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NRS 433V TOPIC 5 Assignment

NRS 433V TOPIC 5 Assignment

NRS 433V TOPIC 5 Assignment

Research Critiques and PICOT Statement Final Draft
Start Date & Time Due Date & Time Points
Sep 26, 2022, 12:00 AM Oct 2, 2022, 11:59 PM 260
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 qualitative, quantitative, and mixed methods research
critiques on two articles for each type of study (four 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.
Use the “Research Critiques and PICOT Question Guidelines – Final Draft” document to organize your
essay. Questions under each heading should be addressed as a narrative in the structure of a formal paper.
Please note that there are two new additional sections: Outcomes Comparison and Proposed Evidence-Based
Practice Change.
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 guidelines 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 required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is
located in Class Resources if you need assistance.

Solved

Research Critiques and PICOT Question Guidelines – Final Draft

When answer a nursing PICOT question, it is important to consider both qualitative and quantitative research articles. Qualitative research articles provide detailed, real-world information about a particular subject, while quantitative research articles focus on data and statistical analysis. By considering both types of article, researchers can get a well-rounded view of their topic and develop a more comprehensive answer to the PICOT question. The purpose of this assignment is to analyze both the qualitative and quantitative articles I, II, II, and IV including summary, study design, results of the studies, and the ethical considerations. NRS 433V TOPIC 3 DQ1 AND DQ2

PICOT Question

In critically ill patients, does using a daily chlorhexidine bath prevent acquisition of methicillin-resistant Staphylococcus aureus (MRSA) within 30 days?

Qualitative and Quantitative Studies

Background

The two qualitative articles considered for the study include: Article I, “Missed infection control care and healthcare associated infections” by Bail et al., (2021), and Article II, “Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings” by Lowe et al., (2021). On the other hand, the two quantitative studies considered in topic 1 include Article III: “Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates” by Schuetz et al., (2021), and Article IV: “Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus Aureus Hospital-acquired Infections in Critical Patients” by Pratt et al., (2022).

Qualitative article I found that missed infection control care and healthcare associated infections are a significant problem in hospitals across the United States. The study’s main problem was that gaps in infection control care were leading to increased rates of healthcare associated infections. The purpose of the study was to identify those gaps and to develop interventions to address them. The objective was to reduce the incidence of healthcare associated infections by 50%.To achieve this objective, the researchers conducted a survey of hospital infection control practices nationwide. They then used the data from the survey to create a toolkit designed to help hospitals improve their infection control care. This article is important to nursing because it discusses missed infection control care and how this can lead to healthcare associated infections. The authors point out that errors in infection control are often made due to nurse fatigue and lack of oversight. The main research question in this article is: How does nurses perceive missed infection control in healthcare settings?

Qualitative article II found that infection prevention and control (IPC) is a critical issue for healthcare facilities in conflict-affected settings. Due to the increased risk of transmission of communicable diseases, IPC measures are essential to protect patients, staff, and visitors from infection. The purpose of this article is to summarize the key challenges and opportunities for IPC in hospitals in conflict-affected settings. The objective is to facilitate a better understanding of the unique context within which IPC must be implemented in these settings, and to identify potential solutions that can improve IPC practices. The main problem in many conflict-affected settings is the lack of basic infrastructure and supplies necessary for effective infection prevention and control (IPC). Without functioning water and sanitation systems, it is difficult to prevent the spread of bacteria and other pathogens. And without proper healthcare supplies, such as gloves, masks, and disinfectants, nurses are often unable to properly clean and disinfect hospital wards and equipment. The main research question is: What are some of the challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings? NRS 433V TOPIC 5 Assignment

According to quantitative article III, 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 (Pratt et al., 2022). The purpose of the study was to identify factors associated with progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) carriers. The study’s 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 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?

How the Articles Support the Nurse Practice Issue Chosen

There are two main ways that qualitative article I and II can be used to address the issue of using a daily chlorhexidine bath to prevent acquisition of methicillin-resistant Staphylococcus aureus (MRSA). First, the articles can be used to support the efficacy of chlorhexidine baths in preventing MRSA acquisition. This is particularly relevant given that some experts have questioned the effectiveness of chlorhexidine in preventing MRSA infections. Second, the articles can be used to provide evidence-based recommendations for how best to implement chlorhexidine baths in order to maximize their ability to prevent MRSA infections. On the other hand, quantitative article III and V 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. NRS 433V TOPIC 5 Assignment

There is a great deal of variability in both the interventions and comparison groups used in research on the four articles and the PICOT question. 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.

Method of Study

For article I, authors used a retrospective observational study design to examine the relationship between missed infection control care and healthcare associated infections. For qualitative article II, the study was conducted using a qualitative methodology, with interviews being the primary data collection method. For article III, case-control study design was used while article IV 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”).

One benefit of retrospective observational study design is that it is less expensive and time consuming than other types of study designs. A limitation of retrospective observational study design is that it can be difficult to accurately recall information about past events. For article II, one benefit of qualitative methodology with interviews is that the researcher can obtain rich and in-depth data from participants. This allows for a greater understanding of the phenomenon being studied. Additionally, the interviewer can build rapport with participants, fostering an open and honest exchange of information. A limitation of qualitative methodology with interviews is that it can be difficult to generalize findings to a wider population. Additionally, because interviews are time-consuming and resource-intensive, they may not be feasible for every research project.

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 5 Assignment

Results of Study

From the article I, it is clear that missed infection control care and healthcare associated infections are major problems in the healthcare industry. There are a number of factors that contribute to this problem, including understaffing, lack of resources, and insufficient training (Bail et al., 2021). Qualitative study II found that there are a number of challenges to infection prevention and control in these types of settings. These include: insecurity and Violence, which can make it difficult to access healthcare facilities; population movement, which can increase the risk of transmission; economic hardship, which can lead to patients skipping treatment or not being able to afford necessary medications; and a lack of trained personnel, which can make it difficult to provide sufficient care (Lowe et al., 2021).

According to study III, 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). Study IV found that chlorhexidine has a broad-spectrum of antibacterial activity and is effective against both gram-positive and gram-negative bacteria.

There are a few implications of the four studies on healthcare acquired infection and prevention in nursing practice. First, it is clear that healthcare acquired infections are a serious problem in the hospital setting. Patients who contract these infections are at risk for serious complications, including death. Second, both studies underscore the importance of infection control measures in preventing the spread of these infections. Nurses play a vital role in infection control, and it is important for them to be up-to-date on the latest evidence regarding best practices. Finally, the studies highlight the need for more research on this issue. As healthcare providers strive to provide quality care and keep patients safe, it is critical that we continue to learn more about how to prevent healthcare acquired infections. NRS 433V TOPIC 5 Assignment

Ethical Considerations

When conducting research, it is important to consider two main ethical considerations: informed consent and protecting participants from harm. Informed consent means that participants must be given information about the study before they decide whether or not to participate. This includes information about the purpose of the research, what will happen during the study, and any potential risks or benefits. Participants should also be informed that they are free to withdraw from the study at any time. Protecting participants from harm is also important. Researchers must take steps to ensure that participants will not be harmed physically or emotionally as a result of taking part in the study. This may include ensuring that there are no physical risks involved and providing psychological support if needed.

The researchers in the four articles applied informed consent in different ways. In the first article, the researcher 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. In addition, the researcher 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.

Outcomes Comparison

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 four quantitative articles are comparable to the anticipated outcomes. The four 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

A daily chlorhexidine bath may help prevent the acquisition of methicillin-resistant Staphylococcus aureus (MRSA). MRSA is a type of staph bacteria that is resistant to many antibiotics. It can cause serious skin infections, and in some cases, death. Studies have shown that when healthcare workers use chlorhexidine to clean their hands before and after patient contact, they are less likely to acquire MRSA. 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 professionals should consider implementing a daily chlorhexidine bath as part of an overall strategy to prevent MRSA acquisition. NRS 433V TOPIC 5 Assignment

Conclusion

A daily chlorhexidine bath may be an effective way to prevent the acquisition of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare settings. A growing number of studies have shown that the use of chlorhexidine bathing programs can lead to a decrease in MRSA prevalence and incidence rates. In one study, for example, the incidence of MRSA among ICU patients was reduced by more than 50% after the introduction of a chlorhexidine bathing program. While more research is needed to confirm the benefits of chlorhexidine baths for MRSA prevention, the existing evidence suggests that this may be an effective measure worth exploring further. 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 professionals should consider implementing a daily chlorhexidine bath as part of an overall strategy to prevent MRSA acquisition.

References

Bail, K., Willis, E., Henderson, J., Blackman, I., Verrall, C., & Roderick, A. (2021). Missed infection control care and healthcare associated infections: A qualitative study. Collegian, 28(4), 393-399. https://doi.org/10.1111/jan.14909

Barbosa, S., & Milan, S. (2019). Do not harm in private chat apps: Ethical issues for research on and with WhatsApp. Westminster Papers in Communication and Culture14(1). https://doi.org/10.16997/wpcc.313

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 chemotherapy64(10), e01082-20. https://doi.org/10.1128/AAC.01082-20

Lowe, H., Woodd, S., Lange, I. L., Janjanin, S., Barnett, J., & Graham, W. (2021). Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study. Conflict and Health, 15(1), 1-10. https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-021-00428-8

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 Control50(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 Perinatology41(6), 1285-1292. https://www.nature.com/articles/s41372-021-00944-8

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