This qualitative research paper explores community nurses' experiences in managing pressure injuries in patients with dark skin tones. It makes a valuable contribution to the field of nursing, particularly in highlighting the challenges and gaps in managing pressure injuries in people with dark skin tones in the UK. The study's methodology is robust, and the findings are well-presented and supported by participant quotes. The practical recommendations provide a direction for future research and policy development.
In general
1. Ensure keywords are consistent with MESH terms.
2. Be consistent with the term pressure injury. The term pressure injury is used in some places, and pressure ulcer is used in others. The correct term is pressure injury.
3. Ensure that DTI abbreviation is described before use.
Introduction and Background
The introduction effectively outlines the significance of pressure injuries in healthcare, highlighting both the physical and emotional consequences for patients. It draws attention to the financial burden of pressure injuries in healthcare systems, specifically in the UK and the US, making a compelling case to address this issue.
1. If possible, can you provide costs for COMMUNITY-ACQUIRED PRESSURE INJURIES? Here are some potential papers that might be helpful.
Ahn H, Cowan L, Garvan C, Lyon D, Stechmiller J. Risk factors for pressure ulcers including suspected deep tissue injury in nursing home facility residents: analysis of National Minimum Data Set 3.0. Adv Skin Wound Care 2016;29(4):178-90.
Cai S, Mukamel DB, Temkin-Greener H. Pressure ulcer prevalence among Black and White nursing home residents in New York State: evidence of racial disparity? Med Care 2010;48(3):233-9.
Li Y, Yin J, Cai X, Temkin-Greener J, Mukamel DB. Association of race and sites of care with pressure ulcers in high-risk nursing home residents. JAMA 2011;306(2):179-86.
Chen Z, Gleason LJ, Sanghavi P. Accuracy of pressure ulcer events in US nursing home ratings. Med Care 2022;60(10):775-83. 34. Bliss DZ, Gurvich O, Savik K, et al. Are there racial-ethnic disparities in time to pressure ulcer development and pressure ulcer treatment in older adults after nursing home admission? J Aging Health 2015;27(4):571-93.
2. I would shorten the last two sentences to: However, there is limited research exploring the experiences of community nurses managing pressure injuries across different skin tones, particularly in populations with dark skin tones, who are at a higher risk of developing severe pressure injuries (Oozageer Gunowa et al., 2018).
Methodology
The study employs a descriptive qualitative design, which is appropriate for exploring nurses' personal experiences and perspectives. Focus groups and semi-structured interviews allow for a deep exploration of the subject matter. The purposeful sampling method ensures that the participants are relevant to the study's objectives.
1. One shortcoming – which highlights a major concern of the study- is that most of the participants were light-skinned. This, however, supports further research in this area (differences in perception of light and darker-skinned nurses in caring for patients with dark skin).
Findings
The findings are organized into four main themes, providing some of the challenges and experiences of community nurses. Besides relying on self-learning and experience rather than formal education, they highlight some deeper concerns.
1. One area is missed care. As pressure injuries were more severe, this raised the question of the lack of prevention (missed care). A patient at risk is a patient at risk. There also seemed to be significant discomfort in discussing skin color. This is concerning and may represent deeper care issues. I would have liked to see this highlighted.
2. I would have liked to have seen a question on the increased need for prevention due to difficulties in assessment.
3. Also, some exploration of the bias that dark skin may be less prone to breakdown (and hence maybe a reason for the lack of presentation and delayed diagnoses in those with darker skin).