Nursing research
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Analgesic trials have been advocated as a means to reduce pain in persons with dementia (PWDs), but few systematic studies have been reported. ⋯ Acetaminophen use reduced pain behaviors associated with musculoskeletal pain in this sample of PWDs. This provides preliminary evidence that acetaminophen is an effective pain reliever for this population. In addition, the study supports the use of a within-subjects design to examine daily variability in pain behaviors and to demonstrate treatment effects in PWDs.
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Clinical guidelines for the prevention of pressure ulcers advise that pressure-reducing devices should be used for all patients at risk of or with pressure ulcers and that all pressure ulcers should be documented in the patient record. Adherence to these guidelines among elderly hospital patients early in the hospital stay has not been examined in prior studies. ⋯ Use of preventive devices and documentation of pressure ulcers are suboptimal even among patients at high risk.
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The standard approach in a randomized controlled trial (RCT) is to randomize individuals to intervention and control groups. Yet, nursing and other health interventions are often implemented at the levels of health service organizational unit or geographical area. It may be more appropriate to conduct a cluster RCT. However, cluster randomization requires consideration of a number of important issues. ⋯ Cluster RCTs present special challenges in relation to design, conduct, and analysis. Nevertheless, they are an appropriate and potentially powerful tool for nursing research. With careful attention to the issues addressed in this article, researchers can use this approach successfully.
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One of the main problems in conducting clinical trials is low participation rate due to potential participants' misunderstanding of the rationale for the clinical trial or perceptions of loss of control over treatment decisions. ⋯ Participation rates could be enhanced in future clinical trials by using a visual presentation to explain and describe the study as part of the informed consent process. More research is needed to test alternate methods of obtaining informed consent.