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Saturday, 10 May 2014 22:11

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Research Critique


Article:  Friman, A. & Ebbeskog, B. (2010). Wound care in primary healthcare: district nurses’ needs for co-operation and well-functioning organization. Journal of inter-professional care. Vol. 24(1): 90-99


Introduction

Wound management is an essential exercise in patient care. The care that a patient is given with regard to wound care determines how soon he recovers and is discharged from the healthcare facility. The descriptive quantitative research below analyzes nurse’s role in wound management with regard to wound appearance, cooperation with other healthcare professionals and overall wound treatment. This paper critically analyzes a quantitative research study by Friman and Ebbeskog on wound care in primary health care.


Protection of human Participant

Participants for the above study were selected using the random sampling method so as to minimize the manipulation of participants and data. The selected healthcare facilities had to have district and assistance nurses. Additionally, the facility had to have an outpatient clinic and home care operations. It appears that the subjects participated voluntarily in the study as selected nurses were informed in writing and verbally of the purpose of the study (Friman, & Ebbeskog, 2010). Participants were also assured of their anonymity in the study and the information they provided would be treated as confidential. The research study was approved by the Ethics Research committee at   Karolinska Institute.


Data Collection

            There are two variable in the study. The dependent variable is the district nurse whereas the independent variable is the various wound types that patients present at the healthcare facility. Data for the study was collected through two main methods: the wound registration form and the questionnaire that subjects answered. These two methods of data collection were found to be ideal as they allowed the researcher to specifically address the issue of wound management. Using these two methods of data collection, the researcher could easily modify the questions to suit the findings he expects to get. In this research, for instance, the researcher made adjustments with regard to defining the wound appearance and included questions related to cooperation with other healthcare professionals (Friman, & Ebbeskog, 2010). Approximately one week was used to gather data from participants because questionnaires were answered on one occasion, whereas the wound registration took a week to complete i.e. Monday through Friday.


Data Management and Analysis

Quantitative data from the wound registration form and questionnaires were computerized and processed using Excel, 2002. Dichotomous answers were analyzed separately while questions on rating scales were compiled and grouped in five-graded scales. Numbers and percentages were used to show results descriptively. Qualitative data collected from the data given by respondents were analyzed using theme analysis. The theme analysis methods required that data was transcribed from the questionnaire verbatim, read and categorized based on the data received. The results from the theme analysis were presented as excerpt statements under each response given by the respondent.


 

Findings and Interpretation

The findings of the study revealed that district nurses perceived wound management as within their domain. However, most nurses appreciated the need for contact with the general practitioner so as to make referrals where necessary. The study revealed that a majority of nurses treated wounds without making proper medical diagnosis. Healthcare facilities lack officially defined responsibility for their professionals with regard to wound management. This means that there is a tendency for the task of wound management to be left entirely to the district nurses.


The findings are an actual revelation of the disconnect that exists among healthcare professionals during wound care management. Nurses are left with the task of solely taking care of patient’s wounds even in situation where a physician’s opinion is required. There is an increased risk of wound infections and long periods of wound recovery with ineffective wound management measures. Factors such as lack of co-operation among healthcare professionals causes undue suffering to patients with wounds as their ability to acquire quality services is not guaranteed.


The main limitation of the study is that the viability of the two data collection methods was only tested and confirmed by two district nurses. There was a need to conduct an in-depth analysis of the viability of the study and ascertain that the data collection methods were reliable. Overall, there was a coherent logic to the presentation of findings with results revealing the need for well-defined wound care guidelines at healthcare facilities. The results further reveal the need for nurses to undergo advanced training with regard to diagnosing and taking care of wounds (Friman, & Ebbeskog, 2010). Further, the findings reveal the need for healthcare professionals to cooperate and work together so as to provide patients with optimal wound care management. These findings of the study provide practical guidelines that healthcare facilities can adopt so as to improve patient care. Patients arrive at healthcare facilities expecting quality care. It is the responsibility of healthcare facilities to ensure that they have professionals that can work together to provide optimal patient care.


The article concludes by indicating the need for intensive research on the specific kinds of support and training needed by district nurses so as to advance their skills in wound care.


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