NRS 493 Topic 6 Literature Review GCU

NRS 493 topic 6 literature review GCU

NRS 493 Literature Review

A review of the literature is essential to understanding different sources of evidence for the proposed capstone project initiative aimed at addressing the issue of hospital-acquired pressure injuries (HAPIs) among patients in critical care settings. HAPIs are a critical patient safety issue and hospitals as well as nurses should develop interventions like the care bundle approach to reduce their occurrence and effects on patients at the highest risk like those in critical care. A review of the literature enables nurse researchers to determine effective planning and critical components of their capstone projects. The existing literature sources in the proposed capstone topic focus on different components based on the research question and evidence about HAPIs in critical care settings. The purpose of this paper is to evaluate the existing literature on HAPIs by comparing research questions, sample populations, and limitations with the proposed EBP through the capstone project.

Comparison of Research Questions

Through a comparison of research questions among the used literature in capstone projects, researchers can ascertain the effectiveness of the findings and the related evidence. In this case, most of the sources used in this project support the initiative that focuses on implementing care bundle to reduce the susceptibility of patients to HAPIs due to their state of health. Conversely, the authors of these articles use different research questions which implies that they deploy different approaches due to the purposes of their research and the methodologies used.

In a majority of the various reviewed articles from the literature evaluation table, it is evident that the authors pose critical research questions that are similar to those advanced by this capstone project. In their article, Amirah et al. (2019) explore the prevalence and risk factors associated with critically ill patients in hospitals that lead to HAPIs. The research question in this study is about the prevalence of pressure injuries and their location. Similarly, Qaddumi et al. (2019) pose the very questions. Again, Yilmazer et al. (2022), Edsberg et al. (2022) and Coyer et al. (2022) pose questions about the effectiveness of implementing care bundle to prevent and reduce the prevalence of pressure injuries among critically ill patients in different hospital settings, from intensive care units (ICUs) to those in wards. The implication is that these research questions by the authors of the reviewed articles are similar to the one the capstone project focuses on through its PICOT question and statement.

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Comparison of Sample Populations

Sample populations and settings of any research study affect the overall credibility of evidence, the findings, and even recommendations by authors of such works. At the core of the various literature sources used in this capstone change project is the development of EBP interventions and strategies to reduce HAPIs through increased knowledge and deployment in various care settings. A large population sample allows researchers to generalize findings to different settings. However, sample populations used in any study are determined by different factors like resources and the purpose of such initiatives. In this case, the evaluated literature sources use different sample populations and even settings. For instance, Edsberg et al. (2022) use a sample consisting of over 290,000 patients in more than 1800 acute care settings while Lindhardt et al. (2019) and Coyer et al. (2021) use intensive care units without expressing the number of participants. Yilmazer et al. (2022), Amirah et al. (2019), and Pittman et al. (2019) use different sample populations ranging from over 200 participants to 460 working in critical care settings. The implication is that while these sources use different population samples, their study settings are strikingly similar as they all carry their trials in critical care areas like ICUs and high-dependency units (HDUs).

Comparison of Limitations of the Studies

Researchers highlight the limitations of their studies to enable future inquiries to address such gaps and ensure that unexplored areas are also discovered to improve the efficacy of the suggested interventions. Again, limitations also demonstrate and improve the overall credibility of studies and their findings. Common limitations that the reviewed studies highlight include small sample populations that cannot be generalized to larger populations, research designs that fail to consider other critical aspects of the investigations, and settings as the authors all focus on critical care areas. The increased prevalence of HAPIs in different care settings also means that the researchers must think broadly in other areas to reduce the overall effects on patient safety. The limitations may not constitute significant effects on the overall findings of this project. However, it is essential to expand the scope of HAPIs and not just for patients in critical care but even those with longer stays in inpatient settings and even those with terminal illnesses that lead to limited or lack of mobility.

Conclusion & Recommendations

Comparing research questions, sample populations, and limitations in evaluated literature for the capstone project is important to determine the overall relationship with the proposed interventions and the developed PICOT question and research problem statement. All studies constituting the literature in justifying and supporting the use of suggested interventions should be based on credible sources that constitute appropriate study samples, demonstrate research questions, and have expected conclusions as well as recommendations for future inquiries about the issue. The sources in this case are positively linked to the proposed change project as they address the various components of the study and related outcomes. However, limitations like small sample sizes and limited settings may impact the credibility of the evidence and further application. As such, future studies should ensure that they address these limitations and use acceptable population samples to enhance overall credibility and deployment in various situations.


Amirah, M., Rasheed, A., Parameaswari, P., Awajeh, A., Issa, M., & Abdallah, M. (2019).

Pressure injury prevalence and risk factors among adult critically ill patients at a large intensive care unit. Journal of Intensive and Critical Care, 5(2), 9. DOI: 10.21767/2471-8505.100128

Coyer, F., Cook, J. L., Doubrovsky, A., Campbell, J., Vann, A., McNamara, G., … & Fulbrook,

P. (2022). Implementation and evaluation of multilayered pressure injury prevention strategies in an Australian intensive care unit setting. Australian Critical Care, 35(2), 143-152.

Cox, J., Edsberg, L. E., Koloms, K., & VanGilder, C. A. (2022). Pressure injuries in critical care

patients in US hospitals: results of the International Pressure Ulcer Prevalence Survey. Journal of Wound, Ostomy, and Continence Nursing, 49(1), 21. DOI: 10.1097/WON.0000000000000834

Edsberg, L. E., Cox, J., Koloms, K., & VanGilder-Freese, C. A. (2022). Implementation of

pressure injury prevention strategies in acute care: results from the 2018-2019 International Pressure Injury Prevalence survey. Journal of Wound, Ostomy, and Continence Nursing, 49(3), 211. DOI: 10.1097/WON.0000000000000878

Grešš Halász, B., Bérešová, A., Tkáčová, Ľ., Magurová, D., & Lizáková, Ľ. (2021). Nurses’

knowledge and attitudes towards the prevention of pressure ulcers. International journal of environmental research and public health, 18(4), 1705.

Lindhardt, C. L., Beck, S. H., & Ryg, J. (2020). Nursing care for older patients with pressure

            ulcers: A qualitative study. Nursing open, 7(4), 1020-1025. DOI: 10.1002/nop2.474 

Pittman, J., Beeson, T., Dillon, J., Yang, Z., & Cuddigan, J. (2019). Hospital-acquired pressure

injuries in critical and progressive care: avoidable versus unavoidable. American journal of critical care, 28(5), 338-350.

Qaddumi, J. A., & Almahmoud, O. (2019). Pressure ulcers prevalence and potential risk factors

among intensive care unit patients in governmental hospitals in Palestine: A cross-sectional study. The Open Public Health Journal, 12(1).

Yilmazer, T., & Tuzer, H. (2022). Effectiveness of a Pressure Injury Prevention Care Bundle;

Prospective Interventional Study in Intensive Care Units. Journal of Wound, Ostomy and Continence Nursing, 49(3), 226-232. DOI: 10.1097/WON.0000000000000875

NRS 493 Topic 6 Literature Review GCU

While the implementation plan prepares students to apply their research to the problem or issue they

have identified for their capstone project change proposal, the literature review enables students to map

out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known

and what is not known in the evidence. Students will use the information from the earlier PICOT Question

Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the

following sections:

1. Title page

2. Introduction section

3. A comparison of research questions

4. A comparison of sample populations

5. A comparison of the limitations of the study

6. A conclusion section, incorporating recommendations for further research

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student

Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become

familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support

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