Free Nursing Dissertations - Complete A 3000 Word Literature Review Surrounding Current And Historical
Complete a 3000 word literature review surrounding current and historical nursing practices in pressure area care in order to demonstrate the use of evidence-based practice.
Undergraduate Degree Level Essay
3,000 words
Introduction
The healthcare professions have had to deal with pressure sores from before recorded time. We can find pressure sores on the mummies of Egyptian noblemen which are more than 5,000 years old. (Thomson-Rowling J 1961) They are still with us today. A study from over two decade ago quoted findings of pressure sores on 29% of hospital inpatients, 33% of ITU patients and 66% of elderly patients with fractured hip pathology and at the time of death 24% of the population have them (all figures relate to stage 2 or greater pressure sores) (Eckman KL. Decubitus 1989;2:36-40).
Historically, the nursing profession has based its activities and procedures on a traditional base and not within a framework of scientific verifications (Roper N 1977) Three decades ago, writers were calling for nursing to be a research based profession and lamenting the fact that there was a marked lack of research evidence underpinning the routine practice of nursing (Gortner SR 1976).
It is fair to comment that the last three decades has seen a marked change in this state with the progressive advent and emergence of evidence based practice to the point that it is currently considered to be the basis of the majority of professional nursing care. (Yura H et al 1998). There are a number of important factors and considerations that underlie this statement. Hunt’s well publicised plea to the profession that "each nurse must care enough about her own practice to want to make sure it is based on the best possible information" (Hunt J 1981) was met with both enthusiasm and a realisation of the barriers that stood in its way. They included ( and still include) time constraints, limited access to the literature, a lack of training in critical skills of appraisal and, most fundamentally, a professional ethos and ideology that placed a great emphasis on the practical rather than the intellectual component of knowledge together with a work environment that did not actively encourage the seeking out, researching and recording of new information (after Royle J et al 1996).
Critics of evidence based practice have suggested that it promotes the concept of a cookbook of practices that have to be dogmatically followed. (Haynes RB et al. 1996). An arguably more enlightened view would suggest that professional training includes learning the basic pathophysiology and anatomy and acquiring experience. It is the effective application of this experience that requires a sound evidence base. Research evidence can aid the professional decision making process, but cannot either do the clinical examination or collate the vast amount of snippets of information that pass between patient and nurse.
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