The two articles discuss the prevalence of pressure ulcers in hospital and skilled nursing facility patients. The first article finds that using prophylactic foam dressings on high-risk patients in hospitals significantly reduced pressure injury rates. The second article finds that regular assessment and preventative measures like hydropolymer foam dressings eliminated pressure ulcers in a long-term care facility. Both articles indicate that protecting bony areas from pressure and friction can reduce or eliminate pressure ulcers.

1. Running Head : ARTICLE CRITIQUE
RESEARCH ARTICLE CRITIQUE 2
Quantitative Research Article Critique
Uka Anna
Grand Canyon University- NRS 433V
June 9, 2019
The Prevalence of Pressure Ulcer Using Foam or Pad dressing
on Patients in Hospital and Skilled Nursing Facility.
Background
The article by Padula (2017) indicates that hospital acquired
Pressure Injuries (HAPIs) are prevalent, costly, and deadly to
critically ill and acute patients. Their prevalence is 2.5 million
patients annually and the cost 500-150000 USD per case. There
are about 60,000 deaths yearly, causing a health burden. Risk
and skin assessments have become imperative with foam
dressing arising as a new method of preventing pressure

2. injuries and mitigating the problem. through prophylactic
dressings loading forces on tissues between the bony
prominence and support surface is mitigated causing a quality
improvement in injuries among patients who undergo cardiac
surgery. In this study, the focus is on evaluating the efficacy of
prophylactic foam in clinical trial situations through an
observational approach with the purpose of establishing how
effective and valuable it is in preventing HAPI rates.
On the other hand, in a quantitative study conducted by
Frain (2008), it is indicated that extended care where numerous
medical regimens are afforded, there is an enhancement of
rehabilitation on the patients. Heel pressure which has
prevalence rates of 19-32 percent resulting from hip fractures,
diabetic neuropathy, structural deformities, and cerebrovascular
accidents and implicated in the study. Heel ulcers are indicated
to be common and critical, hence requiring care. Since there is
no information on long-term care, this study provides a study on
that.
How these two articles support the nurse practice issue that I
choose in relation to PICOT Question And Ethical
consideration Comment by Linnette Nolte: Please delete this
as this is a narrative paper. Insert a short heading in APA
format
The PICOT pays attention to the population of hospital patients
and skill nursing facility patient. The research is focused on
reducing pressure ulcer by protecting the bony area with pad
dressing, the effects is very positive as we look in to the
population involved. Comment by Linnette Nolte: What is
your PICO question?
The study responded to the PICOT question by offering a
positive relationship between pad dressing and reduction of
pressure ulcer among patients. On the other hand, the article by
Frain (2008) indicates research into what impact long-term care
has on decreasing heel ulcers.
Method of Study:
The study by Padula (2017) was carried out through a

3. retrospective observational cohort study in the US acute care
academic medical centers while examining the effectiveness and
value of prophylactic 5-layer sacral dressings to prevent HAPI
rates in the acute context. There was the acquisition of all
pressure injury rates between 2010 and 2015 with the clinical
database providing quarterly hospital-level administrative
information on hospitalization of patients in the entire system
of over 250 academic medical centers. The all-cause pressure
injury rates; were merged with a quarter. lt hospital-level
information which the manufacturers of foam dressings gave
about the purchases on the 5-layerfoam. Comment by Linnette
Nolte: This sentence loses its meaning??
There was a longitudinal data analysis to the cohort for every
hospital to act as its own control due to variation of initiation
on the foam usage. Counts of pressure injuries acquired from
hospitals underwent the inclusion, exclusion criteria of AHRQ
Patient Safety Indicator for critically ill and acute patients after
which aggregate hospital data was conducted. Comment by
Linnette Nolte: What study is this?
On the contrary, a study by Frain (2008) conducts a study
among 40 of the 42 residents in a skilled care unit of a 470-bed,
long term amenity in Royersford, Pa. Through a random
selection, this population included participants observed for a
year. There was the inclusion of 37 staff members and given
that the study was within the nursing care standards no
individual consent was required. The only permission acquired
was from the administrator. The acquisition of demographic
data of the patients was accessed when the program set in and
Braden scales Scores were computed on a quarterly plan. The
collecting, recording, and maintaining of data was by the
Certified Wound and Ostomy Care Nurse. As easy-to-use heel
assessment form to served with aspects such as skin assessment,
orientation to the heel assessment, training, use of visual and
hands-on models, proper techniques where foam blocks, foam
splints, and pillows were checked. Within the three stages
incidence rates, deaths, transfers, discharges were checked.

4. There is also a literature review which indicates that Some
long-term care facilities where there is professional nursing
care when compared with the other care facility that had been
evaluated as being at low risk using a pressure ulcer, it was
discovered that hydro polymer foam dressings decreased the
prevalence of heel ulcers 72% in 2 years. The study had been
conducted among 52 patients compared the effectiveness of
hospital pillows on the patients. Comment by Linnette Nolte:
I don’t understand this sentence Comment by Linnette Nolte:
What are the benefits and limitations of each study?
Results of Study
Therefore, the study by Padula (2017) uses a representative
sample of 38 of over 240 academic medical centers merged with
data on purchase f prophylactic 5-layer foam sacral dressings.
There are observations in 912 hospitals with 631 having the
prophylactic foam 5-layer where 1.03 million patients are
hospitalized. In the average medical center where there are 1754
hospitalizations per quarter, there are 2586 units of prophylactic
sacral dressing representing the whole number of patients for an
average 7-day period. The foams were given to high-risk
patients and indeed there was a decrease in the pressure injury
rates. Therefore, with an increased prophylactic dressing from
2.60 USD to 20 USD per patient, there was a decline in pressure
injuries from 120 USD expenditure per patient to 43 USD. The
results imply that the usage of prophylactic foam dressings on
patients is significant in the reduction of pressure injuries
among patients for they help discover unobserved factors.
In the study by Frain (2009), completion rates for heel
assessment were 79 percent for the 21 women and 19 men. At
the end of the assessment, none of the patients had heel pressure
ulcer because of the regular assessment, caregiver awareness,
staff education, and preventive measures. It, therefore, implies
that early detection, continuous assessment, the use of
hydropolymer foam dressings among other preventive
mechanisms reduce and can eliminate the prevalence of pressure
ulcers because it helps in preventing further infections and

5. offers the required care environment.
Outcomes Comparison
The comparative analysis of the two articles shows that the
usage of diverse long-term methods in attending to patients who
have ulcers has a higher impact on the elimination of the
pressure ulcers as compared to the use of prophylactic 5-layer
foam dressing alone. However, even the usage of the foam
whetherhydropolymer foam dressings or prophylactic 5-layer is
still significant in the healing of a patient.
All in all the two articles indicate that it is possible to reduce or
do away withpressure ulcer by protecting the bony area with pad
dressing because it prevents further infections and enhances
healing. Comment by Linnette Nolte: ulcers
References
Frain, R. (2008). Decreasing the incidence of heel pressure
ulcers in long-term care by increasing awareness: results of a 1-
year program. OstomyWound Management, 62-68. Retrieved
from
https://pdfs.semanticscholar.org/ad65/4a52aa235ffb05e1e51ced
200db153303697.pdf
Padula, W. (2017). Effectiveness and value of prophylactic 5-
layer foam sacral dressings to prevent hospital-acquired
pressure injuries in acute care hospitals: an observational cohort
study. Journal of Wound, Ostomy and Continence Nursing,
44(5), 413–419. doi:doi: 10.1097/WON.0000000000000358
hello, you conducted a good critique of these artilces Please
discuss the benefits and limitations of each article and clearly
state your PICO qeuston. Please proofread your paper as many
sentences lose their meaning. Good work! Linn

6. 2
Running Head: MASS MEDIA INDUSTRY
1
MASS MEDIA INDUSTRY
2
Mass Media Industry
Torrin Bouvia
16 June 19
Mass Media Industry Assessment
Mass Media is an industry which is more concern about
broadcasting, news media, publishing, as well as the internet. In
this paper, I will discuss it as the service since even in
categorization, it’s a service industry. This is particularly my
interest industry bearing in mind that I happen to be a reporter
in one of the news radio stations. Besides being a reporter, this
industry is interesting because it is an informative industry
which tends to unify the world into one within a very short

7. period of time. For instance, it is through this industry that
other industries grow (Timothy, & Lotz, 2016).
This industry is more specifically trending up. In the current
world, technology is advancing which increases industrial
competition more especially in the business sector. For other
industries to maintain their influence in the industry for those
already in the industry because of stiff competition, marketing
of their products is vital. This is to ensure that their potential
customers, as well as the public, are informed of their products,
the new changes as well as offers that are available besides
attracting the attention of other new customers. For this to be
achieved, social media which can only be accessed through the
internet is mostly used to get in touch with the local and
international customers. The radios, as well as television
services, are also used in carrying out the marketing activity,
hence the reason for the upward trend of this industry. Also, the
sharing of information, as well as the trending news in the
world, is shared to the public through the mass media industry,
hence contributing to its upward trend but it must be noted that
technological innovation is the main factor that is making the
mass media industry trend to continue growing upward (Graber,
& Dunaway, 2017).
The process of entry into the industry is easy because after
establishing all the physical and material resources besides the
human resources, the only requirement that is supposed to be
met is registration from the relevant regulatory bodies in the
host country and the business is set to go. The exit of the
industry is also simple but some investors find it difficult to
exit because of the huge returns from the mass media industry
business (Alimuddin, 2017). Personally, I have experience of
five years in this industry whereby I have worked as a radio
reporter in the sports department. There is a challenge for the
new entrant who are venturing into this industry under the
human resources section because, the effectiveness of an
individual in this industry doesn’t depend on the academic
qualifications only but also how interactive and individual is,

8. for instance, an individual who is social will easily be
acknowledged in this industry compare to an anti-social
individual even if there are disparities in their academic
qualification when it comes to reporters as well as presenters in
the industry. However, this is different from the management
positions in the industry (Crane, Kawashima, & Kawasaki,
2016).
The consumers who are the public have got a lot of
anticipations from this industry which needs to be fulfilled. To
start with, the consumers expect accuracy as well as the
conformity of the aired or share information. This is to ensure
that the exact information on the ground is shared without
alterations. The consumers also want fast and useful
information from this industry. For instance, communication
companies should ensure that they share the trending news
which is beneficial to the public as faster as possible. Finally,
the consumers want friendliness from this industry (White,
Nielsen, & Valentini, 2017).
References:
Alimuddin, A. (2017). Growth of the Mass Media Industry in
Indonesia.
Crane, D., Kawashima, N., & Kawasaki, K. I. (2016). Culture
and globalization theoretical models and emerging trends. In
Global culture (pp. 11-36). Routledge.
Graber, D. A., & Dunaway, J. (2017). Mass media and American
politics. Cq Press.
Timothy, H., & Lotz, A. (2016). Understanding media
industries. Oxford University Press.
White, C. L., Nielsen, A. E., & Valentini, C. (2017). CSR
research in the apparel industry: A quantitative and qualitative
review of existing literature. Corporate Social Responsibility

9. and Environmental Management, 24(5), 382-394.
RUNNING HEAD: ARTICLE CRITIQUE
6
QUALITATIVE RESEARCH CRITIQUE PART 1
Qualitative Research Critique Part 1
Uka Anna
Grand Canyon University
June 1, 2019
The Prevalence of Pressure Ulcer and Pressure Injury in the
Hospital & Skilled Nursing Facility Using Foam Dressings.
Comment by Linnette Nolte: Remove bold font
Background of Study
The research indicates that hospital-acquired pressure injury(

10. HAPI) has been on the decline in America between 2010 and
2014 as a result of efforts by Medicaid and Medicare services
as well as the Agency for Healthcare Research and Quality. In
the study by (Rondinelli, Zuniga, Kipnis, Kawar, llu, & Escobar
2018) the background information shows that the study
establishes that despite health care institutions having reduced
rates of hospital-acquired pressure injuries, the situation is not
eliminated. Resultantly, there is need for assessment in both
health service and nursing research. The objective of the study
is to offer a description of HAPI incidence, risk-adjusted
hospital variation, and risk factors within the contemporary
integrated healthcare system of California among 35- hospital
inpatient cohort. The focus was given to Kaiser Permanente
with conceptual consideration of immobility, tissue tolerance,
decreased activity, change in sensation, and immobility. Other
aspects like acute illness and chronic conditions. The study
offers the following significance to the study to enhance
understanding of HAPI, what causes it, and the prevalence
cases.
Pressure ulcer (PU) is caused by multiple factors and its
pathogenesis shows a multifactorial process that involved
hormonal changes, inflammatory aspects, impaired blood
perfusion, degenerative changes, and reduced immune
protection. A disturbingly rising situation in PU cases among
the old especially those who suffer from frailty and chronic
illnesses calls for higher awareness of therapeutic and
preventive measures like protecting the bony areas with pads
and repositioning every 2 hours to combat this. In the second
study conducted by Santamaria et al. (2015) reports that among
the elderly, pressure ulcers are prevalent, and they continue to
rise as well as increase costs especially on the older adults who
ail from chronic diseases. The study observes that currently
there is a high level of awareness to extensive, preventive, and
therapeutic processes for treating pressure ulcers with internal
risk factors being comorbidities that agreeably increase pressure

11. ulcers. The study pays attention to common chronic illnesses
such as diabetes, cardiovascular complications, renal diseases,
chronic pulmonary complications, and neurodegenerative
disorders. Besides, conditions such as anemia, malnutrition,
incontinence, disability, frailty, and hospitalization are essential
in the multi-disciplinary study of PU in old patients. The
objective of the research is to offer a description of acute and
chronic conditions that are risk aspects in elder patients for
developing PU.Comment by Linnette Nolte: Both articles are
not qualitative
How These two Articles Support the Nurse Practice Issue I
choose and The PICOT:
The first article by Rondinelli et al. (2018) assists the study by
answering the PICOT because it shows the prevalence of HAPI
in healthcare as related causes, and what population that is
mostly affected with pressure ulcer. On the other hand, the
second study inquiries into the prevalence of PU among elder
patients are how risk factors increase such cases. Both studies
have a relevant objective that answers the PICOT question of
the study. Comment by Linnette Nolte: What is your PICO
question?
Method of Study:
In the first article, the method the study used was a
longitudinal analysis of retrospective inpatient episodes for
patients who were hospitalized between January 1st, 2013 and
June 30th, 2015 (Rondinelli et al., 2018). The key outcome was
the emergence of a HAPI over time. Among the predictors in the
case included HAPI risk factors using the Comorbidity Point
Score, the severity of illness through the Laboratory-Based
Acute Physiology Score, and the Braden Scale for predicting
Ulcer risk. There was the observation of the patients and
documentation of information on HAPI across the 35 hospitals.
On the contrary, in the second study by Santamaria et al.
(2015), there is an overview of comorbidities with PU in three
diverse patient settings which are the acute hospital,
community, and long-term health care with patients who have

12. chronic diseases, old, and with pressure ulcer grade 2 and over.
The study too relied on the European and National Pressure
Ulcer Advisory Panels’ conceptual framework, which covers
indirect, potential, and direct causal risk factors, it becomes
possible to assess chronic illnesses to determine the risk factors
of chronic conditions and complicating situation that possibly
have an impact to the risk for the development of PU.
Results of Study
From the first article by Rondinelli et al. (2018), it is indicated
that out of an analysis that involved 1661 HAPI inpatients and
726,605 non-HAPI episodes, the HAPI prevalence was 0.57
among 1,000 patient days which is 0.2 percent of episodes.
There were a significant protective HRs among female patients
who were in the emergency room for a medical cause. It means
an age, the severity of illness, comorbidity indexes, and the
Braden score as essential predictors of the HAPI prevalence.
The study indicates that HAPIs is fertile ground for research
and quality improvements plans. Furthermore, the use of
patients within the same context offered low baseline HAPI
incidence, meaning in future studies there should be a
recalibration of the model. The inclusion of diabetes led to a
nonsignificant HR for a predictor that has a strong association
with HAPI. Therefore, future studies require to analyze the
administrative, hospital, and staffing aspects that can quantify
the incidence-based interventions and how they impact on HAPI
incidences. An exploration of large data sets, the potential of
EMR-generated composing scores, and predictive analytics are
necessary. Besides, comorbidity burden score, Braden Scales
scores, and severity-of-illness scores are important here. There
is substantial inter-hospital variation in HAPI incidence a
situation remarkable where variables are included.
The results in the second study by Santamaria et al. (2015) it is
shown that advanced heart disease where there is low cardiac
output and/or decreased oxygenation, impact in situations of
blood perfusion and peripheral ischemia that contribute to the
emergence of PU. When a patient has cerebrovascular accidents

13. or dehydration or edema, then there are higher chances of
having PU. With diabetes, a patient lacks sensory perception
from diabetic neuropathy, hence non-healing wounds occur
especially on the foot. Other vascular complications and
pressure When people age, pulmonary functions go down, there
is a decline in vital capacity, increase in airway dead space and
a decline in hypoxia, ventilatory response which reduce lung
functioning. Moreover, the issues of inflammation, advanced
pulmonary disease cause PU. The prevention of PU among
adults with severe pulmonary illnesses, calls for management of
edema, minimization of bedrest while ill, optimization of
nutrition, and optimization of endurance and activity. Another
intervention would be the use of soft silicone multi-layered
foam dressings in the prevention of sacral and heel pressure
ulcers in trauma and critically ill patients
For patients with a decline in the functioning of the kidney in
aged individuals after the glomerular filtration rate and renal
blood flow declines. More illnesses like hypertension and
diabetes increase impaired kidney functioning cause issues of
chronic illnesses and PU (Santamaria et al. 2015). Besides,
musculoskeletal disorders, neurodegenerative disorders, and
common conditions of malnutrition, anemia, and infectious
disease prevent the healing of wounds and result in concurrent
infections that cause PU. It is also inevitable for elders with
incontinence, hospitalization, and polypharmacy increase
incidences of PU. It thus becomes important that people who
care for the elders and the elders themselves closely monitor
risks and work against them for the better health of the people.
It is important that using chronic participants could expose a lot
of data on the prevalence of PU and help prevent it.
Ethical Considerations
In the first study by Rondinelli et al. (2018), there was a
mutually exclusive agreement that sought approval from KP
Northern California and Southern California Institutional
Review Board for the safeguarding of the participants by
checking braden scale during admissions and protecting,

14. repositioning patients every 2 hours and protecting the bony
areas of at risk patients with ABD pads. On the other hand, in
Santamaria et al. (2015) there is an ethical consideration in the
effectiveness of soft silicone multi-layered foam dressings in
the prevention of sacral and heel pressure ulcers in greater
population of trauma and critically ill patients. Comment by
Linnette Nolte: Who approved the study?Comment by Linnette
Nolte: Conclsion per your rubric. What are the nursing
implications?
References
Rondinelli, J., Zuniga, S., Kipnis, P., Kawar, L.N., Liu, v. &
Escobar, G.J. (2018). Hospital-Acquired Pressure Injury Risk-
Adjusted Comparisons in an Integrated Healthcare Delivery
System. Nurs Res., 67(1), 16-25.
doi:10.1097/NNR.0000000000000258
Santamaria N, Gerdtz M, Sage S, McCann J, Freeman A,
Vassiliou T, De Vincentis S, Ng AW, Manias E, Liu W, Knott
J. (2015). A randomised controlled trial of the effectiveness of
soft silicone multi-layered foam dressings in the prevention of
sacral and heel pressure ulcers in trauma and critically ill
patients: the border trial. Int Wound J. ;12:302–308.
Hello, you have a good topic but need to state your PICO

15. question. Your artilces are not qualitative. Your only revison
is to critiqu 2 qualitative articles for week 5. Please add a
conclusion. Linn
Research Critique Guidelines
To write a critical appraisal that demonstrates comprehension of
the research study conducted, address each component below
for qualitative study in the Topic 2 assignment and the
quantitative study in the Topic 3 assignment.
Successful completion of this assignment requires that you
provide a rationale, include examples, or reference content from
the study in your responses.
Qualitative Study
Background of Study:
· Identify the clinical problem and research problem that led to
the study. What was not known about the clinical problem that,
if understood, could be used to improve health care delivery or
patient outcomes? This gap in knowledge is the research
problem.
· How did the author establish the significance of the study? In
other words, why should the reader care about this study? Look
for statements about human suffering, costs of treatment, or the

16. number of people affected by the clinical problem.
· Identify the purpose of the study. An author may clearly state
the purpose of the study or may describe the purpose as the
study goals, objectives, or aims.
· List research questions that the study was designed to answer.
If the author does not explicitly provide the questions, attempt
to infer the questions from the answers.
· Were the purpose and research questions related to the
problem?
Method of Study:
· Were qualitative methods appropriate to answer the research
questions?
· Did the author identify a specific perspective from which the
study was developed? If so, what was it?
· Did the author cite quantitative and qualitative studies
relevant to the focus of the study? What other types of literature
did the author include?
· Are the references current? For qualitative studies, the author
may have included studies older than the 5-year limit typically
used for quantitative studies. Findings of older qualitative
studies may be relevant to a qualitative study.
· Did the author evaluate or indicate the weaknesses of the
available studies?
· Did the literature review include adequate information to build
a logical argument?
· When a researcher uses the grounded theory method of
qualitative inquiry, the researcher may develop a framework or
diagram as part of the findings of the study. Was a framework
developed from the study findings?
Results of Study
· What were the study findings?
· What are the implications to nursing?
· Explain how the findings contribute to nursing
knowledge/science. Would this impact practice, education,
administration, or all areas of nursing?

17. Ethical Considerations
· Was the study approved by an Institutional Review Board?
· Was patient privacy protected?
· Were there ethical considerations regarding the treatment or
lack of?
Conclusion
· Emphasize the importance and congruity of the thesis
statement.
· Provide a logical wrap-up to bring the appraisal to completion
and to leave a lasting impression and take-away points useful in
nursing practice.
· Incorporate a critical appraisal and a brief analysis of the
utility and applicability of the findings to nursing practice.
· Integrate a summary of the knowledge learned.
Quantitative Study
Background of Study:
· Identify the clinical problem and research problem that led to
the study. What was not known about the clinical problem that,
if understood, could be used to improve health care delivery or
patient outcomes? This gap in knowledge is the research
problem.
· How did the author establish the significance of the study? In
other words, why should the reader care about this study? Look
for statements about human suffering, costs of treatment, or the
number of people affected by the clinical problem.
· Identify the purpose of the study. An author may clearly state
the purpose of the study or may describe the purpose as the
study goals, objectives, or aims.
· List research questions that the study was designed to answer.
If the author does not explicitly provide the questions, attempt
to infer the questions from the answers.
· Were the purpose and research questions related to the
problem?

18. Methods of Study
· Identify the benefits and risks of participation addressed by
the authors. Were there benefits or risks the authors do not
identify?
· Was informed consent obtained from the subjects or
participants?
· Did it seem that the subjects participated voluntarily in the
study?
· Was institutional review board approval obtained from the
agency in which the study was conducted?
· Are the major variables (independent and dependent variables)
identified and defined? What were these variables?
· How were data collected in this study?
· What rationale did the author provide for using this data
collection method?
· Identify the time period for data collection of the study.
· Describe the sequence of data collection events for a
participant.
· Describe the data management and analysis methods used in
the study.
· Did the author discuss how the rigor of the process was
assured? For example, does the author describe maintaining a
paper trail of critical decisions that were made during the
analysis of the data? Was statistical software used to ensure
accuracy of the analysis?
· What measures were used to minimize the effects of researcher
bias (their experiences and perspectives)? For example, did two
researchers independently analyze the data and compare their
analyses?
Results of Study
· What is the researcher's interpretation of findings?
· Are the findings valid or an accurate reflection of reality? Do
you have confidence in the findings?
· What limitations of the study were identified by researchers?
· Was there a coherent logic to the presentation of findings?
· What implications do the findings have for nursing practice?

19. For example, can the findings of the study be applied to general
nursing practice, to a specific population, or to a specific area
of nursing?
· What suggestions are made for further studies?
Ethical Considerations
· Was the study approved by an Institutional Review Board?
· Was patient privacy protected?
· Were there ethical considerations regarding the treatment or
lack of?
Conclusion
· Emphasize the importance and congruity of the thesis
statement.
· Provide a logical wrap-up to bring the appraisal to completion
and to leave a lasting impression and take-away points useful in
nursing practice.
· Incorporate a critical appraisal and a brief analysis of the
utility and applicability of the findings to nursing practice.
· Integrate a summary of the knowledge learned.
Reference
Burns, N., & Grove, S. (2011). Understanding nursing research
(5th ed.). St. Louis, MO: Elsevier.
© 2016. Grand Canyon University. All Rights Reserved.
4