Description
- For the first template in week 6 you will choose either a Qualitative or a Quantitative Review (Please do not complete both Quantitative and Qualitative Appraisal). Your second article is a Systematic Review Appraisal, and your 3rd article is an Evidence Based Clinical Practice Guideline.
- Make sure you receive approval from faculty in week 4 for the article you use to complete either the Qualitative or Quantitative Review and for the Systematic Review. There are hyperlinks to these templates in week 6 instructions. Do not create your own word document with answers.
- Each section of the template is required to be completed as this assignment builds on your Evidence Based Practice Project. Each template has a citation that must be submitted and in APA 7th ed format. Answers to questions in Synopsis sections are required (see template examples mentioned above in your book). Credibility section Yes/No answers are also required. The Comments area is also required and should be at least 1-3 sentences noting how this article relates to your nursing issue topic from week 2 and what you thought was significant.
November 13, 2022
Healthcare-Associated Infections (HAIs) are infections acquired in healthcare situations (while receiving care), in a hospital, or any other health facility/provider. HAIs typically develop 48 hours after admission or within a month (30 days) after receiving healthcare (Haque et al., 2018). HAIs are typically associated with the devices used in healthcare, like ventilators and catheters. Although nursing best practices encourage proper sterilization, cleaning and storage of devices, there are cases where the level of care provided by a hospital (or lack thereof) causes infections (Haque et al., 2018). Carelessness or negligence at a personal level or failure to incorporate internal policies aimed at encouraging hygiene in healthcare situations can lead to a surge in HAI morbidity and mortality. According to the CDC (2019), 1 in every 31 patients in hospitals is diagnosed with at least one HAI every day. This translates to approximately 1.7 million diagnoses every year. HAIs are responsible for 99,000 deaths annually (CDC, 2019).
Preventing the spread of HAIs is an important aspect of nursing practice since the most at-risk population is patients with weak or compromised immune systems- those in intensive, palliative and surgical care. The most common HAIs include surgical site infections (SSI), ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABDI), and catheter-associated urinary tract infections (CAUTI) (Haque et al., 2018). There are several evidence-based methods of mitigating and minimizing HAI morbidity and mortality- practicing hand hygiene before and after handling patients/devices, cleaning surfaces & devices with alcohol before & after handling patients, screening patients & organizing them in cohorts, antibiotic stewardship, public health surveillance and most importantly following patient safety guidelines (Haque et al., 2018).
The Selected Quantitative Article and PICOT Question
The selected journal article for the topic by Basu et al. (2021) offers an interesting perspective on HAIs in critical and intensive care situations. The quantitative research was conducted to determine the impact of COVID-19 and the associated enhanced hygiene practices & internal policies on the major types of HAIs- CAUTI, CLABDI, VAP and SSI. COVID-19 was a sudden and devastating scare to the entire world, sweeping through 2020 and claiming the lives of millions. The infectious nature of the virus encouraged people to improve hand hygiene. Nurses all over the world reported increased hand hygiene compliance rates. There was also enhanced hygiene compliance in healthcare situations, especially in high-risk intensive care situations.
The study aimed to determine whether these enhanced hygiene compliance rates had an effect on the morbidity and mortality of HAIs in a 700-bed teaching hospital in India. Data was collected from the hospital’s monthly HAI surveillance system, compiled from January 2019 to December 2020. The complete PICOT question, therefore, is:
Patient population- critical and intensive care patients in a 700-bed facility.
Intervention- systemically enhanced hygiene compliance rates because of COVID-19..
Comparison- normal hygiene compliance rates based on nurse volition and prerogative.
Outcome- reducing HAI morbidity and mortality.
Time- a year.
In patients in critical & intensive care settings (P), how did the systemic enhancement of hygiene compliance rates during COVID-19 (I), compared to average compliance rates pre-COVID (C), influence the morbidity and mortality of HAIs in the facility (O) over a year (2020)?
References
Basu, M., Mitra, M., Ghosh, A., & Pal, R. (2021). Prevention of hospital-acquired infections: A construct during Covid-19 pandemic. Journal of Family Medicine and Primary Care, 10(9), 3348. https://doi.org/10.4103/jfmpc.jfmpc_742_21
CDC. (2019). HAI data. Centers for Disease Control and Prevention. https://www.cdc.gov/hai/data/index.html
Haque, M., Sartelli, M., McKimm, J., & Abu Bakar, M. B. (2018). Health care-associated infections – an overview. Infection and Drug Resistance, Volume 11(11), 2321–2333. https://doi.org/10.2147/idr.s177247
