MNP6101 Evidence Based Practice And Research Design
Question:
1. Identify how the researcher addresses the five following areas of the selected journal article, using the attached “Evidence Table”:
• background or introduction
• review of the literature
• discussion of methodology
• data analysis
• researcher’s conclusion
2. Critique whether the evidence presented in each section of the journal article supports the researcher’s conclusion.
3. Explain the protection of human subjects and cultural considerations of the journal article.
4. Identify strengths and limitations of the study.
5. Describe how the evidence informs nursing practice.
B. Evaluate a primary qualitative research peer-reviewed journal article (suggested length of 3–5 pages) that has healthcare implications by doing the following:
1. Identify how the researcher addresses the five following areas of the selected journal article, using the attached “Evidence Table”:
• background or introduction
• review of the literature
• discussion of methodology
• data analysis
• researcher’s conclusion
2. Critique whether the evidence presented in each section of the journal article supports the researcher’s conclusion.
3. Explain the protection of human subjects and cultural considerations of the journal article.
4. Identify strengths and limitations of the study.
5. Describe how the evidence informs nursing practice.
C. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
Answer:
(1) Background Information
The occurrence of nosocomial infection is almost 2-5 times higher in the patients of Intensive Care Unit (ICU) when compared to general impatient hospital population and the rate is even higher in the developing countries. In order to explore the microbiology and resistance pattern of the infections related to ICU in India, a study was organized. The study reveals the rate of different infections (Venkataraman et al., 2018).
(2) Review of Literature
For quality care and proper management of ICU acquired infections, the most essential prerequisite is infection surveillance. In a study, organized in a medical ICU, it has been analyzed in most of the patients the rate of pneumonia is higher and the rate of VAP is also found to be higher there (Habibi et al., 2008). Another study showed that a urinary tract infection is most common nosocomial infection in their setting and it also followed by surgical site infection and wound infection (Kamat et al., 2008). The longer the patients stay in ICU, the chances of getting infected becomes higher according to (Kaur et al., 2015).
(3) Discussion of Methodology
A quantitative study was organized in the ICU or surgical departments of hospitals across India. The study included the patients who are staying more than or equal to 48 hours in the ICU. 15 ICUs across India participated in the study and site investigators were the main deciding authority who collected data from the medical records of the patients and who were discharged alive from the hospital were contacted via telephone call to collect data with the use of study-specific data collection form. After the collection of the data all were entered into a pre-designed online database for further analysis.
(4) Data Analysis
After the summarization of the data, it was analyzed. From the 381 participating patients, 346 had a single ICU acquired infection and there were 267 VAP infections, 86 CRBSI infections, and 43 CAUTI infections. The rate of infection shows variation in the result and it depends on the setting and type of ICU also.
From the study, the conclusion is that VAP is the most common ICU acquired infection followed by CRBSI and CAUTI.
(A2) Quantitative: Researcher’s Conclusion
(1) Background Information
The researcher’s conclusion is supported in the background by a detailed introduction about the issue.
(2) Review of Literature
The researcher’s conclusion is supported in the review of the literature by some studies and journals which were performed by some previous researchers. All the previous studies proved the fact that infection rate is higher in ICU.
(3) Methods
The researcher’s conclusion is supported in the methods by organizing a quantitative data analysis method. The participating ICUs also proved the fact.
(4) Data Analysis
The researcher’s conclusion is supported in the data analysis by survey based quantitative data analysis method. It produced the same result which the researchers concluded.
The researcher’s conclusion is supported in the conclusions by the result after the completion of the survey. The results indicated VAP infection is higher in rate.
(A3) Quantitative: Protection and Considerations
Before the conduction of the study, the approval and consent from the ethics committee of all the study centres were obtained. The nature of the study was observational. Hence, the consent from the patients was also obtained from the study centres before conduction the study.
(A4) Quantitative: Strengths and Limitations
2 Strength
The main strength was the sample size, as various organizations participated in the study and the study included a microbiology laboratory which produced a robust result.
2 Weakness
The details of patients without ICU infection were not collected and the investigators did not decide colonization against infection so the study could have over-diagnosed or under-diagnosed infections.
(A5) Quantitative: Evidence Application
The result indicates that ICU acquired infections are higher in rate, and nurses should take more care in this regard to avoid the issue.
(B1) Qualitative: Article Areas
(APA citation) of article
Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S. (2017). Acute care nurses’ responses and recommendations for improvement of hand hygiene compliance: A cross-sectional factorial survey research study. American journal of infection control, 45(6), 620-625.
(1) Background Information
Hand hygiene is one of the effective practices to counter healthcare acquired infections. Nurses always stay directly in touch with the patients and so their hand hygiene is very much important in this regard. In order to understand how the nurses maintain hand hygiene while dealing patients, a study was organized (Chatfield et al., 2017).
(2) Review of Literature
From previous researches it has been found that in some developing countries, lack of cleaning resources affect the hand hygiene culture (Wasswa et al., 2015). No study could found any penalty or fine in the intervention of hand hygiene. Many other authors suggested that other researchers should continue their work in providing evidence which will be used to identify components of multi-component intervention (Talbot et al., 2013).
(3) Discussion of Methodology
The method of the survey was grounded in the framework of Bandura’s cognitive theory (Valkenburg et al., 2016). A qualitative survey was designed on staff nurses and there were 400n participants. Each participant has a target of 8 vignettes and then there will be 3200 observations as a result. With the use of Microsoft word and excel, vignettes were physically produced using R statistical software. The participants took part in the group interviews and online surveys.
(4) Data Analysis
With the use of R version the statistical analyses were conducted. Different participants produced different results. The intra-class correlation was 0.24 calculated from the result. The participants indicated that culture and intrinsic motivation has massive influence on the hand hygiene behaviour.
Researchers from the result indicated the use of goal setting and to incorporate the maintenance of hand hygiene as the culture in healthcare. Further research is required for understanding about how nurses consider hand hygiene as their culture.
(B2) Qualitative: Researcher’s Conclusion
(1) Background Information
The researcher’s conclusion is supported in the background by a brief introduction about the issue of hand hygiene among the nurses.
(2) Review of Literature
The researcher’s conclusion is supported in the review of the literature by some previous studies. All the studies were about hand hygiene and explored that lack of cleaning resource is also a barrier.
(3) Methods
The researcher’s conclusion is supported in the methods by qualitative data analysis method performed in the framework of Bandura’s cognitive theory.
(4) Data Analysis
The researcher’s conclusion is supported in the data analysis by statistical data analysis using R version.
(5) Conclusions
The researcher’s conclusion is supported in the conclusions by proving the fact that hand hygiene should be incorporated as culture in healthcare.
(B3) Qualitative: Protection and Considerations
All the instruments were approved by the university ethics board and they also gave the approval for conducting survey. All the participants who participated in the group interviews provided physical signature and those who participated in the online surveys indicated their consent electronically.
(B4) Qualitative: Strengths and Limitations
2 Strength
A huge number of participants were there in the survey which produced many observations as a result. The method of data analysis was statistical which produced accurate result.
2 Weakness
The survey could not incorporate some important factors. The sample was not random and a there was a range in the geographical location also, as all the participants were from US.
(B5) Qualitative: Evidence Application
The findings from the analysis help the nurses to understand the usefulness of hand hygiene and to incorporate this practice in their work.
References
Habibi, S., Wig, N., Agarwal, S., Sharma, S. K., Lodha, R., Pandey, R. M., & Kapil, A. (2008). Epidemiology of nosocomial infections in medicine intensive care unit at a tertiary care hospital in northern India. Tropical doctor, 38(4), 233-235.
Kamat, U. S., Ferreira, A. M. A., Savio, R., & Motghare, D. D. (2008). Antimicrobial resistance among nosocomial isolates in a teaching hospital in Goa. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine, 33(2), 89.
Kaur, M., Gupta, V., Gombar, S., Chander, J., & Sahoo, T. (2015). Incidence, risk factors, microbiology of venous catheter associated bloodstream infections-A prospective study from a tertiary care hospital. Indian journal of medical microbiology, 33(2), 248.
Wasswa, P., Nalwadda, C. K., Buregyeya, E., Gitta, S. N., Anguzu, P., & Nuwaha, F. (2015). Implementation of infection control in health facilities in Arua district, Uganda: a cross-sectional study. BMC infectious Diseases, 15(1), 268.
Talbot, T. R., Johnson, J. G., Fergus, C., Domenico, J. H., Schaffner, W., Daniels, T. L., … & Hickson, G. B. (2013). Sustained improvement in hand hygiene adherence: utilizing shared accountability and financial incentives. Infection Control & Hospital Epidemiology, 34(11), 1129-1136.
Venkataraman, R., Divatia, J. V., Ramakrishnan, N., Chawla, R., Amin, P., Gopal, P., … & Abraham, B. (2018). Multicenter observational study to evaluate epidemiology and resistance patterns of common intensive care unit-infections. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 22(1), 20.
Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S. (2017). Acute care nurses’ responses and recommendations for improvement of hand hygiene compliance: A cross-sectional factorial survey research study. American journal of infection control, 45(6), 620-625.
Valkenburg, P. M., Peter, J., & Walther, J. B. (2016). Media effects: Theory and research. Annual review of psychology, 67, 315-338.
Use the following coupon code :
SAVE10