Blog

PICOT

The PICOT guidelines are questions that help clinicians discover the answers to their research (Walden Student Center for Success, 2012). With these guidelines in mind I formulated the question “Is the daily use of CHG for all pediatric inpatients who have no allergy to CHG associated with a lower incidence of bacterial infection in these same patients?”

The P in the acronym stands for population or patients, in the case the characteristics of the population would be all patients who are staying in the hospital, especially for an extended period or those who have risk factors such as central lines.

The I stands for the intervention, which would be the daily chlorahexadine baths. This intervention would help reduce the risk of hospital acquired infections such as MRSA or c diff. Comparison is the next step and is what the C stands for.

In this case the comparison of the effectiveness of daily CHG baths would be compared to not doing CHG baths. The O stands for outcomes that we would hope to see, which would be a decrease in hospital acquired infections.

The T is the last and final letter and stands for time. In my hospital, the study was conducted over a three-month period to see if we saw a decrease in our hospital acquired infections. Using evidence based research I will find the conclusion to this question.

Evidence Based Research

When conducting research, it is very important to have filtered information and unfiltered information. “Filtered information is information that has been appraised for quality and clinical relevance (Hierarchy of Evidence Pyramid).”

Filtered information includes systematic review, critically appraised topics and critically appraised individual articles (Hierarchy of Evidence Pyramid). “Unfiltered information is evidence that has not necessarily been appraised for quality.

This information tends to come from primary sources (Hierarchy of Evidence Pyramid).” Unfiltered information includes randomized controlled trials, cohort studies, case-controlled studies and expert opinion (Hierarchy of Evidence Pyramid).

When searching the Walden Database for articles on my PICOT question, I used the search terms “CHG Bath,” “CHG Bath in Pediatric Patients,” and “Reducing infection using CHG Bath.” The first article I found multiple studies done on multiple patients with bone marrow transplants.

The purpose of the study was to see if bathing them daily with CHG would decrease the acquired infections, which it did. This article would be considered a systemic review because it had multiple resources and multiple studies.

When searching for critically appraised topics it was very difficult to find one that had a cohort study that had to do with CHG baths, there were some articles about other ways to reduce infection, but none that involved CHG.

The next article I found falls under the topic of expert opinion, in the case the expert opinion came from the nurses. In this study done in 2017, they interviewed nurses, nurse’s aides and nurse managers. They found that all interviewed did find a decrease in infection when CHG baths were used, however many times the nurses did not have time to administer the baths.

Research Advice

I think that when conducting a search for evidence base practice it is important to stay open minded and patient. Staying open minded will help you think of different search terms that may yield different search results. It is also important to be patient while searching so that you can stay focused and weed out the unwanted results.

References

Laureate Education (Producer). 2012g). Hierarchy of evidence pyramid. Baltimore, MD:Author

Musuuza, J. S., Roberts, T. J., Carayon, P., & Safdar, N. (2017). Assessing the sustainability of daily chlorhexidine bathing in the intensive care unit of a Veteran’s Hospital by examining nurses’ perspectives and experiences. BMC Infectious Diseases, 17(1)

Polit, D.F., & Beck C.T. (2017). Nursing research: Generating and assessing evidence for

nursing practice (10Th ed.). Philadelphia, PA: Wolters Kluwer

Robeson, P., Dobbins, M., DeCorby,K., &Tirillis, D. (2010). Facilitating access to pre-processed research evidence in public health. BMC Public Health,10,95.

Rosselet, R., Termuhlen, A., Skeens, M., Garee, A., Laudick, M., & Ryan-Wenger, N. (2009). CH