NRS 433 Research Critiques and PICOT Statement Final Draft
NRS 433 Research Critiques and PICOT Statement Final Draft
NRS 433 Research Critiques and PICOT Statement Final Draft
The PICOT question was about hospital-acquired infections (HAI). In many healthcare settings, hospital-associated infections are common, leading to health complications and a longer stay in hospitals. On the other hand, nurses or medical professionals involved in the treatment processes and the general handling of the patients are also prone to these infections. The associated hospital infections often lead to a longer hospital stay, a scenario that causes financial complexities to the victims and their families. In many cases, hospital-acquired infections occur because of mishandling of the patients, wrong medications, poor services delivery, inadequate diagnosis processes, and inappropriate nurse to patient ratio (Widmer & Malik, 2015). With the evidenced-based practices being introduced into different healthcare settings, most medical professionals are on the verge of identifying the possible causes of Hospital associated infections and act appropriately towards mitigating some of the causes.
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PICOT Question
The revised PICOT question is thus; For the inpatients’ population, (P) how does decongestion of wards and widening of spaces between ward beds (I) as compared to congestion and narrowing of spaces between ward beds (C) reduce hospital-acquired infections (O) for the period of hospitalization?
Research Critique
Quantitative and Quantitative Studies
Background
The quantitative and qualitative studies applied were in line with the PICOT question. From the qualitative article, “An observational case study of hospital-associated infections in a critical care unit in Astana, Kazakhstan” by Viderman et al. (2018), the problems of hospital-associated infections are on the rise, the problem causes increased complications, and a longer hospital stays among the patients. The aim of the study is, therefore, to evaluate the effects of the infections on mortality and ICU stay. One of the main objectives of the article is to assess the rate of healthcare-associated infections in Astana, Kazakhstan. One of the research questions from the article was; what is the trend of healthcare-acquired infections in Astana? Another qualitative article identified for the study was, “Healthcare-Associated Infections—A New Pathology in Medical Practice” by Voidazan et al. (2020). According to the author, hospital-associated infections cause a problem of increased mortality rates as well as the advancement in health conditions that are already being experienced by the patients in healthcare settings. On the other hand, associated hospital infections are regarded as one of the major public problems that lead to an increased time of hospitalization and the high costs of healthcare. From the article, there is about sixteen million additional hospitalizations yearly due to hospital-acquired infections. The main purpose of the article is to scrutinize the trends often recorded in hospital-associated infections, prevention, and control strategies in the healthcare system. One of the main objectives of the article is to analyze the control strategies when it comes to the processes aimed at reducing hospital-acquired infections. From the article, the research question was: what are some of the control strategies of hospital-acquired infections (Dang & Dearholt, 2017).
One of the quantitative articles considered in the study was “Hospital-acquired infections before and after healthcare reorganization in a tertiary university hospital in Norway” by Andersen, Rasch, Hochlin, Tollefsen, and Sandvik (2009). The main problem in the article is the increased hospital-acquired infections in healthcare settings. Patient overcrowding in hospitals and other healthcare facilities is the main cause of increased health-associated infections. The study also tests whether there is a relationship between patient overcrowding and ill-health among the hospital staff. One of the main objectives of the research article is to show the trends in infectious diseases within the healthcare system. One of the research questions in the article is; what is the trend in the rates of infectious diseases within healthcare settings. The second quantitative article considered in the research was “Patients with infectious diseases, overcrowding, and health in hospital staff” by Virtanen et al. (2011). The main objective of the quantitative research article is to examine the rate of acquired infections among the patients at the tertiary university hospital in Oslo. The study was done to determine the comparison before and after the healthcare reorganization. One of the research questions in the article was: what is the trend in hospital-associated infections in Norway? The purpose of the study is to examine the rate of hospital-acquired infections before and after the healthcare reorganization in Norway.
How do these two articles support the nurse practice issue you chose?
The quantitative articles provided contain critical information that is essential when it comes to addressing the PICOT question on hospital-acquired infections. The idea of trends in hospital-acquired infections enables the researcher to analyze trends when it comes to the examination of the interventions. Besides, the two quantitative articles present a clear and succinct analysis of the hospital-associated infections as well as the possible causes in different healthcare settings. The articles also give unconventional views on the PICOT question, statement, and present elaborate models that are essential in the processes of analysis. The literature reviews from the two articles present theoretical approaches that are critical when it comes to the analysis of hospital-acquired infections in various healthcare settings. The articles also consist of evidenced-based practices that guide the achievement of the best practices in healthcare settings, a scenario that can greatly reduce the cases of hospital-acquired infections.
From the PICOT statement, there is a close link between the PICOT question and the research articles that were presented. Both the qualitative and quantitative articles were mainly about healthcare-associated infections. The quantitative research articles took quantitative approaches to determine the associated healthcare questions. The result was valid in relation to the PICOT statements. The qualitative articles are significant to the PICOT since they provide critical trends of healthcare-associated infections, as well as the procedures that can be used to reduce the increasing cases of longer hospital stay. The articles also highlight essential steps that can be applied to enable nurses and the entire medical professional teams to manage the cases of hospital-associated infections. The two qualitative research articles relate directly to the PICOT question. The findings of these research articles are critical when it comes to the understanding of hospital-acquired infections.
Method of Study:
The two qualitative research articles apply qualitative approaches. Similar methodologies have been applied in the two articles to collect information and data. The same methodologies have been used to answer the objectives and the research questions. Also, in both the qualitative articles, the authors apply a literature review to highlight the theoretical approaches when it comes to the elaboration of the problem statements as well as the possible solutions. However, the two articles differ in one aspect; Viderman et al. (2018) integrate an observational approach in his work whereby there is the combination of both the qualitative and quantitative methodologies while the other article only uses one of those. The advantage of the qualitative approach is that they reduce the budget used in the entire process of the study; also, there is an increased possibility in the accuracy in making conclusions. With the qualitative approaches, the whole process becomes easier as the information is mainly extracted from the already available sources.
For the two qualitative articles, the quantitative approaches were used to prove the hypotheses and answer the research questions. One advantage of the quantitative research approach is that they present information based on the data, a scenario that leads to the accuracy in the information. The two quantitative articles provide steps and procedures in the hospital decongestion, the activities that are always conducted to reduce the spread of hospital-acquired infections. The information about decongestion and the procedures that can be followed is critical when it comes to the implementation of evidence-based practices. In most cases, hospitals and healthcare institutions lack professionals who are able to conduct research and establish findings that will enable medical organizations to perfect their operational processes in an attempt to ensure positive patient outcomes.
Results of Study
From the qualitative article by Viderman et al. (2018), hospital-acquired infections mainly arise from surgical, whereby there are many cases of contamination. Also, the hospital-acquired infections result from ventilator-associated pneumonia. Finally, the article stipulates that hospital-associated infections often arise from the blood transfusion processes and urinary tract infections. On the other hand, Voidazan et al. (2020) stipulated that hospital-acquired infections are prevalent in public hospitals due to the overcrowding characterized by the need for urgent medical care. Low nurse to patient ratio is also one of the main factors when it comes to the increase in the number of hospital-acquired infections.
The quantitative articles found out that there were declining trends in hospital-associated infections in Norway healthcare facilities between the years 1995 and 2002 (Percival et al., 2017). In the same period, there were increased cases of hospital-acquired infections due to the rise in the number of somatic patients and the cases of workloads in hospitals. In most cases, the associated hospital infections rise with an increase in the number of patients within the healthcare facility.
The four studies selected have implications on the nursing practice. First, they establish approaches that are critical in evidenced-based practices. The outcomes or the study findings from the four articles are critical when it comes to the processes geared towards improving the medical processes and treatment procedures in different medical facilities. The outcomes also inform the quality approaches that need to be undertaken to enhance the healthcare delivery processes.
Ethical Considerations
In both the qualitative and quantitative articles, one of the main ethical concern is the confidentiality of information. The data obtained were secured to ensure security in the access. On the other hand, before the acquisition of the information, the consent was signed to ensure legal authorization. In the quantitative research processes, while conducting surveys to obtain data, the study participants had to sign the consent forms to confirm their acceptance in the study processes. For the qualitative research, while accessing the databases, the administrators were contacted to ensure the authenticity of the information. The application of ethics in the research processes often ensures that the results obtained are valid, and the information acquired can be used to enhance the clinical processes.
Outcomes Comparison
The PICOT question was about hospital-acquired infections (HAI). The anticipated outcome of the PICOT question is to show that widening and increasing the spacing between the hospital beds can reduce the rates of hospital-acquired infections. In many healthcare settings, hospital-associated infections are common, leading to health complications and a longer stay in hospitals. On the other hand, nurses or medical professionals involved in the treatment processes and the general handling of the patients are also prone to these infections. The associated hospital infections often lead to a longer hospital stay, a scenario that causes financial complexities to the victims and their families (Nanda et al., 2019). In many cases, hospital-acquired infections occur because of mishandling of the patients, wrong medications, poor services delivery, inadequate diagnosis processes, and inappropriate nurse to patient ratio. With the evidenced-based practices being introduced into different healthcare settings, most medical professionals are on the verge of identifying the possible causes of Hospital associated infections and act appropriately towards mitigating some of the causes.
The qualitative and the quantitative articles are significant to the PICOT since they provide critical trends of healthcare-associated infections, as well as the procedures that can be used to reduce the increasing cases of longer hospital stay. The articles also highlight essential steps that can be applied to enable nurses and the entire medical professional teams to manage the cases of hospital-associated infections. The two qualitative research articles relate directly to the PICOT question. The findings of these research articles are critical when it comes to the understanding of hospital-acquired infections.
Proposed Evidence-Based Practice Change
From the PICOT statement, there is a close link between the PICOT question and the research articles that were presented. Both the qualitative and quantitative articles were mainly about healthcare-associated infections. The quantitative research articles took quantitative approaches to determine the associated healthcare questions. The result was valid in relation to the PICOT statements. The qualitative articles are significant to the PICOT since they provide critical trends of healthcare-associated infections, as well as the procedures that can be used to reduce the increasing cases of longer hospital stay. The articles also highlight essential steps that can be applied to enable nurses and the entire medical professional teams to manage the cases of hospital-associated infections. The two qualitative research articles relate directly to the PICOT question. The findings of these research articles are critical when it comes to the understanding of hospital-acquired infections. The PICOT statement about hospital-acquired infections borrows a lot of ideas and concepts from the two qualitative articles presented, including the interventions and other mechanisms of managing healthcare infections among the patients. The authors of the qualitative articles elaborate succinctly on the preventive measures and approaches that can be used to reduce HAI (Wattal & Oberoi, 2016). Therefore, there are strong links between the PICOT question and the qualitative research articles used in the study. In other words, they provide alternative view approaches on how to answer the PICOT question; they also provide elaborate models and theories that can be used to link the problems of hospital-acquired infections with evidenced-based practices in the healthcare settings. From the literature reviews of these articles, there are numerous theories elaborating on hospital-acquired infections, including historical trends. The articles provide evidence-based practices that may lead to the solution to increasing hospital-associated infections. There is also the presentation of the best practices that can be undertaken to enhance or to promote evidence-based practices in healthcare settings.
Also, quantitative research articles relate directly to the PICOT question. The two articles mainly concentrate on hospital decongestion in the aim of reducing the cases of hospital-acquired infections. In other words, the two quantitative articles investigate the impacts of hospital decongestion on the reduction of hospital-acquired infections. There is a direct relationship between the results from these two articles with the expected outcome of the PICOT question. The main objectives of all the above articles directly relate to the PICOT questions. The main aim of the two is to show ways of reducing hospital-acquired infections through the use of scientific approaches or evidence-based practices. Also, the two four articles, both quantitative and qualitative, directly provide a solution to the nursing practice problem that was identified in the PICOT, i.e., the hospital-acquired infections.
The quantitative research articles apply the methodology whereby there is a collection of raw data, which were analyzed to show the impacts of bed spacing on the number of hospital-associated infections. The approach enhanced the validity and authenticity of the outcome. Meaning the study was critical in addressing the PICOT question. In other words, the ideals and findings from the study are suitable while addressing the problem of hospital-acquired infections.
The information provided in the PICOT statement and in the article analysis can be used to formulate evidence-based practice changes in the healthcare settings. For instance, these approaches can be used to enhance practices aimed at reducing the spread of contagious diseases. Given the data and trends provided in both the qualitative and quantitative articles, a hospital can formulate evidenced-based strategies to reduce or eradicate the spread of infections from one patient to the other. In many healthcare settings, the last thing that patients want is further infections from hospitals. Nurses and other healthcare professionals play critical roles when it comes to the prevention of the illnesses associated with healthcare settings. They are able to achieve this through the application of evidence-based practices on infection control policies. Keeping data from every patient and analyzing them to find the ideal information is critical when it comes to processes of infection control in healthcare settings. Infection control is beneficial to both the patients and the healthcare workers.
The two quantitative articles provide steps and procedures in the hospital decongestion, the activities that are always conducted to reduce the spread of hospital-acquired infections. The information about decongestion and the procedures that can be followed is critical when it comes to the implementation of evidence-based practices. In most cases, hospitals and healthcare institutions lack professionals who are able to conduct research and establish findings that will enable medical organizations to perfect their operational processes in an attempt to ensure positive patient outcomes. The lack of human resources is also evidenced where there is a lack of enough medical professionals, including nurses and doctors. Training more medical experts are therefore needed to ensure the achievement of evidence-based practices. However, with these resources and the expected research outcome, healthcare workers to adopt many concepts in an attempt to establish best practices that can reduce the rate of hospital-acquired infections.
The application of evidence-based practices often requires a lot of research to find some of the best approaches that can be used to impact the treatment processes. The eradication of hospital-associated infections needs the collection of data from the patients. Currently, most hospitals are using the concepts or approaches that are not ideal in reducing cases of hospital-acquired infections. Thus, through research involving the collection of data, there is a need for changes in the evidenced-based practices so as to reduce the ever-increasing numbers of HAI. The concepts applied in reducing HAI depend on the healthcare setting and the number of medical professionals and nurses involved. Also, the system may depend on the nature of practices undertaken in a given healthcare facility. What works for one facility may not be relevant to other hospitals. While trying to eradicate hospital-acquired infections, there is always the need for the hospitals to collect individual data, analyze them, and use them in the decision making processes to decide on the appropriate evidence-based practices.
References
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.
Nanda, A., Maiti, T. K., & Savardekar, A. R. (2019). Complications in Vascular Neurosurgery—Overview. In Complications in Neurosurgery (pp. 31-36). Content Repository Only!.
Percival, S. L., Williams, D., Cooper, T., & Randle, J. (Eds.). (2017). Biofilms in infection prevention and control: A healthcare handbook. Academic Press.
Wattal, C., & Oberoi, J. K. (2016). A Four-Step Approach to Antibiotic Stewardship in India: Formulation of Antibiotic Policy. In Hospital Infection Prevention (pp. 77-78). Springer, New Delhi.
Widmer, M. K., & Malik, J. (Eds.). (2015). Patient safety in dialysis access. Karger Medical and Scientific Publishers.
Assessment Description
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.
PICOT Question
Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.
The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).
Research Critiques
In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.
The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.
Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.
Proposed Evidence-Based Practice Change
Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.
General Requirements
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
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 required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Attachments
NRS-433V-RS5-ResearchCritiquePICOTGuidelines.docxNRS-433V-RS5-Research-Critique-PICOT-
Research Critiques and PICOT Statement Final Draft – Rubric
To stay current on best practices, nurses should read, examine, and assess published research and care recommendations, particularly in their major field. Nursing practice has developed over time, and many outdated techniques are no longer acceptable as a result of the new evidence-based practice. EBP is the merging of “clinical experience, most recent research, and patient preferences to create and implement best practices for patient care”. The utilization of nursing research in the implementation of EBP reforms is an ongoing process. As patients’ ailments get more complex, the aging of persons with various chronic conditions rises, and technology advances, nurses’ roles in improving patient outcomes become increasingly important. RNs are well-positioned to recognize issues and influence patient care (Schmidt, 2018).
I work in home care and have a tracheostomy patient. When doing trach care, EBP recommendations are implemented. Using EBP recommendations results in improved care for the patient. This can range from how frequently you suction a patient to weekly tracheostomy changes. Although saline is routinely used to loosen secretions, it is no longer recommended because saline may flood particles into the lower respiratory tract and cause decreased oxygenation after suctioning. EBP recommendations must be used by nurses and other healthcare providers who care for patients with tracheostomies to reduce differences in practice and improve patient outcomes. Research has shown that standardizing tracheostomy care and educating caregivers helps reduce hospital readmissions (Lawrence et al., 2020).
Addressing the patient’s holistic requirements necessitates that the nurse treat both emotional and physical needs. Spiritual care is one part of emotional care, is an important component of holistic nursing care, and is frequently covered in most nursing textbooks that introduce basic ideas. Spiritual care is often overlooked or avoided for fear of interfering with the patient’s personal beliefs (Connerton & Moe, 2018). It is critical to inquire about the patient’s beliefs and whether they would prefer spiritual assistance. Some patients may require further assistance, particularly if they are suffering from a terminal illness or are on hospice; spiritual care has been linked to decreased pain and lower levels of depression. Nurses can benefit from spiritual and self-care as well. Spiritual and self-care can reduce stress, sadness, and burnout in nurses (Connerton & Moe, 2018). Spiritual and self-care include eating well, getting enough sleep, exercising, and connecting with a higher power through meditation or prayer.
References
Connerton, C. S., & Moe, C. S. (2018). The Essence of Spiritual Care. Creative Nursing, 24(1), 36–41. https://doi.org/10.1891/1078-4535.24.1.36
Lawrence, P. R., Chambers, R., Faulkner, M. S., & Spratling, R. (2020). Evidence-Based Care of Children with Tracheostomies: Hospitalization to Home Care. Rehabilitation Nursing, 46(2), 83–86. https://doi.org/10.1097/rnj.0000000000000254
Schmidt, M. (2018). Nursing Research: Understanding Methods for Best Practice. Lc.Gcumedia.Com. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/5
Hello BettyAnn,
I think your example of how you use Evidence based practice in your specialty is an amazing application. Evidence based practice goes to show us that our field is every changing and we are always learning new things. “Evidence-based practice is now widely recognized as the key to improving healthcare quality and patient outcomes” (Chien, 2019). It is also important to stay up to date on the latest evidence based practices because just as you explained the practices are always changing and we need to follow the latest research to make sure we are providing the best patient care. If your facility was not up to date on their EB practices then you could still be flushing the trach and causing potential harm to the patient.
Reference:
Chien L. Y. (2019). Evidence-Based Practice and Nursing Research. The journal of nursing research : JNR, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346
BettyAnn,
I enjoyed reading how evidence-based practice effects your workplace and how you care for tracheostomy patients. Nursing professionals’ decision-making regarding patient care is significantly impacted by evidence-based practice. It advances nursing knowledge and abilities, which encourages the performance of more research studies and aids nurses in advancing improved clinical practices. Patients receive complete treatment when evidence-based interventions are used. Evidence-based practice encourages continuity, group training, and collaboration. The presence of an advocate or mentor for evidence-based practice who works with the unit’s staff to incorporate the method into patient care legitimizes it and aids nurses in understanding why they do what they do rather than just how to do it (Schmidt, 2018).
References:
Schmidt, M. (2018) Application of Evidence-Based Resea
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