The criteria and issues involved in a process of transferring research-based knowledge into innovation protocols for nursing practice are discussed. Three sets of criteria are identified: (a) criteria that pertain to evaluating and integrating studies that constitute a base, (b) criteria that address the issue of how relevant the base is for nursing practice, and (c) criteria related to the potential for evaluation in the clinical setting. The format of the innovation protocol is presented. It is suggested that the protocol may be seen as a form of methodological approximation between research and practice. It is also noted that the process involved in identifying research bases for utilization can serve to identify needs for the conduct of nursing research in the future.

Developing research-based innovation protocols: process, criteria, and issues.

OBJECTIVE:The aim of the study was to examine the effect of external pressure of the bed surface on heel skin temperature in adults in the first 3 days after hip surgery.DESIGN:A quasi-experimental study in a prospective, within-subjects, repeated-measures design.SETTING:This study was perfo

/pdf/changes-in-heel-skin-temperature-under-pressure-in-hip-1kgmhy2snd.pdf

Changes in Heel Skin Temperature under Pressure in Hip Surgery Patients

/pdf/a-study-to-investigate-the-relationship-between-a-user-s-4yklbf1u1y.pdf

A Study to Investigate the Relationship Between a User’s Thermal Comfort and Seat Pan Materials

Pressure ulcers represent an ongoing challenge, particularly in immobile patients, that must be met by all health professionals. Extrinsic influential factors involved in the development of pressure ulcers include local shear forces, skin friction, moisture, and temperature for a patient in bed. Objectives: Based on the relationship between pressure ulcers and skin temperature, we sought to study the influence of different bed support surface covers on skin temperature. The purpose of this study was to determine the influence of support surface materials and their effects on skin temperature at high risk areas of the body known to develop pressure ulcers. A quasi-experimental study with a non-probability sampling was used. A total of 31 subjects (14 males and 17 females) between 19 and 29 years old participated in this study. Methods: The same standard foam bed cushion was used and three different types of surface protectors (also known as ticking) were chosen for comparison: no cover, cotton, or plastic. Skin temperature measurements were obtained from areas of high risk for developing pressure ulcers: sacrum, right and left scapula, right and left elbow, and right and left calcaneus. Results: Upon analysis of the protective effect of different support surface coverings on the local skin temperature, we observed that temperatures were lower in all risk areas that had no support surface protector and were greater when the surfaces were in contact with protector material, with increases up to 2.13 degreesC. Conclusions: The type of support surface protector material greatly influences skin temperature depending on the specific area of the body in contact with the surface. The protective plastic that is currently used in hospitals may increase the risk of skin lesions. Simple changes in practices could help minimize the negative impact that plastic protectors contribute to the skin. Regardless, the surface area should be covered with protective covers that do not produce an increase in local temperature and hygienically maintain their integrity.

Influence of different bed support surface covers on skin temperature.

Localised changes in the temperature of the skin are a valuable guide to the condition of tissue subjected to ischaemia. Thermography has significant advantages in the detection of these temperature abnormalities, but environmental and other factors may influence thermographic results. Accessories to enhance thermographic researching and interpretation are suggested. Three clinical applications of thermography are discussed.

The use of thermography in the prevention of pressure sores

1) Serial thermograms were taken after the application of various intensities and durations of localized pressure on the medial surface of the human forearm. 2) Thermal response of the body surface to localized pressure was quantified. 3) It was found that usually a time period of between 1 to 3 minutes elapsed before the body surface attained a maximum elevation of temperature from the time the localized pressure is removed. 4) It was found that increased intensity of pressure (5 psi vs. 3 psi) and longer duration (20 minutes vs. 10 minutes) caused larger thermal responses. 5) It is suggested that high resolution medical thermography may eventually become a useful tool in the fitting of prosthetic and orthotic devices and for the prediction of pressure sores formation so prophylactic measures can be started immediately on immobilized patients.

Goller H

Papers

The effect of external pressure on skin temperature distribution by thermography.