Running head: ETHICAL ANALYSIS 1

Ethical Analysis

Sareece S. Guerrero

Grand Canyon University: NSG-324-BOSA

January 19, 2020

ETHICAL ANALYSIS 2

Introduction

The quality indicator that was the focal point of the research article selection was

pressure injuries. The International Journal of Nursing Studies contains a study called, “A

multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost

of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing

home residents”. Research misconduct and violation of subject rights were evaluated to analyze

whether the study was ethically sound. Upon evaluation of the methods, the study that compared

the effectiveness of static air and alternating air pressure mattresses was found to be ethically

sound.

Pressure Injury

A quality indicator that is fascinating in how prevalent and impactful it is in hospital care

settings is pressure injuries. The study chosen from the International Journal of Nursing Studies

was about comparing cost effectiveness and effectiveness in preventing pressure ulcers from a

static air mattress and an alternating air pressure mattress. The study took place in Flanders,

Belgium in twenty-six nursing homes with 308 participants over the age of 65 who used

alternating air pressure. There were 154 participants who used the static air mattress and 154

who were the control group that continued using their alternating pressure mattress. In the 14

days of observation, 8/154 people either developed a pressure ulcer or worsened their current one

with the static air, and 18/154 people did with the alternating air pressure. It also took longer for

the static air group to develop an ulcer than the alternative with a median 10.5 days compared to

5.4 days. The costs of the static air mattress were significantly lower with considerations of the

lifespan of the user and equipment (Beeckman, Serraes, Anrys, Van Tiggelen, Van Hecke, &

Verhaeghe, 2019, p. 105-113).

ETHICAL ANALYSIS 3

Methods Evaluation

Any kind of action towards the client must be ethical, and there are principles that must

be met carefully, especially in a study like this. This study did not involve deliberate treatment

that could harm, rather it implemented already effective treatments to compare and see which is

best. They categorized each client based on their age, gender, BMI, incontinence status, Braden

score, cardiovascular disorders, and neurological disorders. The nursing interventions such as

providing nutritional needs was also taken into consideration. The section 2.9 called Ethical

Approval states, “All study procedures were conducted in accordance with the ethical principles

of the 1975 Declaration of Helsinki. The study was approved by the ethics committee of Ghent

University Hospital. All participants or their representatives provided oral and written informed

consent in conformity with ethical approval (registration number: EC/2017/0266). The study was

registered at ClinicalTrial.gov (under identification no. NCT03597750)” (Beeckman, et al., 2019,

p. 105-113). This shows that the nature of the study was not one that implemented dangerous

care without consent and without anonymity.

Subject Rights

The clients that were used in this study took place in Belgium, and they have different

laws when it comes to patient rights in research. But the Patient Bill of Rights from the U.S.

Department of Health and Human Services is the one that will be referred to in determining the

study’s protection of its subjects. The Belmont Report also contains three main ethical principles:

beneficence, justice, and respect for persons. This means the study should have the subjects with

no harm done to them, be treated equally, and be entitled to protection (National Commission for

the Protection of Human Subjects of Biomedical and Behavioral Research, 1979). One of the

significant sections of the patient’s rights is to safe, and respectful care that is consistent with
ETHICAL ANALYSIS 4

their beliefs. The methods that the study used were not in violation of this right because each

subject understood, gave consent, and were not deliberately harmed. Another significant right

was to have all communications and records involving their care treated as confidential by law

(National Institutes of Health, 2019). There were no specific statements regarding the patient

information being kept confidential, but the names of the subjects and any identifiable data was

not open in the study. Although it lacks specificity, it can be assumed that the study maintained

its ethical principles in subject rights based on its statement mentioned in the Ethical Approval

section.

Conclusion

It can be easy to simply claim a study is ethical based on its approval of an ethics

committee and being in a renown journal, but it is also important to evaluate the methods and

collection of data closely to make sure the subjects were safe. The randomized controlled clinical

trial compared the effectiveness of a static air mattress and an alternating air pressure mattress by

keeping a control group who was already using the alternating air ones with another group of

subjects that used the static. The care given to the patients did not deviate from the kind of care

they were given before besides the mattress used. The data they collected for the selection of

subjects and results were used to categorize them based on factors that might be correlated to the

prevalence of pressure injuries, but no forms of identifiable data were included to keep it

confidential. The subjects were given informed consent to participate and were also informed of

their rights. Therefore, it is apparent that this study was ethically sound.
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References

Beeckman, D., Serraes, B., Anrys, C., Van Tiggelen, H., Van Hecke, A., & Verhaeghe, S. (2019).

A multicentre prospective randomised controlled clinical trial comparing the

effectiveness and cost of a static air mattress and alternating air pressure mattress to

prevent pressure ulcers in nursing home residents. International Journal of Nursing

Studies, 97, 105-113. Retrieved from:

http://dx.doi.org.lopes.idm.oclc.org/10.1016/j.ijnurstu.2019.05.015 

National Commission for the Protection of Human Subjects of Biomedical and Behavioral

Research. (1979). The Belmont Report. U.S. Department of Health, Education, and

Welfare. Retrieved from: https://www.hhs.gov/ohrp/regulations-and-policy/belmont-

report/read-the-belmont-report/index.html

National Institutes of Health. (2019). Patient bill of rights. U.S. Department of Health and

Human Services. Retrieved from:

https://clinicalcenter.nih.gov/participate/patientinfo/legal/bill_of_rights.html