Capstone Project Evidence Table

Evidence Table


van Leen, M., Hovius,S., Neyens,J., Halfens, R., Schols, J. (2011). Pressure Relief, cold

foam or static air? A single center, prospective, controlled randomized clinical trial

in a Dutch nursing home. Journal of Tissue Viability, 20,30-34.




People suffering from a medical condition that limits their ability to change position are at a high risk of developing pressure ulcers. There is no clear correspondence between the types of mattress that the patient uses; either static air overlay mattress or a cold form mattress, and the risk of developing pressure ulcers.


ReviewoftheLiterature The literature review of articles revealed the gaps in knowledge which the study was based on (Bryman, 2015). The review was centered on the evidences regarding the types of mattresses used in preventing pressure ulcers which revealed scanty information. The researchers used 3 resources for their literature.  The articles covered various topics revolving around atrial on two types of mattresses in enhancing tissue viability, bead bed system for the prevention of the pressure ulcers as well as the pressure ulcers-decreasing mattresses.








DiscussionofMethodology Van Leen et al., 2011 conducted a prospective controlled trial study which is a quantitative study. It entailed patients being enrolled in the study and monitored on a weekly basis for the development of bed sores with respect to the type of mattresses that they were assigned. 84 patients who scored 12 points on the Norton scale and having no pressure ulcers were assigned matresses with 42 receiving the cold foam mattreses and 41 receiving the static air overlay. In the event of pressure ulcers grade 2 or higher, repositioning was done.


DataAnalysis  The study used statistical analysis of the research findings before drawing the conclusions (Busk, & Marascuilo, 2015).The analysis led to the determination of differences in the development of pressure areas.17.1% of participants who used cold foam mattress developed pressure ulcers while 4.8% of those who used static air overlay contacted pressure sores. Descriptive statistics were used (Ott, & Longnecker, 2015). In this case, it described the rates and incidences of patients that developed the pressure ulcers.


Researcher’sConclusion Van Leen et al., (2011) concluded that static overlay mattresses provided a better prevention of pressure sores than cold foam mattresses. This conclusion was based on the ability which was determined to be 4.8% versus 17.1%.


A2. Researcher’s Conclusion

The study indicated that the type of mattress used for individuals with limited ability to position themselves contributes to the development of pressure ulcers. Reposition is only needed when there are signs of a pressure sore when static air overlay are in position. Use of foam only increases chances of developing pressure ulcers and need for repositioning. This conclusion provides for support of the determination by the literature review which identified scant information relating to mattresses being used to prevent pressure sores. In addition, the conclusion also reflects the outcome of the data analysis that determined higher incidences of pressure sores with patients using cold foam mattresses than those using static overlay mattresses.

A3. Protection and Considerations

Privacy of the participants was well taken care of as the names of the individuals who consented to participate in the study are not indicated (Fiske & Hauser, 2014). Confidentiality of the information was however not assured as the researchers did not indicate the use of information obtained from the study.

A4.Strengths and Limitations


A wide range of participants were chosen: those with a score lower than 12 points on the Norton scale.


With the study population at 83 patients, the number is relatively small limiting the study to the institutions where they were conducted. The outcome of the study cannot be generalized to other institutions or care centers.

It is not clear how the participants were chosen, whether randomly or systemically, to represent the entire population. As eluded by Yin, (2017), such inconsideration can lead to biasness.

A5.Evidence Application

Information from study provides significant evidence that is applicable in nursing patient so as to prevent the development of pressure sores. These entail use of static air overlay mattress as well as repositioning. Nurses ought to apply this especially to patient who are bedridden or unable to change their positions in their beds and are predisposed to pressure area care (Demarre et al., 2015). However, the study did not indicate the communication to nursing practice.


McInnes, Elizabeth., Phillips. R., Middleton, S., Gould, D. (2014). A qualitative study of senior hospital

managers’ views on current and innovative strategies to improve hand hygiene. BMC Infectious



BackgroundorIntroduction  Hand hygiene forms one of the standard operation procedure that is key in the prevention of transmission of microorganism in various care settings. The preventive intervention have been recognized by various agencies including WHO and CDC. Various interventions have been put in place to enhance the compliance to the practice. In working towards the strategies various care providers have worked and researched on ways to improve the practice. Despite the critical role of hospital manager, no research has been done to seek their views on the practice. This gap prompted the study.
ReviewoftheLiterature The literature review utilized articles published within the last 10 years. All the articles were related to the topic of study. The review also revolved around articles relating to enhancement of hand hygiene practices
DiscussionofMethodology The qualitative study utilized face to face interview in collecting data from leaders in a tertiary referral hospital. This method was appropriate for the study as it was able to determine the views of the participants (Creswell, & Creswell, (2017).
DataAnalysis Theme analysis of the data was conducted. This entailed examination, pinpointing and noting of various patterns in the data collected (Silverman, 2016).Seven themes were determined from the analysis and they included: culture change starts with leaders, refresh and renew the massage, connecting the five moments to whole patient journey, actionable audit result, empowering patients, reconceptualizing non-compliance and start using the hammer.
Researcher’sConclusion  From various hospital senior managers, there exist various interventions that can be put in place to strengthen the hospital hand hygiene strategies. The suggestions entail organizational support and leadership. The researchers also determined the need to do more research on the hospital staff’s views of hand hygiene strategies.


B2. Researcher’s Conclusion

Based on the perspectives of the senior hospital managers, various suggestions to support hand hygiene strategies emerged. These include the support that is needed from the organization level as well as the leadership taking the forefront in the campaign. This conclusion is supported by the gap that existed prompting the study which noted the absence of the organizational leadership in promoting adherence to hand hygiene. It is further supported by the data analysis that determined various elements for instance culture change that starts with the leaders. The literature review also determined the gap that existed in promoting hand hygiene with no study dwelling on views of hospital managers towards hand hygiene.

B3. Protection and Considerations

The researchers obtained informed consent from the participants who were willing to be engage in the study. At the same time, the study only considered to include only individuals in leadership positions. The study was also approved by the St Vincent’s Hospital Sydney Human Research Ethics Committee.

B4. Strengths and Limitations


Being the first study examining the view of hospital managers on hand hygiene, it provides literature to the medical field that would guide subsequent research on suggestions of leaders to enhance adherence to hand hygiene.


The study was conducted in a tertiary care center with views from senior staff members. The views obtained however may not be representative of all the senior managers within the hospital nor other similar settings. This impairs it generalizability.

B5. Evidence Application

Having determined the need for further research on views of other staff members on hand hygiene, the nursing research team are directed to venture in the area for the subsequent research activities. At the same time, with realizations of aspects such as leadership and organizational support, this can be applied inn care centers to promote adherence of hand hygiene among staff members.




Bryman, A. (2015). Social research methods. Oxford university press.

Busk, P. L., & Marascuilo, L. A. (2015). Statistical analysis in single-case research. Single-Case

 Research Design and Analysis (Psychology Revivals): New Directions for Psychology

and Education, 159.

Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed

            methods approaches. Sage publications.

Fiske, S. T., & Hauser, R. M. (2014). Protecting human research participants in the age of big


Harriss, D. J., & Atkinson, G. (2015). Ethical standards in sport and exercise science research:

2016 update. Int J Sports Med36(14), 1121-1124.

Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five

approaches. Health promotion practice16(4), 473-475.

Neuman, W. L., & Robson, K. (2014). Basics of social research. Pearson Canada.

Ott, R. L., & Longnecker, M. T. (2015). An introduction to statistical methods and data analysis.

Nelson Education.

Silverman, D. (Ed.). (2016). Qualitative research. Sage.

Yin, R. K. (2017). Case study research and applications: Design and methods. Sage