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Educational Strategies To Improve The Repositioning Of Bedridden Patients Assignments

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A pressure injury is one of the common accidents for patients, who are bedridden. People, who are suffering from paralysis or bedridden for a long time due to surgery, are more prone to the issues. Healthcare professionals take various steps for the assessment of pressure injuries. In addition, precaution is much better than treatment. In that aspect, repositioning the bedridden patient shows positive results in reducing the risk of pressure ulcers. In the nursing curriculum, education is provided on the different repositioning strategies based on the condition of the patient.

As the pressure sore is developed from the long and sustained pressure on a specific body part, frequent repositioning is crucial for the bedridden patient. It helps to preserve tissue vitality and transfer the pressure from one body part to another. As per the different nursing guidelines, repositioning every two hours is considered the best practice. Hence, in this research proposal discussion is done on the different education strategies of the nurses, which is about the repositioning of bedridden patients. The importance and benefits of repositioning for risk management and quality care are also discussed.

Aim and research question

In research, the selection of aim is one of the important and first steps. The aim is to decide how to formulate research questions. It is also need to find what the expected outcome of the study is. The aim of this study is "to evaluate the role of nursing educational strategies on the repositioning of bedridden patients in order to prevent pressure injury"

A research question is also developed here, which will help to find the answer. The research question of this study is

"To what extent can nursing education on patient repositioning lead to better pressure injury management in a bedridden patient?”

Project Rationale

The issue is most bedridden patients are suffering from pressure injuries. The disease can be complicated for the patient who is suffering from diabetes. As stated by Iblasi et al. (2022), 3rd and 4th stages of the pressure injury can lead to blood poisoning, which results in the death of the patient. Risk assessment in the first stage is very beneficial to prevent the patient from a life-threatening situation. Besides, taking proper precautions for people, who are prone to pressure injury is beneficial (Tak et al. 2022). It has been found that repositioning the patient periodically is helpful. In most cases, it is the obligation of nurses to perform the repositioning.

Hence, it is important to discuss the education strategy of the nurse. As repositioning is helpful, providing proper knowledge to the nurse can improve the strategy of repositioning (Mamom, and Daovisan, 2022). In that aspect, this topic is selected for the nurse. Performing a study on this topic will help the nurse to gather more knowledge on repositioning. As a result, the risk of pressure injury can be reduced for the bedridden patient.

Literature Review

There is much-existing literature present that is relevant to this study. Conducting a literature review is helpful to analyze the existing knowledge on the research topic. A qualitative descriptive study was found, which stated the repositioning strategies taken by the nurse. It has been stated in the articles that most nurse use repositioning every 2 hours for 24*7 in high-quality facilities (Li et al.2022). The nurses perform this strategy as this is considered the best practice in the field of repositioning Other studies also stated the importance of frequent repositioning. As stated by Sharp et al. (2019), 86-90% of nurses agree that responding needs to be done frequently to prevent the patient from pressure injury. It has been found that nurses are aware of their role in this, which is possible due to the good education strategy on the topic. Another observational study stated that though repositioning is the best practice, there is a lack of skill and motivation among the nurse to use this frequently. According to Latimer et al. (2015), the strategy is performed during the daytime; however, during the night shift repositioning is neglected.

Along with repositioning, pressure relief devices are also used to prevent pressure injuries in some hospitals (Haavisto et al. 2022). However, lack of knowledge and neglect are two main issues here. Another observational study found that nurses used reposting frequently, however, they did not perform the skin assessment (Li et al. 2022). Skin assessment is an important part here, which states only reposting is enough or not for the patient. Without proper skin assessment, it is impossible to understand whether the patient developed any symptoms of the pressure injury or not. Hence, the assessment of risk is neglected here. On the other hand, Cortes et al. (2021) argue that only performing the repositioning is not enough to prevent pressure injury. In many cases, two hourly repositioning strategies failed to protect the bedridden patient from developing pressure ulcers. The nurses use the air mattress along with the reposting to find the best outcome.

Lack of education and support is a major challenge for the nurse. As discussed by Adibelli & Korkmaz (2022), nurses are not aware of the evidence-based recommendation for pressure injury. Besides, a systematic approach is important for the prevention of injury. However, when the nurse does not use a systematic approach, that increases the chance of pressure injury. However, lack of support service is the main reason behind that. Yup et al. (2019) also discussed the neglect of care in the nighttime. Though nurses are aware of their role, repositioning protocol is not followed by them during night shifts. However, there are many patient-related things, which do not allow the nurses to reposition them frequently (Lavallee et al. 2018). All of them affect the repositioning strategies of the nurses.

However, there are some flaws in the literature. Some articles that are used for the literature review have done observational studies. As the findings of those studies are based on observation, there are chances that nurses can change their behavior. There are also chances of sampling bias (Li et al, 2022). On the other hand, when some nurses are completely aware of their role, some are neglecting their duty. Hence, the study results vary based on the healthcare organization and country. Lack of proper knowledge and the lack of nursing staff in the hospitals could be the possible reason for it.


The approach to data collection

In a study, the research team selects the specific types of approach for the collection of data. There are two important approaches in the data collection process, which are the "Qualitative approach" and the "Quantitative approach". According to the author Lury (2020), in a qualitative approach, the research team collects data that can be described and analyzes those to find an outcome. In the case of the "quantitative approach", more focus is given to the numerical data. Especially in the research, where logical answer is required, these types of data are used. However, as numerical data cannot be analyzed from different perspectives, this is not useful when researchers are seeking a descriptive answer (De Groot, & Spiekerman, 2020). At the time of collecting both the data, some specific sources are used where the authentic data can be collected. "Primary source" is used when answers are collected from human beings who are related to the study topic, such as "interview, survey, group discussion" and others (Nayak, & Singh, 2021). "Secondary source" means the existing data, which was collected by other researchers, such as "Articles, Websites" and others.

In this study, researchers will use the “Qualitative approach". As the research topic is to find the different educational strategies for repositioning, it is hard to explain them through numerical data. As stated by the researcher Lury (2020), the use of "Qualitative data" will allow the researchers to discuss and analyze different viewpoints. Hence, this approach is chosen. In this study, both "Primary and secondary qualitative data” will be collected.

Collection of evidence

The collection of evidence is important to support the aim of the research. In this research, evidence will be collected from different secondary sources. Existing research pacers are one of the top pieces of evidence to support the aim here (Smith, 2019). As the study is about the learning of nursing on reposting bedridden patients, information related to the topic will help the researcher to evaluate the topic more effectively. It is important to select some authentic sources to collect those data. As stated by Pandey & Pandey (2021), Google Scholar, PubMed, and science direct are some authentic sources to select the research paper. 20 articles will be selected by searching with a specific keyword. Among them, specific 10 articles will be finalized for collecting evidence. In order to perform the selection method perfectly, the researcher will use the inclusion-exclusion method (Smith, 2019). However, it is important to focus on the keyword while searching as those keywords will help to find evidence that is more relevant.

Research instruments

In this study, “Interview” will be performed as a research instrument. In the first step, the sample will be selected for the interview. The second step is to develop interview questions for the interview. The participant will answer the questions and those will be collected as the “primary source” for the study. The reason for conducting the interview is to find the necessary information from the people who are directly linked with the study topic (De Groot, & Spiekerman, 2020). Hence, a more authentic and relevant answer will be found. However, the researcher needs to ensure that all the interview questions are developed in a way, which will support the purpose of the study. As a result, it will be possible to find the outcome of interest.

Sampling method

There are various types of sample methods, which can be utilized as per the study types. The random sampling method is used, when each sample has the same probability of selection. There are no specific requirements for the sample. As stated by Pandey & Pandey (2021), some researchers prefer the "Systematic sampling method". In these types, samples chosen after giving intervals in the same position, such as each 3rd person, are selected from a list. Another important sampling strategy is “convenient sampling”, which will be applied in this study (Smith, 2019). This is a probability sampling method, where participants are seated based on some specific requirement. In order to perform this study effectively, Nurses from different hospitals will be chosen for the interview, which have some experience in handling bedridden patients and repositioning (Haavisto et al. 2022). The number of participants will be 5 and their ages will be between 25-30 years. A consent form will be provided before the interview and after signing that the interview will start.

Data analysis

The researcher will perform analysis of the data after the collection of all the relevant data. There are many types of analysis performed based on the type and sources of the "data". In this study, both "primary and secondary qualitative" will be analyzed. As stated by Pandey & Pandey (2021), an "Interview transcript" is a useful method for the analysis of data, which are collected through interviews. Hence, this analysis strategy will be used. Besides, "thematic analysis" will also be used for the analysis of existing articles. In this process, some common aspects of each literature will be selected and the researcher will describe those.

Ethical consideration

Ethical consideration is another major part of any study, which is considered the application of fundamental principles in the study. In this study, the researchers will maintain all the ethics related to the research. As human involvement is there in the research, all the possible risks will be mitigated and a safe environment will be provided (Nayak, & Singh, 2021). Besides, consent will be taken from the participant whenever needed. Nonjudgmental and equal approach will be used while asking question to the participant and it will be free from any kind of harassment. All the data protection protocols and confidentiality will be maintained. Besides, acknowledgement will be providing to the authors of “secondary data”.

Reference list


  • De Groot, A.D. & Spiekerman, J.A., (2020).Methodology. Hague :De Gruyter Mouton.
  • Lury, C., (2020).Problem Spaces: How and Why Methodology Matters. USA:John Wiley & Sons.
  • Nayak, J.K. & Singh, P., (2021).Fundamentals of Research Methodology Problems and Prospects. India: SSDN Publishers & Distributors
  • Pandey, P., & Pandey, M. M. (2021). Research methodology tools and techniques. USA: Bridge Center.
  • Smith, L. T. (2019). Decolonizing research: Indigenous storywork as methodology. UK: Bloomsbury Publishing.
  • Journals
  • Adibelli, S., & Korkmaz, F. (2022). Pressure injury prevention practices of intensive care unit nurses in Turkey: A descriptive multiple-methods qualitative study. Journal of Tissue Viability, 31(2), 319–325
  • Cortes, O. L., Herrera-Galindo, M., Villar, J. C., Rojas, Y. A., Del Pilar Paipa, M., & Salazar, L. (2021). Frequency of repositioning for preventing pressure ulcers in patients hospitalized in ICU: protocol of a cluster randomized controlled trial. BMC Nursing, 20(1), 1–121
  • Haavisto, E., Kielo-Viljamaa, E., Hjerppe, A., Puukka, P., & Stolt, M. (2022). Consistent Practices in Pressure Injury Prevention at Long-term Care Facilities. Advances in Skin & Wound Care, 35(3), 1–10.
  • Iblasi, A. S., Aungsuroch, Y., Gunawan, J., Gede Juanamasta, I., & Carver, C. (2022). Repositioning Practice of Bedridden Patients: An Evolutionary Concept Analysis. SAGE open nursing, 8, 23779608221106443.
  • Latimer, S., Chaboyer, W., & Gillespie, B. M. (2015). The repositioning of hospitalized patients with reduced mobility: a prospective study. Nursing Open, 2(2), 85–93.
  • Lavallee, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: A feasibility study. Health & Social Care in the Community, 27(4), e417–e427
  • Li, Z., Marshall, A. P., Lin, F., Ding, Y., & Chaboyer, W. (2022). Registered nurses’ approach to pressure injury prevention: A descriptive qualitative study. Journal of Advanced Nursing, 78(8), 2575–2585
  • Mamom, J. and Daovisan, H., 2022. Telenursing: How do caregivers treat and prevent pressure injury in bedridden patients during the COVID-19 pandemic in Thailand? Using an embedded approach. Journal of Telemedicine and Telecare, p.1357633X221078485.
  • Sharp, C. A., Schulz Moore, J. S., & McLaws, M.-L. (2019). Two-Hourly Repositioning for Prevention of Pressure Ulcers in the Elderly: Patient Safety or Elder Abuse? Journal of Bioethical Inquiry, 16(1), 17–34.
  • Tak, S.H., Choi, H., Lee, D., Song, Y.A. and Park, J., 2022. Nurses' Perceptions About Smart Beds in Hospitals. CIN: Computers, Informatics, Nursing, pp.10-1097.
  • Yap, T. L., Kennerly, S. M., & Ly, K. (2019). Pressure Injury Prevention: Outcomes and Challenges to Use of Resident Monitoring Technology in a Nursing Home. Journal of Wound, Ostomy, and Continence Nursing, 46(3), 207–213.
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