted in Arak town in Iran in the year 2016, the study steps were clearly identified. These include the background, the purpose, the methodology, the sampling, the statistical analysis, the results, the discussion of the results, and the conclusion. Randomized Controlled Quantitative Study Essay Example The initial sample size for the study was n=80 orthopedic patients. However, the final sample after consideration of the inclusion and exclusion criteria in detail was n=77. Of these, n=39 were assigned to the study group while the remaining n=38 were taken as controls (Hekmatpou et al., 2018). Being a well-designed and conducted study, the measures of major variables appear reliable and valid. These are the independent and the dependent variables. The independent variable in this case is the application of aloe vera gel on the bony prominences of the study subjects that bear weight when immobile. The dependent variable on the other hand is the development of pressure ulcers.
The validity and reliability of the two major variables draws from the fact that the design of the study is experimental and that the study and control groups are randomly assigned. This means that the results will be a true reflection of what was being measured and also that they can be generalizable to the entire population of orthopedic patients.
Data Analysis, Untoward Events, and Appropriateness of Results in the Context of Previous Studies
Analysis of the data was undertaken through not only descriptive statistics but also nonparametric inferential statistics for generalizability purposes. Randomized Controlled Quantitative Study Essay Example The researchers used the statistical software referred to as the SPSS 21 to carry out the analysis. Tables and charts formed part of the descriptive statistics as were means and standard deviations. Nonparametric inferential tests used were Chi-square tests, Fisher’s exact test, Friedman, independent t-test, and analysis of variance (ANOVA). The researchers do not report any untoward event that may have occurred during the time that the study was being conducted. In this study, the results fit very well with previous studies that have also demonstrated circumstantially that aloe vera is beneficial in preventing pressure ulcers. As a matter of fact, the authors have also observed that the plant has been used as medicine from as early as 1500 BC (Hekmatpou et al., 2018). This shows that apart from the circumstantial evidence, there is also anecdotal evidence for the place of aloe vera in the prevention of pressure ulcers.
The Meaning of the Research by Hekmatpou et al. (2018) to Clinical Practice
Professional nursing practice as with all other domains of healthcare is governed by the concept of evidence-based practice or EBP. This is the doctrine whereby an intervention is only considered worthy of trying on a patient if there is existing current scholarly peer-reviewed and published literature supporting its efficacy. This is what has come to be known as best practice and is contrasted with common practice. In common practice that as rampant before, nurses would just use any intervention because they have seen others using the same. This they would do without questioning whether the intervention was efficacious or not in bringing about exceptional and required patient outcomes (Melnyk & Fineout-Overholt, 2019). To facilitate the increase in the body of knowledge that is EBP, nurses nowadays frequently engage in what is referred to as clinical inquiry. This is the questioning of long-held traditions involving the use of interventions that add no value in the production of good patient outcomes. The PICOT model is used and the scholarly articles providing the required evidence are searched using key words from research databases such as CINAHL and PubMed. The PICOT model allows for a statement of the problem in researchable terms.
The study by Hekmatpou et al. (2018) is a model case for evidence-based practice (EBP). The researchers asked themselves whether the available anecdotal and circumstantial evidence could translate into concrete proven scientific evidence on the efficacy of aloe vera in preventing pressure ulcers. They went ahead and designed a scientific study that produced statistically significant results that are hopefully also clinically significant. The study results therefore provide evidence that can be cited in clinical practice as EBP in the management and prevention of pressure ulcers. This is what the study means to clinical practice. It has enriched the body of EBP available with regard to managing and preventing pressure ulcers in orthopedic and other patients.
Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on hospital-acquired pressure ulcers prevention: A systematic review. International Wound Journal, 16(5), 1087-1102. http://dx.doi.org/10.1111/iwj.13147
Hekmatpou, D., Mehrabi, F., Rahzani, K., & Aminiyan, A. (2018). The effect of Aloe Vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: A randomized triple-blind clinical trial. BMC Complementary and Alternative Medicine, 18(1), 1-11. https://doi.org/10.1186/s12906-018-2326-2
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Mitchell, A. (2018). Adult pressure area care: Preventing pressure ulcers. British Journal of Nursing, 27(18), 1050-1052. https://doi.org/10.12968/bjon.2018.27.18.1050
Write a fully developed and detailed APA essay addressing each of the following points/questions. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least one (1) source using citations in your essay. Make sure to cite using the APA writing style for the essay.
Conduct a literature search to select a quantitative research study related to an issue bedside nurses face and conduct an initial critical appraisal. Respond to the overview questions for the critical appraisal of quantitative studies below. This critical appraisal should be written in complete sentences (not just a numbered list) using APA format.
Is this quantitative research report a case study, case control study, cohort study, randomized control trial or systematic review?
Where does the study fall in the hierarchy of evidence in terms of reliability and risk of bias?
Why was the study done? (Define the problem and purpose.)
Were the steps of the study clearly identified?
What was the sample size?
Are the measurements of major variables reliable and valid? Explain.
How were the data analyzed?
Were there any untoward events during the conduct of the study?
How do the results fit with previous research in the area? (This may be reflected in the literature review.)
What does this research mean to clinical practice? Randomized Controlled Quantitative Study Essay Example