Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research NURS 6052

Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research NURS 6052

A critical appraisal assists in reducing the research burden by enabling a researcher to identify and focus more on relevant articles to their research question. The research can either provide support or disapprove the claims made by the researcher through the utilization of quality, and evidence-based practice interventions. The selected topic for the research study is use of resilience training to redice the problem of nurse burnout among nurses in different care settings. Nurse burnout remains a critical problem that impacts the quality of care and patient outcomes in different care setting. Resilience training allows nurses to develop and use evidence-based interventions to reduce burnout and enhance their overall performance and improve the quality of care.

Evidence-based practice (EBP) incorporates best practices from studies and patient care information with clinician experience and patient preferences leading to the delivery of highest quality of care, and improving patient outcomes. The use of EBP requires care providers to formulate a clinical question of interest. In this case, the PICOT question is: Among nurses with burnout (P), does resilience training (I) compared to no intervention (C) reduce burnout(O) in six months (T)? The purpose of this assignment is to appraises critically peer-reviewed article for evidence to support resilience training among nurses with burnout to reduce its prevalence.

The prevalence of CLABSI is high, compromising the quality of care provided to patients admitted to hospitals. As a result, there is a need to investigate evidence-based practices that can be used to reduce health issues, particularly in the ICU. The goal of this study is to evaluate the evidence on the various measures of responding to CLABSI in inpatient units.

Evaluation Table

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Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4
	Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). https://doi.org/10.2807/1560-7917.es.2016.21.46.30400	Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M., Schüpbach, R., Falk, C., Sax, H., Kuster, S., & Schreiber, P. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007	Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the chlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (Changing baths): A stepped wedge cluster randomized trial. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01112-4	Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. https://doi.org/10.1371/journal.pone.0180473
Evidence Level * (I, II, or III)	III	I	I	II
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**	The classic RCT methodology is best suited for medical interventions in which the therapy has a significant micro-effect. Moreover, treatment	No conceptual or theoretical framework indicated.	No theoretical framework defined	No theoretical framework defined.
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	The study involved a systematic review and meta-analysis conducted in conformity to the PRISMA and MOOSE guidelines. Sources from the various databases including MEDLINE, CINAHL, EMBASE, Scopus and Cochrane were involved. Only studies that involved randomized trials, and quasi experiment on the effect of CHG bathing versus non-CHG bathing in preventing CLABSI among the adult populations were included.	The study involved a non-randomized clinical trial. The study focused on the patients admitted in the ICU in the University Hospital Zurich.	The study involved a wedged cluster-randomized design conducted in four sequences.	The study involved cross-sectional survey.
Sample/Setting   The number and characteristics of patients, attrition rate, etc.	Data were obtained from reputable journal sources and covered studies conducted in clinical setting.	The study was conducted in an ICU setting.	The study was conducted in the university hospital setting.	The study was conducted in healthcare setting
Major Variables Studied   List and define dependent and independent variables	The dependent variable was CHG baths while the independent variable was the risk of CLABSI.	The predictor variable included the daily chlorhexidine bathing in ICU and while the outcome variable was risk of CLABSI.	The dependent variable was CHG bathing while the independent variable was CLABSI rates.	The dependent variable was knowledge, attitude and practice among nurses while the outcome variable was CLABSI rates.
Measurement   Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	The DerSimonian average intervention was used in estimating the average intervention effect. The logistic regression model was used in estimating the relationship between the dependent (predictor) and the outcome variable.	The statistics conducted included multivariable regression analysis, odd ratio, and descriptive statistics.	The primary statistics used included descriptive statistics and linear regression model.	Chis-square and t-test were used.
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	The data analysis was quantitative based. The risk for CLABSI infections reduced the incidence of CLABSI by about 40%. The effect of the CHG bath was significant (0.67, 95% CI: 0.53–0.85).	The study was quantitative based. Multivariate analysis indicated that the intervention was significant (OR 0.47, 95% CI 0.26e0.84, P¼0.011).	The study findings indicated that the number of healthcare providers correctly identifying facts about CHG bathing increased, from 31.11 to 50.0% (χ2 = 9.32, p = .002).	Majority of nurses, with frequencies ranging from 70.7% to 90.1% were aware of the CLABSI prevention guidelines. Nursing workshops and courses (67.3%) was the main source of information CLABSIs prevention, followed by guidelines (42.7%), and internet (30.7%).
Findings and Recommendations   General findings and recommendations of the research	CHG bathing can help in reducing the risks of CLABSI among the patients admitted in hospitals.	CHG bathing can help reduce the risk of CLABSI in the ICU unit.	Educating the healthcare providers on the CHG bathing improves its implementation and reduce the risk for CLABSI.	Improved knowledge on CLABSI prevention helps in enhancing adherence to infection prevention protocols.
Appraisal and Study Quality     Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?	The study involved a large sample population and the data covered were appropriate. On the other hand, the main weakness is that the study was based on adult populations alone and so cannot be inferred to children. However, the findings from the study can be used in reducing CLABSI among the adults.	The study’s setting was appropriate and could provide reliable answers to the research question. On the other hand, the weakness of the study was monocentric and did not monitor the intervention and this could bias the findings. However, the results from the study are feasible.	The study recruited adequate sample population. On the other hand, the weakness was that the CHG bathing processes were not standardized and this could affect the outcome recorded. The findings from the study are feasible for clinical practice.	The study covered various aspects influencing CLABSI prevention measures. The statistical tests were appropriate. On the other hand, the main weakness was lack of standard method for measuring attitude and level of knowledge. The findings from the study are feasible and can be used for clinical practice.
Key findings	CHG bathing reduces the risk for CLABI.	CHG bathing reduces the CLABSI.	There is a need to educate ICU nursing on CHG bathing protocols.	There is need to increase education programs on reducing CLABSI.
Outcomes	Reduced CLABSI	Reduced cases of CLABSI among the ICU patients.	Increased awareness on CHG bathing	Increased knowledge on CLABSI prevention.
General Notes/Comments	Healthcare institution should implement the CHG baths among other interventions to reduce CLABSI.	The use of CHG bath can be used to reduce the risks for CLABSI among patients in ICU.	Healthcare institutions should have standard guidelines for CHG bathing.	Educating the nurses on CLABSI prevention measures allows them to implement to protocols accordingly.

 

Critical Appraisal of Research

The studies looked into the best practices for reducing CLABSI in ICU patients. Nosocomial infections are common in patients with catheters and central lines. Furthermore, studies show that the risk of CLABSI increases with the length of hospital stay (Afonso et al., 2016). Healthcare providers must make certain that appropriate interventions are used and that patients are only discharged when they are ready. As a result, it is necessary to monitor and ensure safe practices in order to reduce the risk of CLABSI in patients. Bathing in CHG has been shown to reduce the risk of CLABSI (Reynolds et al., 2021). Variations in CHG bathing protocols among healthcare institutions, on the other hand, continue to be a major source of concern. As a result, procedure standardization and increased awareness are required so that all nurses understand what they should do when interacting with patients.

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The study by Esposito et al. (2017) indicated a gap in the knowledge and practice of the CHG prevention measures by the nurses in the ICU units. Also, the study

indicates variations in the attitudes of the nurses towards the clinical practice and this affects the level of its implementation in the healthcare settings. Therefore, there is a need to create awareness and let the nurses understand the importance and the procedures involved in the CHG bathing as part of preventing the CLABSI. Besides, there should be guidelines published and that are readily available to ensure standardized safety protocols in the ICU units. The burden of CLABSI is high and this needs that adequate and prompt interventions must be developed to curb the health menace. The guidelines should be made available to all inpatient units. Thirdly, there is a need to conduct regular trainings on the CLABSI prevention measures to ensure that all the nurses have updated information on how to respond to the CLABSI.

Finally, there is enough evidence from the analysis that CHG bathing can reduce CLABSI. Though, future studies should be conducted to explore other alternative methods that can be used alongside the intervention especially among children. In addition, having a standard protocol for CHG bathing will means that all people will be aware of what they should do to prevent CLABSI.

Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research NURS 6052 References

Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). https://doi.org/10.2807/1560-7917.es.2016.21.46.30400

Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. https://doi.org/10.1371/journal.pone.0180473

Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the chlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (Changing baths): A stepped wedge cluster randomized trial. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01112-4

Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M., Schüpbach, R., Falk, C., Sax, H., Kuster, S., & Schreiber, P. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007

Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research

The burden of CLABSI is high and this compromises the quality of care delivered to the patients admitted in the hospitals. Therefore, there is need to explore the evidence-based practices that can be used to reduce the health issue especially in the ICU. The purpose of this study is to appraise the evidences provided on the various measures of responding to the CLABSI in the inpatient units.

Evaluation Table

 

Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4
	Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). https://doi.org/10.2807/1560-7917.es.2016.21.46.30400	Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M., Schüpbach, R., Falk, C., Sax, H., Kuster, S., & Schreiber, P. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007	Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the chlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (Changing baths): A stepped wedge cluster randomized trial. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01112-4	Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. https://doi.org/10.1371/journal.pone.0180473
Evidence Level * (I, II, or III)	III	I	I	II
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**	The conceptual framework not indicated	No conceptual or theoretical framework indicated.	No theoretical framework defined	No theoretical framework defined.
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).	The study involved a systematic review and meta-analysis conducted in conformity to the PRISMA and MOOSE guidelines. Sources from the various databases including MEDLINE, CINAHL, EMBASE, Scopus and Cochrane were involved. Only studies that involved randomized trials, and quasi experiment on the effect of CHG bathing versus non-CHG bathing in preventing CLABSI among the adult populations were included.	The study involved a non-randomized clinical trial. The study focused on the patients admitted in the ICU in the University Hospital Zurich with the cases of CLABSI analyzed after the implementation of CHG bathe.	The study involved a wedged cluster-randomized design conducted in four sequences. The indices of CLABSI among the patients undergoing the CHG bathing were analyzed before and after the implementation of bath protocol in the hospital.	The study involved cross-sectional survey where the target population were given questions to indicate their level of knowledge and awareness on CHG bathing.
Sample/Setting   The number and characteristics of patients, attrition rate, etc.	Data were obtained from reputable journal sources and covered studies conducted in clinical setting. The sample population was 22,850 patients with 8% attrition rate.	The study was conducted in an ICU setting. The sample population was 5008 patients.  All participants were included. The attrition rate was 0%.	The study was conducted in the university hospital setting. The total sample population was 1640. All the participants were included in the study. Attrition rate was 0%.	The study was conducted in healthcare setting. A total of 335 nurses were included in the study. The attrition rate was 0%.
Major Variables Studied   List and define dependent and independent variables	The major variables were CHG bath and risk for CLABSI. The dependent variable was CHG baths while the independent variable was the risk of CLABSI.	The major variables were daily CHG bathe and CLABSI incidences. The predictor variable included the daily chlorhexidine bathing in ICU and while the outcome variable was risk of CLABSI.	The variables were CHG bath and CLABSI rates. The dependent variable was CHG bathing while the independent variable was CLABSI rates.	The variables were knowledge and attitude towards CHG bath and the CLABSI rates. The dependent variable was knowledge, attitude and practice among nurses while the outcome variable was CLABSI rates.
Measurement   Identify primary statistics used to answer clinical questions (You need to list the actual tests done).	The DerSimonian average intervention was used in estimating the average intervention effect. The logistic regression model was used in estimating the relationship between the dependent (predictor) and the outcome variable.	The statistics conducted included multivariable regression analysis, odd ratio, and descriptive statistics.	The primary statistics used included descriptive statistics and linear regression model.	Chis-square and t-test were used.
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).	The data analysis was quantitative based. The risk for CLABSI infections reduced the incidence of CLABSI by about 40%. The effect of the CHG bath was significant (0.67, 95% CI: 0.53–0.85).	The study was quantitative based. Multivariate analysis indicated that the intervention was significant (OR 0.47, 95% CI 0.26e0.84, P¼0.011).	The study findings indicated that the number of healthcare providers correctly identifying facts about CHG bathing increased, from 31.11 to 50.0% (χ2 = 9.32, p = .002).	Majority of nurses, with frequencies ranging from 70.7% to 90.1% were aware of the CLABSI prevention guidelines. Nursing workshops and courses (67.3%) was the main source of information CLABSIs prevention, followed by guidelines (42.7%), and internet (30.7%).
Findings and Recommendations   General findings and recommendations of the research	CHG bathing can help in reducing the risks of CLABSI among the patients admitted in hospitals. Therefore, healthcare institutions should adopt CHG bathing.	CHG bathing can help reduce the risk of CLABSI in the ICU unit. Therefore, healthcare institutions should adopt CHG bathing.	Educating the healthcare providers on the CHG bathing improves its implementation and reduce the risk for CLABSI. Therefore, healthcare institutions should adopt CHG bathing.	Improved knowledge on CLABSI prevention helps in enhancing adherence to infection prevention protocols. Therefore, healthcare institutions should adopt CHG bathing.
Appraisal and Study Quality     Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?	The study involved a large sample population and the data covered were appropriate. On the other hand, the main weakness is that the study was based on adult populations alone and so cannot be inferred to children. However, the findings from the study can be used in reducing CLABSI among the adults.	The study’s setting was appropriate and could provide reliable answers to the research question. On the other hand, the weakness of the study was monocentric and did not monitor the intervention and this could bias the findings. However, the results from the study are feasible.	The study recruited adequate sample population. On the other hand, the weakness was that the CHG bathing processes were not standardized and this could affect the outcome recorded. The findings from the study are feasible for clinical practice.	The study covered various aspects influencing CLABSI prevention measures. The statistical tests were appropriate. On the other hand, the main weakness was lack of standard method for measuring attitude and level of knowledge. The findings from the study are feasible and can be used for clinical practice.
Key findings	CHG bathing reduces the risk for CLABI.	CHG bathing reduces the CLABSI.	There is a need to educate ICU nursing on CHG bathing protocols.	Ther PLACE THIS ORDER OR A SIMILAR ORDER WITH SUPERIOR NURSING PAPERS TODAY AND GET AN AMAZING DISCOUNT © 2023 Search Search for: Go to top