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Miami Regional University
Instructor: Roberto Carmona
Course Code: NUR4100
Date: July 14, 2021
In this term paper, a topic will be identified and discussed in detail. The research questions that may be used to study the topic effectively will be identified. Additionally, a theoretical framework, previous research on the topic as well as evidence-based practice will be analyzed in this case. That will ensure that this term paper has the correct and conclusive information about the topic that will be discussed.
The topic of study is “What is the best treatment for itching (pruritus) in hospitalized patients?” Pruritus is an unpleasant sensation that provokes a person to have the desire to scratch themselves. It is irritable and annoying. Therefore, this paper will identify some of the effective treatments of pruritus in hospitalized patients to avoid hospital-acquired infections.
The research question is used to enable a study to address the topic as well as to attain the research objectives. The research question in this paper will be “comparing two or more topical agents for effectiveness in reducing puriceptive pruritus.
The hypothesis that will be used in this paper is “There is no significant difference between the effectiveness of different topical agents in reducing puriceptive pruritus.
Interrelationship Between Theory, Research, and EBP
Various treatment alternatives may be used in the treatment of itchy skin among hospitalized patients. That prevents them room from having hospital-acquired infections. The treatments that are used for itchy skin have a primary focus of removing or eliminating the itchy feeling that a patient feels. In some cases, controlling the itchy skin may be challenging to the patient (Rayner et a., 2017). That requires them to be subjected to different treatment alternatives to identify the most effective one.
One of the treatment alternatives that may be used is oral medications. The oral medications that are used to prevent or reduce the itchiness in the skin are serotonin reuptake inhibitors and antidepressants. Such medications help reduce the itchy skin among hospitalized patients. However, for them to be effective, they must be used for a period of between eight and 12 weeks. Examples of serotonin reuptake inhibitors that may be used include sertraline and fluoxetine.
Another treatment alternative that may be used is corticosteroid ointments and creams. These are medicated creams and ointments that are applied to the skin in itchy places to reduce itchiness. They are also applied in itchy areas that have turned red. After the ointments and creams are applied on the itchy part of the skin, it should be covered with damp cotton wool. That moisturizes the skin and thus enabling it to absorb the medication into the skin (Taphoorn et al., 2018). Additionally, it has a cooling effect which is essential for most itching skins as they have a heat sensation. In cases of chronic itchiness, the hospitalized patients should bathe for 20 minutes with lukewarm water before applying the medication. That makes it easier for the medication to be absorbed.
Light therapy is also effective in reducing itchy skin among hospitalized patients. Light therapy is a therapeutic procedure that entails exposing the patient’s skin o a particular type of light. The light is essential as it enables the itchiness to reduce. However, light therapy must be carried out severally to be effective.
The hospitalized patients may also be applied to other ointments and creams that may be effective in the reduction of the itchiness in the skin. Some of the ointments and creams that may be used include calcineurin inhibitors such as pimecrolimus and tacrolimus. Additionally, topical anesthetics, doxepin as well as capsaicin may also be used to relieve the hospitalized patients from the itchiness in their skin.
Nowak and Yeung (2017) investigated the diagnosis and treatment of pruritus. The article used secondary data to answer its research question which was, “Effectiveness of treatment alternatives such as topical agents, nonpharmacologic treatments and systemic therapies in treating itchy skin.” The article used data from other articles in the PubMed and MEDLINE databases. To identify the most effective sources of secondary data, the article used the keywords pruritus or itch. According to the article, the use of all the treatment methods identified was effective if the directions were followed as required.
Kouwenhoven et al. (2017) investigated the use of oral antidepressants in the treatment of chronic pruritus. The objective of the study was to evaluate the effectiveness of oral antidepressants in the treatment of chronic pruritus. This article was also a systematic review that evaluated the effectiveness of antidepressants in treating chronic pruritus from the results of previous studies that have been done on the topic. The previous research papers that were used were extracted from EMBASE, PubMed, Web of Science, and Cochrane databases. The risk of bias was assessed using the Cochrane Risk of Bias tool for randomized controlled trials and studies and the Newcastle-Ottawa Scale for the observational studies. The study evaluated the data collected from 35 previous studies conducted on the topic. Some of the oral antidepressants whose effectiveness was evaluated included amitriptyline, fluoxetine, paroxetine, nortriptyline, mirtazapine, fluvoxamine, sertraline, and doxepin. According to the studies that were evaluated, they indicated that the antidepressants that are used are effective in reducing chronic pruritus. Thus, they may be considered for patients with chronic pruritus as they are effective.
Pereira and Ständer (2017) investigated the emerging and current treatment alternatives that are used to treat patients with pruritus. According to the article, chronic pruritus is an issue that decreases the quality of life of most hospitalized patients. Thus, a lit of care should be provided to the patient with the illness. The study indicates that one of the methods that are used in treating health disorders is therapeutic methods. Although the method is effective, it is still challenging for clinicians to implement. Additionally, the study indicates that healthcare practitioners should also implement the use of ointments and creams to ensure that the itchiness in the patient’s body is reduced significantly. Thus, the study indicates that the use of ointments and creams can be used effectively to reduce the itchiness in the skin.
Stull et al. (2016) investigated the advances in the therapeutic strategies that may be used in the treatment of pruritus. The illness is an illness that may arise from both non-dermatological such as cholestasis, kidney disease, neuropathy, and lymphoma and dermatological conditions. Over time, research has been conducted to identify the most effective treatment alternatives that may be used. That is because it is a health issue that affects most hospitalized patients, and it decreases their quality of life. The study indicates that currently, no universally effective treatment alternative may be used for treating hospitalized patients with itchy skin. However, healthcare practitioners should use the best treatment alternatives depending on the patient and those that may seem helpful. Additionally, to increase the effectiveness of the treatment alternatives, more than one treatment alternative may be used. That will ensure that the quality of life of the patients is increased.
Evidence-based practice is a problem-solving approach used in the delivery of healthcare that integrates the best evidence from patient care data and previous studies as well as the clinician’s expertise and patient values and preferences. Thus, to identify the best methods to treat itchy skin in hospitalized patients, the evidence-based practice should be used. The goal of evidence-based practice, in this case, is to identify the best treatment alternative that may be used to treat itchy skin among the hospitalized patients. When deciding on the treatment alternative to be used, the healthcare practitioner should consider the effectiveness of the treatment alternative depending on previous research and the patient’s values and preferences. In such a case, the health outcomes that will be arrived at will be essential in reducing the itchy skin among the hospitalized patients.
Credibility of Sources
The sources that have been used in this case are credible. That is because they are peer-reviewed articles. That indicates that the content of the articles has been approved to be used as evidence in the promotion of evidence-based practice in the treatment of itchy skin among hospitalized patients. Additionally, the articles that were used are current as they are from the last five years indicating that they have considered the factors affecting the delivery of healthcare services currently (Samadi, et al., 2016). Additionally, most of the studies that were identified were systematic reviews. That indicates that they used data collected from other primary papers that were conducted on the topic. The use of systematic data increased the credibility of the sources as they implemented ways that may be used to avoid bias that may occur.
In a nutshell, pruritus is an unpleasant sensation that provokes a person to have the desire to scratch themselves. The topic of study is “What is the best treatment for itching (pruritus) in hospitalized patients?” Several treatment alternatives were identified from the research papers evaluated and in the theoretical framework. The most common and effective treatment alternatives that were identified are corticosteroid ointments and creams and the use of oral medications.