We can all agree that there has been an explosion of information in all sectors of interest, especially medicine in general and, specifically, in wound care. The proliferation of online search engines, library services, journals, blogs, webcams, and the like provides a constant stream of information that needs to be received, processed, and hopefully applied to enhance our clinical acumen. Like any other sophisticated processing system, the human brain needs an input filter or a sorting mechanism to provide some logic to this sometimes overwhelming and constant information overload.
Literature Review
A well-done literature review is the perfect way to funnel the latest thought and content into one place that is easily accessible, especially for those of us who still like to hold the printed version of this journal's 25-year anniversary issues in our hands. This month, our featured continuing education article is an excellent example of a well-constructed literature review.
Discursive Prose
A literature review should be a good piece of discursive prose (proceeding by argument or reasoning rather than by intuition). It should not be a list describing or summarizing one piece of literature after another, nor should it be a "serial book report," as one of my professors puts it. A good literature review should be organized into sections that present themes or identify trends, including relevant theory. It should not be merely a list of all the materials published, but it should synthesize and evaluate it according to the guiding concept of the author's intended thesis or research question. It is usually not a good signal to see every paragraph beginning with the name of a researcher.
The continuing education article on page 167, "Comprehensive Program for Preventing Pressure Ulcers-A Review of the Literature," passed the "name of the researcher test" with flying colors. It is an excellent example of the reviewers drawing their own succinct conclusions from a massive literature base. The conclusions are squarely the reviewers' own brand, and they were able to accomplish this because they used a systems approach. They defined their methods upfront, giving the reader guideposts along the journey of the review. They were also looking for evidence to support clinical practices.
Critical Reading Skills
Reading and analyzing a review article require not only excellent reading skills but also good listening skills, as well. As we listen to the review this month, what specific questions guided the analysis and the review?
* Are there any specific components that have consistently been included in multifaceted programs in the literature?
* Is there evidence that these comprehensive programs reduce pressure ulcer incidence and/or prevalence?
The different intervention components were categorized into the following groups: pressure ulcer prevention best practices, staff education, clinical monitoring and evaluation, skin care champions, other campaign elements, and strategies to ensure sustainability. The authors made excellent use of tables. Tables are a great way for the reader to easily digest the findings of the review; in this case, the findings were recorded and summarized in easy-to-read formats or knowledge packets. The criteria for good table construction are that it should stand alone from the prose, but complement the prose. Similarly, the prose should be digestible without the tables. And finally, the tables give the reader an organized way of understanding the methods. One of the tests for good research methods is that they should be reproducible by other researchers. In my view, the protocol used by the authors meets the criteria of replication.
What Is the Take-Home Message for Our Readers?
To strengthen the level of evidence for the practices cited in this review, sites should be encouraged to rigorously evaluate their programs and to publish their results. What I hear in this summary is a challenge for all of you to share the innovations of your specific programs in wound prevention to help enhance the base of evidence and to further benefit our systems of care, clinicians, and patients. "Reading is to the mind what exercise is to the body."-Sir Richard Steele.
Richard "Sal" Salcido, MD
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