Assessment Description
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-reviewed research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the \”Literature Evaluation Table\” to complete this assignment.
Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
The PICOT question will provide a framework for your capstone project.
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Attachments
NRS-433V -RS1-LiteratureEvaluationTable.doc
Find below the content of the attachment. This is to be filled and completed as well because it is part of this assignment. Thank you. Note that no form of plagiarism is acceptable.
Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
The clinical issue selected for study in this paper is hospital-acquired infections. Hospital-acquired infections are also known as healthcare-associated infections (HAI). They are nosocomially acquired infections that are often not present at the patient’s admission. These infections are normally developed after hospitalization. Most hospital-acquired infections may manifest 48 hours after the patient has been admitted. Various agencies including the National Healthcare Safety Network (NHSN) of the Center for Disease Control and Prevention (CDC), keep close monitoring of such infections. This kind of surveillance aims at preventing HAIs and improving patient safety. Types of hospital-acquired infections include central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), Hospital-acquired Pneumonia (HAP), and Ventilator-associated Pneumonia (VAP), and Clostridium difficile infections (CDI). Hospital-acquired infections have been taken seriously in the past few decades. As a result, many hospitals have established measures to prevent those incidences.
Hospital-acquired infections are associated with prolonged hospitalization, increased cost of care, bad disease prognosis, and other negative impacts. In 2014, the CDC released a report indicating that about 4% of hospitalized patients experienced at least one of the HAIs. Pneumonia is the most experienced HAI at 21.8%, followed by gastrointestinal infections (17.1%), urinary tract infections, or UTIs (12.9%) respectively. Hand hygiene and staff education strategies have shown promising results in reducing the incidences of HAIs in healthcare facilities.
PICOT Question:
In hospitalized patients (P), does health workers’ education and hand hygiene (I) compared to no intervention (C) reduce the incidences of hospital-acquired infections (O) in three months (T)?
| Criteria | Article 1 | Article 2 | Article 3 |
| APA-Formatted Article Citation with Permalink | Labi, A. K., Obeng-Nkrumah, N., Owusu, E., Bjerrum, S., Bediako-Bowan, A., Sunkwa-Mills, G., … & Newman, M. J. (2019). Multi-centre point-prevalence survey of hospital-acquired infections in Ghana. Journal of Hospital Infection, 101(1), 60-68. https://doi.org/10.101 6/j.jhin.2018.04.019
Permalink: https://www.sciencedirect.com/ science/article/pii/ S0195670118302573
|
Gezie, H. (2021). Health care workers’ knowledge, attitude and practice towards hospital acquired infection prevention at Dessie referral hospital, Northeast Ethiopia. Health Science Journal, 0-0.
Permalink: https://www.itmedicalteam. pl/articles/health-care-workers-knowledge-attitude-and-practice-towards-hospitalacquired-infection-prevention-at-dessie-referral-hospital-nort.pdf
|
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical care nurse, 37(3), e1-e8. https://doi.org/10.4037/ccn2017694
Permalink: https://aacnjournals.org/ccnonline /article/37/3/e1/3575/Patients-Hand-Washing-and-Reducing-Hospital |
| How Does the Article Relate to the PICOT Question? | The paper describes the prevalence and distribution of HAIs in acute care hospitals in Ghana. | The paper assesses health workers’ knowledge, attitude and practice to reduce HAIs. | The paper advocates for handwashing and educational programs to reduce hospital acquired infections. |
| Quantitative, Qualitative (How do you know?) | This is a quantitative research study because it uses statistical analysis of data (descriptive statistics etc.). | It is a quantitative study because of the use of statistical analysis methods. | This is quantitative study; Wilcoxon rank sum test was used to measures measure difference in infection rates before and after intervention. |
| Purpose Statement | To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. | To assess health care workers knowledge, attitude and practice towards hospital acquired infection prevention at Dessie referral hospital. | To improve patients’ hand hygiene through the promotion and use of hand washing with soap and water, hand sanitizer, or both and improve patients’ education to reduce hospital-acquired infections. |
| Research Question | What is the prevalence and distribution of HAIs in acute care hospitals in Ghana? | Do health workers have knowledge, positive attitude, and right practice to prevent HAIs at Dessie referral hospital? | Can hand hygiene and patient education reduce HAIs in a healthcare setting? |
| Outcome | Common types of HAIs, prevalence of HAIs in hospitalized patients, the most isolated, predictors of HAIs, and the mist isolated microorganisms. | Knowledge of HAIs, attitudes of health workers, and practices in place to reduce HAIs incidences. | Decreased rate of HAIs. Specifically, rates of infection with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile. |
| Setting
(Where did the study take place?) |
at 10 acute care hospitals in Ghana. | In Dessie referral hospital in Ethiopia. | At an adult 36-bed cardiothoracic surgical step-down unit at the University of Michigan Health System, USA. |
| Sample | A total of 2107 inpatients (50.1% of the total bed capacity) participated in the study. | The study included 191 multi-professional health care workers, which represented 90.5% response rate. | All patients in the Unit participated in the study. Further information about the study sample was not provided. |
| Method | A country-wide point-prevalence study was conducted at 10 acute care hospitals, surveying all units/departments at each facility. Study information was collected manually on standardized data forms. | This was a facility based cross sectional study. Self-administered questionnaire was used for data collection. Before data collection one-day training was given for data collectors and supervisor regarding the study, the questionnaires and data collection procedure by the main investigator. | Both patients and staff received pre-and-post intervention questionnaires. Unit leaders followed the trend in new cases of HAI from the infection prevention department’s monthly report, which was then used to evaluate the impact and effectiveness of the project. HAI rates were compared during a 19-month period before and a 19-month period after the intervention. |
| Key Findings of the Study | HAI prevalence was prevalence of 8.2%. Common HAIs were surgical site infections, bloodstream infections, urinary tract infections, and respiratory tract infections. Commonly isolated micro-organism was Escherichia coli. | The result indicates that 86.4%, 76.4% and 77% of respondents had good knowledge and favorable attitude and poor practice towards hospital acquired infection prevention respectively. | Unit-specific infection control data showed that VRE infections decreased by 70% in 19-month period. MRSA infections decreased by 63% in 19-month period. |
| Recommendations of the Researcher | Staff training and establishment of infection measures are recommended. | Health workers should strictly follow hospital acquired infection prevention guidelines. Improving sustainable supplies like personal protective equipment, water supply and hand washing facilities at patient care site. | The authors recommend for handwashing/hygiene and educational programs to reduce hospital acquired infections. |
| Criteria | Article 4 | Article 5 | Article 6 |
| APA-Formatted Article Citation with Permalink | Clack, L., Zingg, W., Saint, S., Casillas, A., Touveneau, S., da Liberdade Jantarada, F., … & Sax, H. (2018). Implementing infection prevention practices across European hospitals: an in-depth qualitative assessment. BMJ quality & safety, 27(10), 771-780. http://dx.doi.org/10. 1136/bmjqs-2017-007675
Permalink: https://qualitysafety.bmj.com /content/qhc/27/10/771.full.pdf |
Barker, A. K., Brown, K., Siraj, D., Ahsan, M., Sengupta, S., & Safdar, N. (2017). Barriers and facilitators to infection control at a hospital in northern India: a qualitative study. Antimicrobial Resistance & Infection Control, 6(1), 1-7. https://doi.org/10.1186/s13756-017-0189-9
Permalink: https://link.springer.com/content/pdf/10 .1186/s13756-017-0189-9.pdf |
Maroldi, M. A. C., Felix, A. M. D. S., Dias, A. A. L., Kawagoe, J. Y., Padoveze, M. C., Ferreira, S. A., … & Figueiredo, R. M. (2017). Adherence to precautions for preventing the transmission of microorganisms in primary health care: a qualitative study. BMC nursing, 16(1), 1-8. https://doi.org/10.1186/s12912-017-0245-z
Permalink: https://link.springer.com/ content/pdf/10.1186/s12912-017-0245-z.pdf |
| How Does the Article Relate to the PICOT Question? | The paper discusses some barriers and facilitators to implementing catheter related bloodstream infection interventions. | The study is about barriers and facilitators to infection control in a hospital in the Northern India. | The article speaks about adherence to precautions for preventing the transmission of microorganisms responsible for HAIs. |
| Quantitative, Qualitative (How do you know?) | This is a qualitative paper because it does not use statistical methods of data analysis. | This is a qualitative paper because it does not use statistical methods of data analysis. | This is a qualitative paper because it does not use statistical methods of data analysis. |
| Purpose Statement | To report an in-depth investigation of the main barriers, facilitators and contextual factors relevant to successfully implementing HAI preventive strategies in European acute care hospitals. | To assess facilitators and barriers to infection control at a private tertiary care hospital in Haryana, India. | To identify issues that determine the adherence of professionals to precautions for preventing transmission of microorganisms in primary health care. |
| Research Question | · What are the main barriers and facilitators to successfully implementing CRBSI prevention procedures?
· What role do contextual factors play? |
What are facilitators and barriers to infection control at a private tertiary care hospital in Haryana, India? | What are the issues that determine the adherence of professionals to precautions for preventing transmission of microorganisms in primary health care. |
| Outcome | Barriers and facilitators to implementing catheter related bloodstream infection prevention interventions. | are facilitators and barriers to infection control at a private tertiary care hospital in Haryana, India. | Issues that determine the adherence of professionals to precautions for preventing transmission of microorganisms in primary health care. |
| Setting
(Where did the study take place?) |
The study was conducted in 6 hospitals in Europe. | The study was conducted in a 1250 bed private tertiary care hospital in Haryana, northern India. | The study was conducted in five primary health care (PHC) units, managed by the Brazilian Family Health Strategy (FHS) in two cities (population 220,000 and 15,000) in the state of São Paulo, Brazil. |
| Sample | A total of 129 individuals were interviewed face to face and other 12 individuals on phone, across the 6 hospitals. The sample included top management officials as well as multidisciplinary healthcare workers. | The study comprised of ten nurses (80% female) and ten doctors (30% female), selected from a wide range of clinical departments including internal medicine, neurology, anesthesia, infectious disease, and three ICUs (cardiac, pediatric, and medicine). | Four focus groups were conducted, with an average size of 5 professionals per group, totaling 20 professionals (11 CHAs, 5 nursing assistants and technicians, and 4 nurses, that agreed to participate). Participants were mostly women (n = 18), with an average of 4.9 years’ working experience in the PHC. Medical professionals were invited to participate in the focus groups, but none did. |
| Method | Participants were purposefully selected for semi structured interviews at multiple hierarchy levels and from key departments including hospital administration, IPC professionals and ICU teams. Themes were identified using both inductive (first site visit) and deductive (second site visit) approaches. | The researchers conducted twenty semi-structured interviews to assess facilitators and barriers to a hospital infection control program. Interview questions assessed the hospital’s infection control policies, focusing on how people, physical environments, tasks, organizations, and tools are barriers and facilitators to the success of ongoing interventions. | This is a qualitative study using focus groups to obtain data. Focus groups took place during the working day and at the participants’ workplace from January to March 2014. The focus groups were run by two researchers who acted as the facilitator and the observer. |
| Key Findings of the Study | Qualitative measures of implementation success included intervention fidelity, adaptation to local context and satisfaction with the intervention program, availability of resources, proper distribution of resources, and proper communication among boundary spanners. The opposite of the identified facilitators become barriers to intervention implementation. | Major barriers included a high rate of nursing staff turnover, time spent training new staff, limitations in language competency, and heavy clinical workloads. Major facilitators include a well-developed infection control team and an institutional climate that prioritizes infection control. | The analyzed content was organized into four thematic categories: low risk perception, weaknesses in knowledge, insufficient in-service training, and infrastructure limitations. These issues impacted adherence to preventing transmission of microorganisms in primary health care. |
| Recommendations of the Researcher | The authors recommend that the identified facilitators be put into consideration while implementing HAIs prevention measures. | Hospitals to ensure a well-developed infection control team and an institutional climate that prioritizes infection control when implementing measures to reduce HAIs in a healthcare environment. | Promoting in-service training/education programs should be the first step towards quality improvement. |
References
Barker, A. K., Brown, K., Siraj, D., Ahsan, M., Sengupta, S., & Safdar, N. (2017). Barriers and facilitators to infection control at a hospital in northern India: a qualitative study. Antimicrobial Resistance & Infection Control, 6(1), 1-7. https://doi.org/10.1186/s13756-017-0189-9
Clack, L., Zingg, W., Saint, S., Casillas, A., Touveneau, S., da Liberdade Jantarada, F., … & Sax, H. (2018). Implementing infection prevention practices across European hospitals: an in-depth qualitative assessment. BMJ quality & safety, 27(10), 771-780. http://dx.doi.org/10. 1136/bmjqs-2017-007675
Gezie, H. (2021). Health care workers’ knowledge, attitude and practice towards hospital acquired infection prevention at Dessie referral hospital, Northeast Ethiopia. Health Science Journal, 0-0.https://www.itmedicalteam.pl/articles/health-care-workers-knowledge-attitude-and-practice-towards-hospitalacquired-infection-prevention-at-dessie-referral-hospital-nort.pdf
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical care nurse, 37(3), e1-e8. https://doi.org/10.4037/ccn2017694
Labi, A. K., Obeng-Nkrumah, N., Owusu, E., Bjerrum, S., Bediako-Bowan, A., Sunkwa-Mills, G., … & Newman, M. J. (2019). Multi-centre point-prevalence survey of hospital-acquired infections in Ghana. Journal of Hospital Infection, 101(1), 60-68. https://doi.org/10.101 6/j.jhin.2018.04.019
Maroldi, M. A. C., Felix, A. M. D. S., Dias, A. A. L., Kawagoe, J. Y., Padoveze, M. C., Ferreira, S. A., … & Figueiredo, R. M. (2017). Adherence to precautions for preventing the transmission of microorganisms in primary health care: a qualitative study. BMC nursing, 16(1), 1-8. https://doi.org/10.1186/s12912-017-0245-z