NURS 6052 Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

There are many reasons why it is important to study clinical issues in different healthcare organizations. For one, healthcare organizations can be very complex and understanding the clinical processes and issues within different types of organizations can help immensely in providing quality patient care. Secondly, with the vast array of different types of healthcare organizations out there, from hospitals to community health centers, private practices to research institutes, it is important to understand the strengths and weaknesses of each type of organization in order to make the best decisions for both patients and providers. And finally, by studying clinical issues within different healthcare organizations, we can learn a great deal about how effective various interventions and treatments are across a wide range of settings. This information can then be used to improve care delivery services to all the patients and facilitate clinical operational processes within healthcare organizations. On of the major clinical issues within healthcare organizations is healthcare acquired infections.

Hospital acquired infections (HAIs) are a leading cause of morbidity and mortality worldwide. In the United States, HAIs account for an estimated 1.7 million infections and 99,000 deaths each year. CDC estimates that on any given day, about one in 31 hospital patients has at least one healthcare-associated infection. Healthcare-associated infections increase length of stay, amplify the severity of illness, and lead to unnecessary suffering and death. They also drive-up healthcare costs—estimated at $20 billion annually in the United States alone. HAIs can be especially devastating for vulnerable populations such as children, the elderly, and those with chronic illnesses or weakened immune systems. Some examples of healthcare-associated infections (HCAIs) include: -methicillin-resistant Staphylococcus aureus (MRSA), -vancomycin-resistant enterococci (VRE), -Clostridium difficile (C. diff.) infection (Grayson et al., 2018).

Treating HCAIs can be difficult and expensive, as well as posing a serious risk to patients’ health and well-being. There are many different approaches have been taken to try and address this problem, including: -improving hand hygiene among healthcare workers, -using personal protective equipment (PPE) properly, and -disinfecting surfaces and equipment correctly.

Hospital Acquired Infections (HAI) are infections that patients acquire while receiving treatment in a healthcare setting, such as a hospital. HAIs are a serious global public health problem and are a leading cause of death and illness. Each year, more than 2 million people in the United States develop HAIs, and about 100,000 of them die. The most common types of HAI are respiratory tract infections (such as pneumonia), urinary tract infections, and bloodstream infections (sepsis). Healthcare-associated gastrointestinal infections account for about one-third of all HAIs (Munoz-Figueroa & Ojo, 2018). There are many ways to prevent HAIs, including good hand hygiene practices, using medications properly, and safely caring for patients. Hospital acquired infections (HAIs) are a leading cause of morbidity and mortality worldwide. In the United States, HAIs account for an estimated 1.7 million infections and 99,000 deaths each year. CDC estimates that on any given day, about one in 31 hospital patients has at least one healthcare-associated infection.

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It is important to develop a PICO(T) question based on hospital acquired infections because it will help to focus the research and determine an answer. The first step in developing a PICO(T) question is to identify the key concepts that will be explored. In this case, we are looking at hospital acquired infections. The next step is to narrow these concepts down into more specific variables that can be measured. For example, we might want to look at the rate of hospital acquired infections in different types of hospitals, or the types of infection most commonly seen in hospitals. Once we have chosen our variables, we can begin to formulate our question. A PICO(T) question asking about the development of Hospital Acquired Infections might look like this: What is the incidence of hospital-acquired infections among different types of hospitals? What are the most common types of the hospital acquired infections? In this case, the population of interest would be hospital patients who acquire infections while hospitalized. The intervention would be any measure or action taken to prevent or treat hospital acquired infections (e.g., hand hygiene protocols, antibiotics).

There are several ways to prevent Hospital Acquired Infections (HAIs). One of the most important is hand hygiene. Hand hygiene includes both washing hands with soap and water and using alcohol-based hand rubs. Both soap and water and alcohol-based hand rubs are effective at killing bacteria and viruses. However, alcohol-based hand rubs are more convenient and can be used more quickly than washing hands with soap and water. For this reason, many healthcare facilities promote the use of alcohol-based hand rubs over traditional hand washing (Lim et al., 2018). However, there are certain situations where it is still best to wash hands with soap and water. This includes when hands are visibly dirty or contaminated with body fluids. The master’s prepared nurse must be aware of the need of teaching hand hygiene to healthcare professionals since doing so will help patients experience fewer healthcare-associated illnesses. HAIs are preventable damage that have an impact on patient safety and treatment not just in the United States but also internationally.

The best healthcare databases are PubMed, CINAHL Plus with Full Text, JBI EBP Database, and Nursing Reference Center. Each database has its own strengths and weaknesses. For example, PubMed is the best database for finding articles from medical journals, while CINAHL Plus with Full Text is the best database for finding articles from nursing journals. If one is not sure which database to use, they should start with PubMed. It is the most comprehensive healthcare database and it covers a wide range of topics. Healthcare databases are important in the research process because they allow researchers to study the health of large populations. This is important because it allows researchers to identify trends and correlations that may not be evident when studying smaller populations. Healthcare databases also contain a wealth of information on patient demographics, health history, and treatment outcomes. This information can be used to improve our understanding of how different treatments work and to develop new treatments for diseases. Finally, healthcare databases can be used to assess the value of different medical treatments. This is important because it allows us to make informed decisions about which treatments provide the most value for our healthcare system.

When embarking on research related to healthcare acquired infections, it is important to review different articles in order to get a well-rounded understanding of the topic. There are a number of reasons for this: 1) To get a sense of the range of opinions and experiences regarding healthcare acquired infections. research on this topic can be controversial, and it is important to be exposed to different perspectives before formulating your own opinion. 2) To learn about different methods that have been used to study healthcare acquired infections. This will help inform your own research design and methodology. 3) To understand what findings have been reported in previous studies on healthcare acquired infections. This will help one plan what hypotheses or Research Questions. Healthcare databases can be used to assess the value of different medical treatments. This is important because it allows us to make informed decisions about which treatments provide the most value for our healthcare system.

Systematic reviews are among the highest levels of evidence in clinical research. Because they employ strict, systematic methodology to search for and identify all relevant studies on a given topic, and then critically appraise and synthesize the findings of those studies, they provide the best possible evidence to inform clinical decision-making. There are several key advantages to using systematic reviews in clinical research: 1. Systematic reviews comprehensively search for and include all relevant studies on a topic, while narrative or traditional literature reviews often miss key studies or give greater weight to lower quality studies. This comprehensive approach provides a more complete picture of the available evidence on a given topic (Halm & Sandau, 2018).

2. Systematic reviews use strict inclusion/exclusion criteria. When embarking on research related to healthcare acquired infections, it is important to review different articles in order to get a well-rounded understanding of the topic. There are a number of reasons for this, for example, to get a sense of the range of opinions and experiences regarding healthcare acquired infections.

Hospital acquired infections, also known as nosocomial infections, are a major cause of illness and death in the United States. Each year, at least two million people in this country contract an infection while receiving hospital care and about 90,000 of them die as a direct result of the infection. A wide variety of pathogens can cause hospital acquired infections. The most common are bacteria, but viruses, fungi, and parasites can also cause these infections. Many different body sites can be affected, but the lungs (pneumonia), urinary tract (bladder or kidney infection), and bloodstream (sepsis) are the most common sites. There are several ways to prevent Hospital Acquired Infections (HAIs). One of the most important is hand hygiene. Hand hygiene includes both washing hands with soap and water and using alcohol-based hand rubs. Both soap and water and alcohol-based hand rubs are effective at killing bacteria and viruses.

References

üHalm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. American Journal of Critical Care, 27(4), 334–337. https://doi-org.ezp.waldenulibrary.org/10.4037/ajcc2018727

üMunoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. British Journal of Nursing, 27(7), 382–388. https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2018.27.7.382

üLim, K., Kilpatrick, C., Storr, J., & Seale, H. (2018). Exploring the use of entertainment-education YouTube videos focused on infection prevention and control. American Journal of Infection Control, 46(11), 1218–1223. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.05.002

üGrayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … Cruickshank, M. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. Lancet Infectious Diseases, 18(11), 1269–1277. https://doi-org.ezp.waldenulibrary.org/10.1016/S1473-3099(18)30491-2

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