NRS 433V Topic 3 Assignment
NRS 433V Topic 3 Assignment
Start Date & Time Due Date & Time Points
Sep 12, 2022, 12:00 AM Sep 18, 2022, 11:59 PM 190
In this assignment, you will write a critical appraisal that demonstrates comprehension of two quantitative
Use the practice problem and two quantitative, peer-reviewed research articles you identifed in the Topic 1
assignment (or two new articles based on instructor feedback in Topic 1) to complete this assignment.
In a 1,000–1,250-word essay, summarize two quantitative studies.
Use the “Research Critique Guidelines – Part II” document to organize your essay.
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. NRS 433V Topic 3 Assignment
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student
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.
Rough Draft Quantitative Research Critique and Ethical Considerations
The clinical issue or nursing practice problem identified is hospital acquired infection. There is a growing concern about hospital acquired infection (HAI). This is an infection that a patient contracts while staying in the hospital for another condition. HAIs can cause serious complications and even death.
PICOT Question: In critically ill patients, does using a daily chlorhexidine bath prevent acquisition of methicillin-resistant Staphylococcus aureus (MRSA) within 30 days?
Quantitative research plays an important role in the research process, providing crucial data and insights that can help support or refute a hypothesis. By measuring variables and controlling for confounders, quantitative studies can provide a great deal of information about cause and effect relationships. This is essential in understanding how the world works and can lead to new breakthroughs in fields such as medicine and nursing. The two quantitative studies considered in topic 1 include Article I: “Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates” by Schuetz et al., (2021), and Article II: “Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus Aureus Hospital-acquired Infections in Critical Patients” by Pratt et al., (2022). The purpose of this assignment is to analyze article I and II and to determine how they will be used to answer the PICOT question.
According to quantitative article I, the following are factors that are associated with a higher risk of progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) colonization in critically ill neonates: presence of lococcus aureus on admission, gestational age <32 weeks, birth weight <1500 grams, mechanical ventilation for >7 days, total parenteral nutrition for >14 days, and broad-spectrum (Schuetz et al., 2021). The main problem in this article is the progression of methicillin-resistant Staphylococcus aureus-colonized among the critically ill neonates. Methicillin-resistant Staphylococcus aureus (MRSA) is a major problem in healthcare settings worldwide. Study I investigated factors associated with progression to MRSA infection in patients who were colonized with the bacterium. The risk factors for progression to infection among MRSA-colonized patients include being older than 65 years, having certain chronic diseases (e.g., diabetes, COPD, HIV/AIDS), having a history of IV drug use, and being admitted to the ICU. NRS 433V Topic 3 Assignment.
The purpose of the study was to identify factors associated with progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) carriers. The study population was composed of adults admitted to a long-term care facility who were either colonized or infected with MRSA. Another objective was to find out what causes symptomatic contamination in newborns with methicillin-resistant Staphylococcus aureus (MRSA) colonization in the neonatal intensive care unit (NICU) (Schuetz et al., 2021). The study found that patients who were younger, male, non-white, and had higher numbers of comorbidities were more likely to progress from colonization to infection. These findings are significant for nurses who care for patients with MRSA colonization. Overall, the study’s findings are significant to the nursing profession particularly when it come to the management of hospital acquired infections. The main research question from the article is: What are some of the factors that cause symptomatic contamination in newborns with methicillin-resistant Staphylococcus aureus (MRSA) colonization in the neonatal intensive care unit?
Quantitative study II looked at the use of alcohol-based nasal decolonization and chlorhexidine bathing to reduce methicillin-resistant Staphylococcus aureus (MRSA) infections in critical patients. The study found that use of these interventions reduced hospital-acquired MRSA infections by over 50%. The study was a double-blind, randomized controlled trial conducted in five U.S. hospitals. In the intervention group, all nasal passages were treated with an alcohol-based decolonization solution twice daily for 5 days. Chlorhexidine bathing was also initiated for all patients in the intervention group, and continued for 7 days after discharge from the hospital. The main problem being addressed in this study is hospital acquired infections and how to reduce them. This study’s objective was to assess the efficiency of a general decolonization approach in a significant academic medical center’s critical care population. The purpose of the study was to show how alcohol-based nasal decolonization and chlorhexidine bathing can be used to reduce methicillin-resistant staphylococcus aureus hospital-acquired infections in critical patients. The article is significant to nursing because it provide strategies for the management of healthcare acquired infections through the application of alcohol-based nasal decolonization and chlorhexidine bathing. The main research question is: Does bathing in chlorhexidine gluconate [CHG] and using an alcohol-based nasal decolonization agent help minimize hospital-acquired laboratory-identified (LabID) Blood infections caused by methicillin-resistant Staphylococcus aureus? NRS 433V Topic 3 Assignment.
How the Two Articles Support the Nurse Practice Issue on Hospital Acquired Infection
The two articles analyze factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized among critically ill neonates and the application of Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus. The findings on the above issues are critical in supporting the nurse practice issue on hospital acquired infections. The information provided in these two articles are critical in answering different aspects of the PICOT question. In other words, the two articles are essential in answering the PICOT question because they analyze the intervention that have been defined in the PICOT.
There is a great deal of variability in both the interventions and comparison groups used in research on the two articles. This can make it difficult to compare the findings of different studies directly. However, looking at the general trends across the two articles, there are some key similarities and differences between what is being done in each group. The intervention groups tend to receive more aggressive treatment for their infection. This may include things like more frequent and/or longer antibiotic administration, earlier transfer to isolation wards, and so on. The comparison groups received standard care for their infection, which may not be as intensive.
Methods of Study
For article I, case-control study design was used while article II was a cohort study where there was a follow-up. The main difference between case-control and cohort studies is that cohort studies follow people over time (a “follow-up”), whereas case-control studies select people who already have the disease or outcome of interest (the “cases”) and compare them with a group of people who do not have the disease or outcome of interest (the “controls”). Cohort studies are thought to be more accurate because they measure exposures/outcomes in real life as they happen. Case-control studies are often limited by recall bias, where cases may remember things differently than controls.
The main benefit of case-control study design is that it is much less expensive and time consuming than other types of epidemiological studies, such as cohort studies. A limitation of case-control study design is that it can be difficult to determine causation because it is retrospective in nature. Cohort studies are a type of observational study, which means that researchers observe what people do (in this case, who contracts a particular disease) and try to identify patterns. This type of study is useful because it can track a large number of people for many years, which allows researchers to identify risk factors for diseases. A limitation of cohort studies is that they cannot prove causation; they can only show correlation. NRS 433V Topic 3 Assignment.
Results of Study
According to study I, the following factors are associated with progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) – colonized, critically ill neonates: – gestational age <37 weeks, – birth weight <1,500 grams, – mechanical ventilation for >48 hours, – history of MRSA colonization or infection, – receipt of total parenteral nutrition (TPN) for >14 days, – concurrent diagnosis of necrotizing enterocolitis (NEC) or sepsis (Schuetz et al., 2021). Also, from the study, critically ill neonates were found to have a significantly higher risk of progression to infection than those who were not colonized by the bacteria.
Study II found that chlorhexidine has a broad-spectrum of antibacterial activity and is effective against both gram-positive and gram-negative bacteria. It is also highly effective against MRSA, making it an ideal agent for use in preventing hospital-acquired infections. Alcohol-based nasal decolonization involves rinsing the nose with a 70% ethanol solution three times per day for 5 days (Pratt et al., 2022). From the study, Decolonization techniques have been linked in the literature to better results and a decrease in MRSA infections.
The two studies on nursing practice provide valuable information on the use of alcohol-based nasal decolonization to prevent infection in methicillin-resistant Staphylococcus aureus (MRSA) -colonized patients. The two studies are critical in enhancing quality nursing practices and healthcare delivery processes.
When conducting research, there are two major ethical considerations that researchers must adhere to: informed consent and protecting participants from harm. Informed consent means that research participants must be fully informed about the risks and benefits of participating in a study, and they must give their consent freely and voluntarily. Researchers must also take precautions to protect participants from any harm that may be caused by the study. This includes ensuring that participants are not put at risk of physical or psychological harm, and that they are not subjected to any uncomfortable or invasive procedures without their consent.
The researchers in the two articles applied informed consent in different ways. In article I and II, the researchers obtained informed consent from all of the participants before they took part in the study (Barbosa & Milan, 2019). This ensured that all of the participants were aware of the risks and benefits associated with participating in the study. Additionally, researchers also took measures to protect the participants from potential harms by ensuring that they were not exposed to any unnecessary risks and by providing them with support if they experienced any negative consequences as a result of taking part in the study.
The anticipated outcome of the PICOT question is that chlorhexidine baths can reduce the risk of acquiring methicillin-resistant Staphylococcus aureus (MRSA) in critically ill patients. A number of studies have shown that chlorhexidine baths are associated with a reduction in MRSA acquisition, and although the exact mechanism by which this occurs is unclear, it is thought that chlorhexidine may potentiate the effects of antibiotics and/or directly inhibit the growth of bacteria (Kim et al., 2020). In addition, chlorhexidine baths appear to be well tolerated by patients and are associated with few side effects. The outcomes of the two quantitative articles are comparable to the anticipated outcomes. The two articles concluded that chlorhexidine has a broad-spectrum of antibacterial activity and is effective against both gram-positive and gram-negative bacteria. It is also highly effective against MRSA, making it an ideal agent for use in preventing hospital-acquired infections.
Proposed Evidence-Based Practice Change
There is a strong link between the PICOT question, the two research articles, and the nursing practice problem. The two articles address the issue of hospital acquired infection; in particular, they are based on the application of daily chlorhexidine bath to prevent acquisition of methicillin-resistant Staphylococcus aureus (MRSA), the main intervention that have been stated in the PICOT question. Chlorhexidine is an alcohol-based agent that kills bacteria on contact. It is available as a liquid, wipe, or gel. The proposed evidence-based practice change is the application of daily chlorhexidine bath prevent acquisition of methicillin-resistant Staphylococcus aureus (MRSA). A daily chlorhexidine bath may help prevent the acquisition of MRSA. Although research is ongoing, current evidence suggests that a daily chlorhexidine bath may be an effective way to reduce the risk of MRSA acquisition in high-risk patients. Healthcare
There is some evidence that suggests daily chlorhexidine baths may help prevent the acquisition of methicillin-resistant Staphylococcus aureus (MRSA) in critically ill patients. However, more research is needed to determine whether or not this is truly the case. Chlorhexidine has a broad-spectrum of antibacterial activity and is effective against both gram-positive and gram-negative bacteria. It is also highly effective against MRSA, making it an ideal agent for use in preventing hospital-acquired infections. The two articles analyze factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized among critically ill neonates and the application of Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus.
Kim, H., Kim, E. S., Lee, S. C., Yang, E., Kim, H. S., Sung, H., … & Chong, Y. P. (2020). Decreased incidence of methicillin-resistant Staphylococcus aureus bacteremia in intensive care units: a 10-year clinical, microbiological, and genotypic analysis in a tertiary hospital. Antimicrobial agents and chemotherapy, 64(10), e01082-20. https://doi.org/10.1128/AAC.01082-20
Pratt, N., Heishman, C., Blizard, K., & Cissell, J. (2022). Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus Aureus Hospital-acquired Infections in Critical Patients. American Journal of Infection Control, 50(7), S31. https://doi.org/10.1016/j.ajic.2022.03.048
Schuetz, C. R., Hogan, P. G., Reich, P. J., Halili, S., Wiseman, H. E., Boyle, M. G., … & Fritz, S. A. (2021). Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates. Journal of Perinatology, 41(6), 1285-1292. https://www.nature.com/articles/s41372-021-00944-8
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