Synthesize Research to Formulate a Recommendation
1. Identify how many articles you have at each level for the hierarchy of evidence. Note that levels 1 and 5 are intentionally missing because they do not include primary research.
Level 2
Four articles (Elli et al., 2022; Haavisto et al., 2022; Yun & Park, 2020; Arisandi et al., 2020)
Level 3
Two articles (Neziraj et al., 2021; Abusalem et al., 2021)
Level 4 - Evidence from well-designed case-control or cohort studies
Two articles (Doroszkiewicz & Halina; Sierakowska, 2021; Kilpatrick et al., 2020)
2. Evaluate how the volume of articles in an evidence level impacts the strength (or weakness) of the literature review, including the articles distribution across levels, identifying the level having the most volume and the difference in the strength of evidence based on whether the majority of the articles have a higher or lower evidence level.
The majority of articles (4 out of 8) are at Level II, which provides a strong foundation for the literature review. Having half of the articles at this higher level of evidence strengthens the overall review. The distribution across Levels II, III, and IV offers a balanced perspective, incorporating both higher-quality evidence and more descriptive studies. The concentration of articles in Level II, followed by an equal distribution in Levels III and IV, suggests a robust evidence base with a good mix of study designs.
3. Discuss the similarities across all the studies with respect to settings, interventions, populations, or findings.
Settings: The majority of the cited studies focus on long-term care facilities, nursing homes, or geriatric care settings.
Populations: The majority also target elderly patients or residents in care facilities.
Interventions: Many studies involve risk assessments, preventive measures, or quality improvement strategies.
Findings: Several studies emphasize the importance of identifying risk factors, implementing preventive interventions, and improving care quality to manage pressure ulcers or overall health risks in elderly populations.
4. Identify the differences between all the studies with respect to settings, interventions, populations, or findings.
Specific interventions vary, ranging from risk assessment tools to implementation of nurse practitioner roles. Likewise, sample sizes differ significantly, ranging from 20 patients to over 12,000. Some studies focus on healthcare professionals,...
9. Evaluate the dissemination differences between stakeholders and external audiences.
The dissemination of evidence-based recommendations differs significantly between stakeholders and external audiences due to their varying levels of expertise, involvement, and information needs. For example, stakeholders such as healthcare professionals, administrators, and policymakers, dissemination would involve detailed, technical information including specific implementation strategies, comprehensive data analyses, and in-depth explanations of methodologies. Conversely, dissemination to external audiences such as the general public or media would focus on more accessible, high-level information. This could include simplified summaries of key findings, emphasizing the broader impacts on patient…
References
Abusalem, S., Polivka, B., Coty, M. B., Crawford, T. N., Furman, C. D., & Alaradi, M. (2021). The relationship between culture of safety and rate of adverse events in long-term care facilities. Journal of Patient Safety, 17(4), 299-304.
Arisandi, D., Ogai, K., Urai, T., Aoki, M., Minematsu, T., Okamoto, S., ... & Sugama, J. (2020). Development of recurrent pressure ulcers risk factors in older patients: A prospective observational study. Journal of Wound Care, 29(Sup4), S14-S24.
Doroszkiewicz, H., & Sierakowska, M. (2021). Factors associated with risk of care dependency in disabled geriatric patients. Scandinavian Journal of Caring Sciences, 35(1), 134–142.
Elli, C., Novella, A., Nobili, A., Ianes, A., & Pasina, L. (2022). Factors associated with a high-risk profile for developing pressure injuries in long-term residents of nursing homes. Medical Principles and Practice, 31(5), 433-438. https://karger.com/mpp/article/31/5/433/825151Haavisto, E., Stolt, M., Puukka, P., Korhonen, T., & Kielo?Viljamaa, E. (2022). Consistent practices in pressure ulcer prevention based on international care guidelines: A cross-sectional study. International Wound Journal, 19(5), 1141-1157. https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.13710Kilpatrick, K., Tchouaket, É., Jabbour, M., & Hains, S. (2020). A mixed methods quality improvement study to implement nurse practitioner roles and improve care for residents in long-term care facilities. BMC Nursing, 19, 1-14.
Neziraj, M., Hellman, P., Kumlien, C., Andersson, M., & Axelsson, M. (2021). Prevalence of risk for pressure ulcers, malnutrition, poor oral health, and falls–a register study among older persons receiving municipal health care in southern Sweden. BMC Geriatrics, 21, 1-10.
Yun, H., & Park, J. (2020). Pressure ulcer risk factors and preventive intervention in long-term care facilities: A mixed-method study. Journal of the Korea Academia-Industrial Cooperation Society, 21(3), 147-155. https://koreascience.kr/article/JAKO202009759222283.pdf
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