Picot Statement final Draft
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.(assignment 1 is attached)
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.(assignments 2, 3 attached)
Refer to “Research Critiques and PICOT Guidelines – Final Draft.”(see attachment). 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
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(Rubric attached).
Rubic_Print_
Format
| Course Code | Class Code | Assignment Title | Total Points | ||||||||||
| NRS-433V | NRS-433V-O501 | Research Critiques and PICOT Statement Final Draft | 300.0 | ||||||||||
| Criteria | Percentage | 1: Unsatisfactory (0.00%) | 2: Less Than Satisfactory (75.00%) | 3: Satisfactory (83.00%) | 4: Good (94.00%) | 5: Excellent (100.00%) | Comments | Points Earned | |||||
| Content | 60.0% | ||||||||||||
| Evidence of Revision | 10.0% | Final paper does not demonstrate incorporation of feedback or evidence of revision on research critiques. | Incorporation of research critique feedback or evidence of revision is incomplete. | Incorporation of research critique feedback and evidence of revision are present. | Evidence of incorporation of research critique feedback and revision is clearly provided. | Evidence of incorporation of research critique feedback and revision is comprehensive and thoroughly developed. | |||||||
| Nursing Practice Problem and PICOT Question | 5.0% | A nursing practice problem is not clearly described or a PICOT question is not included. | PICOT question describes a nursing practice problem but lacks reliable sources. | PICOT question describes a nursing practice problem and includes a few reliable sources. | PICOT question articulates a nursing practice problem using supporting information from reliable sources. | PICOT question clearly articulates a nursing practice problem using substantial supporting information from numerous reliable sources. | |||||||
| Background of Studies | Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is incomplete. | Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is included but lacks relevant details and explanation. | Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is partially complete and includes some relevant details and explanation. | Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is complete and includes relevant details and explanation. | Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is thorough with substantial relevant details and extensive explanation. | ||||||||
| Method of Studies | Discussion of method of studies, including discussion of conceptual/theoretical framework, is incomplete. | Discussion of method of studies, including discussion of conceptual/theoretical framework, is included but lacks relevant details and explanation. | Discussion of method of studies, including discussion of conceptual/theoretical framework, is partially complete and includes some relevant details and explanation. | Discussion of method of studies, including discussion of conceptual/theoretical framework, is complete and includes relevant details and explanation. | Discussion of method of studies, including discussion of conceptual/theoretical framework, is thorough with substantial relevant details and extensive explanation. | ||||||||
| Results of Studies | Discussion of studies results, including findings and implications for nursing practice, is incomplete. | Discussion of studies results, including findings and implications for nursing practice, is included but lacks relevant details and explanation. | Discussion of studies results, including findings and implications for nursing practice, is partially complete and includes some relevant details and explanation. | Discussion of studies results, including findings and implications for nursing practice, is complete and includes relevant details and explanation. | Discussion of studies results, including findings and implications for nursing practice, is thorough with substantial relevant details and extensive explanation. | ||||||||
| Ethical Considerations | Discussion of ethical considerations associated with the conduct of nursing research is incomplete. | Discussion of ethical considerations associated with the conduct of nursing research is included but lacks relevant details and explanation. | Discussion of ethical considerations associated with the conduct of nursing research is partially complete and includes some relevant details and explanation. | Discussion of ethical considerations associated with the conduct of nursing research is complete and includes relevant details and explanation. | Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation. | ||||||||
| Conclusion | Conclusion does not summarize a critical appraisal and applicability of findings. | Conclusion is vague and does not discuss importance to nursing. | Conclusion summarizes utility of the research and importance to nursing practice. | Conclusion summarizes utility of the research from the critical appraisal and the importance of the findings to nursing practice. | Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice. | ||||||||
| PICOT Question, Research Articles, and Nursing Practice Problem Relationship | Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is not included. | Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is incomplete or incorrect. | Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation. | Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is complete and includes relevant details and supporting explanation. | Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is extremely thorough with substantial relevant details and extensive supporting explanation. | ||||||||
| Proposed Evidence-Based Practice Change | The proposed evidence-based practice change is not included. | The proposed evidence-based practice change is incomplete or incorrect. | The proposed evidence-based practice change is included but lacks supporting explanation and relevant details. | The proposed evidence-based practice change is complete and includes supporting explanation and relevant details. | The proposed evidence-based practice change is extremely thorough and includes substantial supporting explanation and numerous relevant details. | ||||||||
| Organization and Effectiveness | 30.0% | ||||||||||||
| Thesis Development and Purpose | Paper lacks any discernible overall purpose or organizing claim. | Thesis is insufficiently developed or vague. Purpose is not clear. | Thesis is apparent and appropriate to purpose. | Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. | Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. | ||||||||
| Argument Logic and Construction | Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. | Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. | Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. | Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. | Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. | ||||||||
| Mechanics of Writing (includes spelling, punctuation, grammar, language use) | Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. | Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. | Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. | Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. | Writer is clearly in command of standard, written, academic English. | ||||||||
| Paper Format (use of appropriate style for the major and assignment) | Template is not used appropriately or documentation format is rarely followed correctly. | Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. | Template is used, and formatting is correct, although some minor errors may be present. | Template is fully used; There are virtually no errors in formatting style. | All format elements are correct. | ||||||||
| Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) | Sources are not documented. | Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. | Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. | Sources are documented, as appropriate to assignment and style, and format is mostly correct. | Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. | ||||||||
| Total Weightage | 100% |
Running Head: RESEARCH CRITIQUE ROUGH DRAFT II 2
RESEARCH CRITIQUE ROUGH DRAFT II 2
Research Critique Rough Draft II
Tina McKane
NRS-433V
March 1, 2020
Tina,
You discussed the 2 required quantitative research studies. You followed the research critique guidelines and your paper was interesting to read. You should include your PICOT statement as part of your introduction along with both article titles and authors. Please review proper formatting of citations and references. Page and paragraph numbers are required for direct quotes. Please remember to include a conclusion. Please remember to include a thesis statement as part of your introduction for it tells the reader the purpose of your paper.
You must incorporate all feedback into your final paper.
Please see rubric for grade.
Thank you,
June
Research Critique Rough Draft II
Background
Health issues are global and linked to all people. Over the recent past, there have been an increase in transmission of different infections in the process of treating other conditions. One of the common illnesses is the catheter associated urinary tract infection (CAUTI). A urinary tract infection refers to any infection within any part of the urinary system such as the bladder, urethra, ureters and kidney. A catheter refers to the tube that is inserted into the patient’s bladder through the urethra so as to drain urine. According to past researches, about 9% of catheterized patients are likely to contract the infection. However, it is important to note that each hospital has an expected risk level of CAUTI infections and it would be penalized in case it have more cases of CAUTI infections than expected. The issue of increased CAUTI infections is significant to nursing especially for the reason that it affects the healthiness of an individual, while nursing aims at ensuring high quality healthiness for patients within a health facility (McClusky, 2018).
The purpose of this paper is to discuss………….
This paper aims at studying the issue of CAUTI infections by reviewing two quantitative articles relating to this issue. Article 1 is entitled “Quantitative Results of a National Intervention to Prevent Hospital-Acquired Catheter-Associated Urinary Tract Infection: A pre-post Observational Study.” Article 2 is entitled “Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study.” The paper aims at providing relevant information about this health issue that would reduce the prevalence of the health issue based on the findings of the two research articles. The purpose is to establish ways of preventing the transmission of CAUTI infections in the course of a treatment. The research questions are: Comment by June Helbig: A lot of information should be cited and referenced.
1. What is the impact of a multimodal initiative on CAUTI in healthcare facilities with high tendency for hospital-transmitted infections?
2. How can the utilization rate of In-dwelling catheter (IDC) get lessened to reduce occurrence of inappropriate urinary catheterization and the period through which a patient is catheterized?
How the articles support the nursing practice issue
The two articles are related to the nursing practices in different ways. This is mainly evident for the fact that they aim at establishing the solution for the CAUTI infections. The PICOT question for the study is “In the Management of CAUTI patients (P), how effective is staff education and regular monitoring of CAUTI cases (I) compared to maintenance of a closed urinary drainage system (C) in preventing the development of CAUTIs (O) for the period of hospital stay (T)?” Article 1 relates to the PICOT question especially in the sense that it works towards analyzing the impact of a multimodal initiative on Catheter-associated urinary tract infections within healthcare facilities with high burden of healthcare associated infections. On the other hand, article 2 also relates to the PICOT question in that it analyzes methods through which the utilization rates of IDC would get lessened through reducing inappropriate urinary catheterization and duration of catheterization. The two articles therefore tend to relate to the nursing practices directly. The reason is that nursing involves ensuring high quality healthcare services for all the patients who visit the particular healthcare facilities. Hence, by finding a way of reducing the transmission rates of CAUTI infection for the entire period when a patient is catheterized within a healthcare institution, this improves the quality of services they get. Hence, it would be imperative to conclude that the articles are related to nursing practice issue (Meddings .et.al, 2019).
Study Method
The study method used in both articles is the quantitative research method. This is the study method that involves the use of numerical data rather than non-numerical data. From the article 1, it is evident that the researchers utilized the quantitative research design especially for the reason that the data is presented I numerical form. Also, the researcher implements the structured research instruments which further confirm that the article follows the quantitative research method. For the article 2, the researcher has also presented the largest percentage of the data in numerical form. There is also the use of the randomized control trial as a method for collecting and analyzing data. This method is used with quantitative data. Comment by June Helbig: This information should be cited.
Results of the study
There are different outcomes for the different articles based on their research questions. For instance, the article 1 aimed at establishing the impact of multimodal initiative on CAUTI in healthcare facilities especially those that are characterized with high transmission rates of the hospital-transited illnesses. Based on the study data and its analysis, the article established that the interventions have no significant effects towards CAUTI and the utilization of the urinary catheter. Hence, this implies that the use of this approach with the aim of curbing CAUTI in hospitals may be termed as ineffective. The other article aimed at establishing the way through which reducing the utilization rate of IDC can be done by avoiding unnecessary catheterization of patients and also through reducing the period that the patient would be catheterized (Parker .et.al, 2017).
Outcomes Comparison
The results of each of he two articles compare to each other in the sense that they both aim at recommending ways of minimizing occurrences of CAUTI in hospitals and other healthcare facilities. Although the first article establishes that the use of multimodal interventions is ineffective when it comes to reduction of the CAUTI infections, it went ahead to give necessary recommendation with respect to the nursing issue. It stated that the web-based programs should be combined with the psychotherapy programs so as to ensure best results as far as reduction of CAUTI in healthcare facilities is concerned. The other article states that the utilization rates of IDC insertions amongst patients would reduce due to reduction in the duration through which a patient is catheterized. The same utilization rates would also be achieved through reducing the use of inappropriate catheterization on patients. This would in turn reduce the chances of transmission of CAUTI amongst patients within a healthcare facility. Hence, it would be imperative to state that both article outcomes are relevant to the health issue under study. Comment by June Helbig: This information should be cited.
References
McClusky, J. (2018). One Year CAUTI Free: A Multi-Disciplinary Team Approach to Reducing CAUTI in a Pediatric Intensive Care Unit. American Journal Of Infection Control, 46(6), S76. doi: 10.1016/j.ajic.2018.04.143
Meddings, J., Manojlovich, M., Ameling, J. M., Olmsted, R. N., Rolle, A. J., Greene, M.T., … & Saint, S. (2019). Quantitative Results of a National Intervention to Prevent Hospital-Acquired Catheter-Associated Urinary Tract Infection: A Pre–Post Observational Study. Annals of Internal Medicine, 171(7_Supplement), S38-S44. Retrieved from:
https://annals.org/aim/fullarticle/2752410
Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC health services research, 17(1), 314. Retrieved from:
https://link.springer.com/article/10.1186/s12913-017-2268-2
Literature Evaluation Table
Student Name: Tina McKane
Tim,
You completed the assignment perfectly!!
Full credit earned!
Thank you,
June
Summary of Clinical Issue:
A catheter associated urinary tract infection (CAUTI) is one of the most commonly hospital acquired infections according to emerging research. Even with the best precautionary measures, the chances of developing this infection are about 9% for catheterized patients. About 9% to
2
4% of these patients develops CAUTI. A good number of hospitalized patients have a urinary catheter increasing the risk of developing CAUTI. In addition, healthcare institutions are penalized for having more than expected CAUTIs making them experience significant financial impacts. CAUTI risk is associated to the dwell time of the catheter. The rate of development of the bacterium causing CAUTIs for catheterized patients is about 4%-7% in a day.
However, this risk approaches 100% if the patients remain with the indwelling urinary catheter for more than thirty days. The recognition that about 75% of CAUTIs can be preventable has resulted in the development of multiple strategies to reduce development of CAUTIs in the healthcare setting. These interventions include simple approaches such as removing urinary catheters that are no longer needed and avoiding placing unneeded urinary catheters. Health care professionals are responsible for taking care of the patients having urinary catheters in the healthcare setting and are therefore important in preventing the development of CAUTIs.
PICOT Question: In the Management of CAUTI patients (P), how effective is staff education and regular monitoring of CAUTI cases (I) compared to maintenance of a closed urinary drainage system (C) in preventing the development of CAUTIs (O) for the period of hospital stay (T)?
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
Meddings, J., Manojlovich, M., Ameling, J. M., Olmsted, R. N., Rolle, A. J., Greene, M. T., … & Saint, S. (2019). Quantitative Results of a National Intervention to Prevent Hospital-Acquired Catheter-Associated Urinary Tract Infection: A Pre–Post Observational Study. Annals of Internal Medicine, 171(7_Supplement), S38-S44. Retrieved from https://annals.org/aim/fullarticle/2752410
Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC health services research, 17(1), 314. Retrieved from https://link.springer.com/article/10.1186/s12913-017-2268-2
Huis, A., Schouten, J., Lescure, D., Krein, S., Ratz, D., Saint, S., … & Greene, M. T. (2020). Infection prevention practices in the Netherlands: results from a National Survey. Antimicrobial Resistance & Infection Control, 9(1), 1-7. Retrieved from https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0667-3
How Does the Article Relate to the PICOT Question?
This article analyzes the effect of a multimodal initiative on CAUTI in hospitals with high burden of health care–associated infection (HAI)
This article analyzes ways in which IDC usage rates can be reduced by reducing inappropriate urinary catheterization and duration of catheterization.
This study aimed to examine the extent to which acute care hospitals have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI).
Quantitative, Qualitative (How do you know?)
This is a quantitative study because data is collected using structured research instruments and is presented in form of numbers.
This is a quantitative study as it uses randomized controlled trial as the research design.
This is a quantitative study because data is presented in form of numbers and researchers compare various variables to determine the outcome.
Purpose Statement
To investigate the effect of a multimodal initiative on CAUTI in hospitals with high burden of health care–associated infection (HAI)
To reduce IDC usage rates by reducing inappropriate urinary catheterization and duration of catheterization.
To examine the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI).
Research Question
What are the effects of a multimodal initiative on CAUTI in hospitals with high burden of health care–associated infection (HAI)?
How can IDC usage rates be reduced by reducing inappropriate urinary catheterization and duration of catheterization?
What is the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI)?
Outcome
With the use of multimodal initiative, the risks of health care associated infections can reduce significantly.
A sample size calculation has indicated that 500 patients per Health District would be sufficient to detect a 40% fall (15 to 9%) in relative IDC insertion rates with a power of 0.8 and alpha 0.05
Surveillance systems for monitoring CAUTI, CLABSI, VAP, and CDI were present in 17.8, 95.4, 26.2, and 77.3% of hospitals, respectively
Setting
(Where did the study take place?)
Acute care, long-term acute care, and critical access hospitals,
Hospitals in NSW, Australia
Acute care hospitals in the Netherlands
Sample
387hospitals
4- four acute care hospitals
47 hospitals
Method
Prospective, national, nonrandomized, clustered, externally facilitated, pre–post observational quality improvement initiative
multiple pre-post control intervention design using a phased mixed method approach
Written interview
Key Findings of the Study
This multimodal intervention yielded no substantial improvements in CAUTI or urinary catheter utilization.
Hospital-wide and multi-hospital interventions help to reduce urinary catheter use and the development of CAUTI.
Most Dutch hospitals report regular use of recommended practices for preventing CLABSI and CDI.
Recommendations of the Researcher
Future studies should focus on how to improve the prevention of CAUTI.
More studies need to be conducted on the topic to provide ways in which integrated approaches can be used to prevent CAUTI.
Future studies should focus on the importance of using integrated approaches to the prevention of CAUTI
Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
Carter, E. J., Pallin, D. J., Mandel, L., Sinnette, C., & Schuur, J. D. (2016). Emergency department catheter-associated urinary tract infection prevention: multisite qualitative study of perceived risks and implemented strategies. infection control & hospital epidemiology, 37(2), 156-162. Retrieved from https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/emergency-department-catheterassociated-urinary-tract-infection-prevention-multisite-qualitative-study-of-perceived-risks-and-implemented-strategies/8A6263415F32FB876EEED70C7E269654
Carter, E. J., Pallin, D. J., Mandel, L., Sinnette, C., & Schuur, J. D. (2016). A qualitative study of factors facilitating clinical nurse engagement in emergency department catheter-associated urinary tract infection prevention. JONA: The Journal of Nursing Administration, 46(10), 495-500. Retrieved from https://journals.lww.com/jonajournal/Abstract/2016/10000/A_Qualitative_Study_of_Factors_Facilitating.4.aspx
Fletcher, K. E., Tyszka, J. T., Harrod, M., Fowler, K. E., Saint, S., & Krein, S. L. (2016). Qualitative validation of the CAUTI Guide to Patient Safety assessment tool. American journal of infection control, 44(10), 1102-1109. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0196655316302930
How Does the Article Relate to the PICOT Question?
This study explores various strategies for reducing the risk of CAUTIs in the healthcare setting.
This article explores the actions of nurse leaders that facilitated clinical nurses’ active involvement in emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention programs.
This article explores the need for CAUTI guide to patient safety (GPS) to prevent CAUTI
Quantitative, Qualitative (How do you know?)
This is a qualitative study because semi structured interviews were used to collect data.
This is a qualitative study because semi structured interviews were used to collect data.
This is a qualitative study because semi structured interviews were used to collect data.
Purpose Statement
To describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs.
To explore the actions of nurse leaders that facilitated clinical nurses’ active involvement in emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention programs.
To qualitatively validate The CAUTI guide to patient safety (GPS)
Research Question
Does early-adopting emergency departments (ED) redesigned workflows minimizes catheter use and ensure proper insertion technique?
What are the actions of nurse leaders that facilitated clinical nurses’ active involvement in emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention programs?
What is the effectiveness of CAUTI guide to patient safety (GPS) in preventing CAUTI?
Outcome
ED CAUTI prevention was perceived to differ from CAUTI prevention in the inpatient setting.
Clinical nurses are best positioned to examine urinary catheter insertion workflow and to suggest improvements in avoiding use and improving placement and maintenance.
Nurse managers found the GPS helpful and complete. There was higher agreement between nurse managers and unit nurses than with physicians.
Setting
(Where did the study take place?)
Six diverse hospitals
6 emergency departments
4 medical intensive care units and 4 medical-surgical units
Sample
52 participants
52 participants
49 participants
Method
Semi structured interviews
Semi structured interviews
Semi structured interviews
Key Findings of the Study
Early-adopting EDs redesigned workflow to minimize catheter use and ensure proper insertion technique
The prevention of CAUTI is an important opportunity for nurse leaders to engage clinical nurses in meaningful improvement efforts
GPS is comprehensive and may be best used to stimulate discussions between stakeholders to address key issues.
Recommendations of the Researcher
Assessment of ED workflow is necessary to identify and modify local practices that may increase CAUTI risk.
The researchers suggest nurse leaders should focus on how urinary catheters expose patients to potential harm to engage clinical nurses in CAUTI prevention,
The current healthcare structures need to be changed to accommodate GPS.
© 2019. Grand Canyon University. All Rights Reserved.
2
ResearchCritique Guidelines – Part I Comment by June Helbig: This is not part of APA formatting.
Name: Tina McKane
Date: February 23, 2020
Tim,
You discussed the 2 required qualitative studies, but you did not write a paper. You answered or responded to each question, but not in “paper” format. Please do not do this for future papers. Include the information you included, but write it as a paper. You discussed the study problem, how it relates to your PICOT statement, the background, study methods, results of study, and ethical considerations. Please write an introduction and include a thesis statement. Please provide your PICOT question in your introduction. Please review proper formatting of citations, references, and your paper. Please use headings. Please incorporate all feedback into your next paper.
Please see rubric for grade.
Thank you,
June
Your paper should start with an introduction.
Qualitative Studies
Background of Study
1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question. Comment by June Helbig: The requirement for you is to write a paper, not to
The first study by Carter et al., 2016 was aimed at exploring the actions of nurse managers that led to the facilitation of active involvement in catheter-associated urinary tract infection, CAUTI, prevention programs in the emergency department. The study examines the influence of nurse administrators on how well the prevention programs work and the various themes that would be relayed in emergency departments as the results of action or inaction by these administrators towards the prevention programs. The second study by Krein et al., 2013 was aimed at identifying the various ways in which CAUTI prevention efforts could be enhanced. This study was based on experiences of hospitals participating in a program by Michigan’s Keystone Center. A program termed as bladder bundle was instigated as a safety program and used to find a way to reduce the unnecessary utilization of urinary catheters. The use of these devices can lead to an increased risk of contracting CAUTI.
How do these two articles support the nurse practice issue you chose?
1. Discuss how these two articles will be used to answer your PICOT question. Comment by June Helbig: This should not be included as part of your paper.
The first article looks into the financial costs associated with CAUTI for institutions and will be used to answer my PICOT questions by looking into the various ways CAUTI can be prevented, therefore, reducing the financial costs associated with it and how nurses can be part of this prevention. The article looks into the insertion of catheters in the emergency department and the role of nurses when it comes to prevention as catheter insertion poses a risk of exposure to patients when it comes to CAUTI (Carter et al., 2016).
As explained in the second article, CAUTI is a common infection categorized as health-associated. The prevention of this infection is critical to improving the kind of care that hospitalized patients receive. This prevention is also essential to meeting the goals under a reductions set, for conditions that are categorized as health-associated which is part of a program by the department of health (Krein et al., 2013). The article will be used to answer my PICOT question by looking into the influence that nurses have in CAUTI prevention.
2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.
The comparison groups and interventions in the first article include nurse managers and nurse engagement. They are comparable to those of my PICOT question as both involve nurses and nurse administrators in dealing with the problem of CAUTI. The prevention of CAUTI is a crucial opportunity for nurse administrators to engage clinical nurses in improvement efforts that are meaningful and effective. The two recognize that clinical nurses are in the best position to examine the insertion workflow of urinary catheters (Carter et al., 2016). There is also a recognition in both that nurses are best positioned in coming up with and suggesting improvements in improving maintenance and placement of these devices and avoiding their use altogether.
The second article compares to the PICOT question through the recognition of barriers for comparison groups and interventions. These barriers include insertion customs and practices for catheters in the emergency department. Requests made by patients and their families, who are common comparison groups for the article and my PICOT question, to have in-dwelling catheters inserted as part of interventions. Lastly, the difficulty of engaging common comparison groups including physicians and nurses (Krein et al., 2013). The interventions in both include engaging physicians and emergency departments as a way to ensure the implementation of processes that are facilitating to indications of appropriate catheter use. Instigating discussions of risk of use of catheters that are in-dwelling with families and patients (Quast et al., 2016). Lastly, inculcating the use of urinary management approaches including the planning of toileting as part of patient safety initiatives.
Method of Study:
1. State the methods of the two articles you are comparing and describe how they are different.
The first article is a qualitative analysis that employs a comparative and multisite case study. It looks into six emergency departments, nine focus groups, and fifty-two interviews. The method used is a content analysis where site summaries were developed and data coded to explicate the themes that were observed in the study. The site summaries and codes were then reviewed to allow the identification of actions undertaken by nurse leaders that allowed the engagement of clinical nurses in the prevention of CAUTI (Carter et al., 2016).
These methods are different from the methods of the second article that used qualitative assessment by sampling twelve hospitals. Data was collected from the Michigan hospitals i.e. the study only looked into Michigan, and key informants were interviewed (Krein et al., 2013). Moreover, there is also differentiation in that only three of the twelve hospitals were visited (Quinn et al., 2019). Analysis for this article was mainly concerned with key issues and perceptions identified to be influential to the implementation of prevention practices for CAUTI.
2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.
The advantage of the case study method used in both studies is that it consumes less time and is less costly and can be very efficient for conditions with a long latency period. The disadvantage is that the method can be subject to selection bias and exposure information can be subject to observation bias. Interviewing, as seen in the second article can be beneficial as it allows for first-hand information and can be disadvantageous in that it can be time-consuming (Gupta et al., 201
7
).
Results of Study
1. Summarize the key findings of each study in one or two comprehensive paragraphs.
The first article found that nurse leaders were crucial to prevention programs for the condition and undertook the following to successfully engage clinical nurses. They held nurses accountable for CAUTI outcome measures and processes. They fostered a culture of teamwork leading to the facilitation of interdisciplinary communication on the alternatives and appropriateness of catheter insertion. The leaders empowered nurses to address and identify improvement opportunities pertinent to the condition (Carter et al., 2016). Lastly, they reframed urinary catheters as devices that could be potentially harmful to patients.
According to the second article, barriers to the appropriate use of catheters and success for the bundle initiative included the following. Custom and norms of catheter use, patient and family request for use of catheters and difficulties engaging physicians and nurses. However, the article proposes solutions to these barriers that include the following (Krein et al., 2013). Engagement of physicians and nurses stationed at the emergency department to implement procedures that allow for indications of appropriate catheter use. Discussions of the risk of catheter use with families and patients (Zengin et al., 2017). Lastly, the utilization of urinary management as part of patient safety programs.
2. What are the implications of the two studies in nursing practice?
The implication of the first study to the nursing practice is that it informs nurse leaders on how to engage clinical nurses in CAUTI prevention. Their engagement can be bolstered through the provision of local data as an indication of the impact that nurse practices have on patient outcomes. The involvement of nurses in the implementation and design of practice changes (Carter et al., 2016). Lastly, shifting focus to the exposure of patients to harm through the use of catheters and therefore shifting the perspective of nurses.
The implication of the second study to the nursing practice is that it encourages the engagement of nurses in programs and initiatives that are geared towards care improvement. An example is the keystone initiative that led to over a third in reductions of catheter use and bolstered the use of practices that promote the timely removal of catheters (Manojlovich et al., 2019). The involvement of nurses in the project made is so successful that it became the model program to be rolled out all over the country.
Ethical Considerations
1. Discuss two ethical consideration in conducting research.
Ethical considerations include respect for privacy and confidentiality. Prior to the study, full consent should be obtained from the participants. There should be a prioritization of respect for the dignity of participants (Zengin et al., 2017). Moreover, participants should not be subjected to harm in any manner whatsoever.
2. Describe how the researchers in the two articles you choose took these ethical considerations into account while performing their research.
The first article obtained consent from the participants as did the second article. The first article remained sensitive to consent considerations and enrolled participating facilities, focus groups, and interviewees to the research. There were also reviews undertaken for site summaries and coded data to ensure that the data was obtained ethically and correctly represented the participants of the research (Carter et al., 2016).
The second research remained ethical by considering the workload of nurses and their consideration of other patient safety priorities beyond the risk posed by catheter insertion. The study ensured that it obtained consent from all participants and collaborated with the bundle initiative to ensure that the problem of CAUTI was correctly represented and the efforts of all stakeholders were considered (Krein et al., 2013).
Conclusion
References
Carter, E. J., Pallin, D. J., Mandel, L., Sinnette, C., & Schuur, J. D. (2016). A qualitative study of factors facilitating clinical nurse engagement in emergency department catheter-associated urinary tract infection prevention. JONA: The Journal of Nursing Administration, 46(10), 495-500. Retrieved from
https://journals.lww.com/jonajournal/FullText/2016/10000/A_Qualitative_Study_of_Factors_Facilitating.4.aspx&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=7213346371135437899&ei=jF1SXpOBCYvJsQKjkKHYCg&scisig=AAGBfm2HKiQsKCTkmzCRJpl8–lJ8gH98g
Gupta, S. S., Irukulla, P. K., Shenoy, M. A., Nyemba, V., Yacoub, D., & Kupfer, Y. (2017). Successful strategy to decrease indwelling catheter utilization rates in an academic medical intensive care unit. American journal of infection control, 45(12), 1349-1355. Retrieved from
https://www.sciencedirect.com/science/article/pii/S0196655317308386
Krein, S. L., Kowalski, C. P., Harrod, M., Forman, J., & Saint, S. (2013). Barriers to reducing urinary catheter use: a qualitative assessment of a statewide initiative. JAMA internal medicine, 173(10), 881-886. Retrieved from
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1672274&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=1414217123608830811&ei=5l1SXr-YIIblmQGCsa9Y&scisig=AAGBfm19SH18586_BLo-4bBf58nv3i8LmA
Manojlovich, M., Ameling, J. M., Forman, J., Judkins, S., Quinn, M., & Meddings, J. (2019). Contextual barriers to communication between physicians and nurses about appropriate catheter use. American Journal of Critical Care, 28(4), 290-298. Retrieved from
https://aacnjournals.org/ajcconline/article-abstract/28/4/290/22001
Quast, J., Knobloch, M. J., Patterson, E., Purvis, S., Shirley, D., & Safdar, N. (2016). Understanding inpatient perceptions of indwelling urinary catheters using the health belief model. infection control & hospital epidemiology, 37(9), 1098-1100. Retrieved from
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/understanding-inpatient-perceptions-of-indwelling-urinary-catheters-using-the-health-belief-model/D44C6215EDC9FFB773FE2C956C850CA1
Quinn, M., Ameling, J. M., Forman, J., Krein, S. L., Manojlovich, M., Fowler, K. E., … & Meddings, J. (2019). Persistent Barriers to Timely Catheter Removal Identified from Clinical Observations and Interviews. The Joint Commission Journal on Quality and Patient Safety. Retrieved from
https://www.sciencedirect.com/science/article/pii/S1553725019304210
Zengin, H., Tekin, İ., & TANRIÖVER, M. D. (2017). Unexpected Barriers Against Patient Safety: The Case For The Indwelling Urinary Catheter. Acta Medica, 48(2), 12-17. Retrieved from
https://actamedica.org/index.php/actamedica/article/download/58/313
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ResearchCritiques and PICOT Question Guidelines – Final Draft
Use this document to organize the content from your four studies into your final draft.
Quantitative and Quantitative Studies
Background
1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.
How do these two articles support the nurse practice issue you chose?
1. Discuss how these articles will be used to answer your PICOT question.
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. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.
Method of Study:
1. State the methods of the articles you are comparing and describe how they are different.
2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.
Results of Study
1. Summarize the key findings of each of the studies into a comprehensive summary.
2. What are the implications of the four studies you chose in nursing practice?
Ethical Considerations
1. Discuss two ethical consideration in conducting research.
2. Describe how the researchers in the four articles you choose took these ethical considerations into account while performing their research.
Outcomes Comparison
1. What are the anticipated outcomes for your PICOT question?
2. How do the outcomes of the four articles you chose compare to your anticipated outcomes?
© 2019. Grand Canyon University. All Rights Reserved.
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