NRS 433 Research Critiques and PICOT Statement Final Draft

NRS 433 Research Critiques and PICOT Statement Final Draft
The PICOT question was about hospital-acquired infections (HAI). In many healthcare settings, hospital-associated infections are common, leading to health complications and a longer stay in hospitals. On the other hand, nurses or medical professionals involved in the treatment processes and the general handling of the patients are also prone to these infections. The associated hospital infections often lead to a longer hospital stay, a scenario that causes financial complexities to the victims and their families. In many cases, hospital-acquired infections occur because of mishandling of the patients, wrong medications, poor services delivery, inadequate diagnosis processes, and inappropriate nurse to patient ratio (Widmer & Malik, 2015). With the evidenced-based practices being introduced into different healthcare settings, most medical professionals are on the verge of identifying the possible causes of Hospital associated infections and act appropriately towards mitigating some of the causes.
PICOT Question
The revised PICOT question is thus; For the inpatients’ population, (P) how does decongestion of wards and widening of spaces between ward beds (I) as compared to congestion and narrowing of spaces between ward beds (C) reduce hospital-acquired infections (O) for the period of hospitalization?
Research Critique
Quantitative and Quantitative Studies
Background
The quantitative and qualitative studies applied were in line with the PICOT question. From the qualitative article, “An observational case study of hospital-associated infections in a critical care unit in Astana, Kazakhstan” by Viderman et al. (2018), the problems of hospital-associated infections are on the rise, the problem causes increased complications, and a longer hospital stays among the patients. The aim of the study is, therefore, to evaluate the effects of the infections on mortality and ICU stay. One of the main objectives of the article is to assess the rate of healthcare-associated infections in Astana, Kazakhstan. One of the research questions from the article was; what is the trend of healthcare-acquired infections in Astana? Another qualitative article identified for the study was, “Healthcare-Associated Infections—A New Pathology in Medical Practice” by Voidazan et al. (2020). According to the author, hospital-associated infections cause a problem of increased mortality rates as well as the advancement in health conditions that are already being experienced by the patients in healthcare settings. On the other hand, associated hospital infections are regarded as one of the major public problems that lead to an increased time of hospitalization and the high costs of healthcare. From the article, there is about sixteen million additional hospitalizations yearly due to hospital-acquired infections. The main purpose of the article is to scrutinize the trends often recorded in hospital-associated infections, prevention, and control strategies in the healthcare system. One of the main objectives of the article is to analyze the control strategies when it comes to the processes aimed at reducing hospital-acquired infections. From the article, the research question was: what are some of the control strategies of hospital-acquired infections (Dang & Dearholt, 2017).
One of the quantitative articles considered in the study was “Hospital-acquired infections before and after healthcare reorganization in a tertiary university hospital in Norway” by Andersen, Rasch, Hochlin, Tollefsen, and Sandvik (2009). The main problem in the article is the increased hospital-acquired infections in healthcare settings. Patient overcrowding in hospitals and other healthcare facilities is the main cause of increased health-associated infections. The study also tests whether there is a relationship between patient overcrowding and ill-health among the hospital staff. One of the main objectives of the research article is to show the trends in infectious diseases within the healthcare system. One of the research questions in the article is; what is the trend in the rates of infectious diseases within healthcare settings. The second quantitative article considered in the research was “Patients with infectious diseases, overcrowding, and health in hospital staff” by Virtanen et al. (2011). The main objective of the quantitative research article is to examine the rate of acquired infections among the patients at the tertiary university hospital in Oslo. The study was done to determine the comparison before and after the healthcare reorganization. One of the research questions in the article was: what is the trend in hospital-associated infections in Norway? The purpose of the study is to examine the rate of hospital-acquired infections before and after the healthcare reorganization in Norway.
NRS 433 Research Critiques and PICOT Statement Final Draft
How do these two articles support the nurse practice issue you chose?
The quantitative articles provided contain critical information that is essential when it comes to addressing the PICOT question on hospital-acquired infections. The idea of trends in hospital-acquired infections enables the researcher to analyze trends when it comes to the examination of the interventions. Besides, the two quantitative articles present a clear and succinct analysis of the hospital-associated infections as well as the possible causes in different healthcare settings. The articles also give unconventional views on the PICOT question, statement, and present elaborate models that are essential in the processes of analysis. The literature reviews from the two articles present theoretical approaches that are critical when it comes to the analysis of hospital-acquired infections in various healthcare settings. The articles also consist of evidenced-based practices that guide the achievement of the best practices in healthcare settings, a scenario that can greatly reduce the cases of hospital-acquired infections.
From the PICOT statement, there is a close link between the PICOT question and the research articles that were presented. Both the qualitative and quantitative articles were mainly about healthcare-associated infections. The quantitative research articles took quantitative approaches to determine the associated healthcare questions. The result was valid in relation to the PICOT statements. The qualitative articles are significant to the PICOT since they provide critical trends of healthcare-associated infections, as well as the procedures that can be used to reduce the increasing cases of longer hospital stay. The articles also highlight essential steps that can be applied to enable nurses and the entire medical professional teams to manage the cases of hospital-associated infections. The two qualitative research articles relate directly to the PICOT question. The findings of these research articles are critical when it comes to the understanding of hospital-acquired infections.
Method of Study:
The two qualitative research articles apply qualitative approaches. Similar methodologies have been applied in the two articles to collect information and data. The same methodologies have been used to answer the objectives and the research questions. Also, in both the qualitative articles, the authors apply a literature review to highlight the theoretical approaches when it comes to the elaboration of the problem statements as well as the possible solutions. However, the two articles differ in one aspect; Viderman et al. (2018) integrate an observational approach in his work whereby there is the combination of both the qualitative and quantitative methodologies while the other article only uses one of those. The advantage of the qualitative approach is that they reduce the budget used in the entire process of the study; also, there is an increased possibility in the accuracy in making conclusions. With the qualitative approaches, the whole process becomes easier as the information is mainly extracted from the already available sources.
For the two qualitative articles, the quantitative approaches were used to prove the hypotheses and answer the research questions. One advantage of the quantitative research approach is that they present information based on the data, a scenario that leads to the accuracy in the information. The two quantitative articles provide steps and procedures in the hospital decongestion, the activities that are always conducted to reduce the spread of hospital-acquired infections. The information about decongestion and the procedures that can be followed is critical when it comes to the implementation of evidence-based practices. In most cases, hospitals and healthcare institutions lack professionals who are able to conduct research and establish findings that will enable medical organizations to perfect their operational processes in an attempt to ensure positive patient outcomes.
Results of Study
From the qualitative article by Viderman et al. (2018), hospital-acquired infections mainly arise from surgical, whereby there are many cases of contamination. Also, the hospital-acquired infections result from ventilator-associated pneumonia. Finally, the article stipulates that hospital-associated infections often arise from the blood transfusion processes and urinary tract infections. On the other hand, Voidazan et al. (2020) stipulated that hospital-acquired infections are prevalent in public hospitals due to the overcrowding characterized by the need for urgent medical care. Low nurse to patient ratio is also one of the main factors when it comes to the increase in the number of hospital-acquired infections.
The quantitative articles found out that there were declining trends in hospital-associated infections in Norway healthcare facilities between the years 1995 and 2002 (Percival et al., 2017). In the same period, there were increased cases of hospital-acquired infections due to the rise in the number of somatic patients and the cases of workloads in hospitals. In most cases, the associated hospital infections rise with an increase in the number of patients within the healthcare facility.
The four studies selected have implications on the nursing practice. First, they establish approaches that are critical in evidenced-based practices. The outcomes or the study findings from the four articles are critical when it comes to the processes geared towards improving the medical processes and treatment procedures in different medical facilities. The outcomes also inform the quality approaches that need to be undertaken to enhance the healthcare delivery processes.
Ethical Considerations
In both the qualitative and quantitative articles, one of the main ethical concern is the confidentiality of information. The data obtained were secured to ensure security in the access. On the other hand, before the acquisition of the information, the consent was signed to ensure legal authorization. In the quantitative research processes, while conducting surveys to obtain data, the study participants had to sign the consent forms to confirm their acceptance in the study processes. For the qualitative research, while accessing the databases, the administrators were contacted to ensure the authenticity of the information. The application of ethics in the research processes often ensures that the results obtained are valid, and the information acquired can be used to enhance the clinical processes.
Outcomes Comparison
The PICOT question was about hospital-acquired infections (HAI). The anticipated outcome of the PICOT question is to show that widening and increasing the spacing between the hospital beds can reduce the rates of hospital-acquired infections. In many healthcare settings, hospital-associated infections are common, leading to health complications and a longer stay in hospitals. On the other hand, nurses or medical professionals involved in the treatment processes and the general handling of the patients are also prone to these infections. The associated hospital infections often lead to a longer hospital stay, a scenario that causes financial complexities to the victims and their families (Nanda et al., 2019). In many cases, hospital-acquired infections occur because of mishandling of the patients, wrong medications, poor services delivery, inadequate diagnosis processes, and inappropriate nurse to patient ratio. With the evidenced-based practices being introduced into different healthcare settings, most medical professionals are on the verge of identifying the possible causes of Hospital associated infections and act appropriately towards mitigating some of the causes.
The qualitative and the quantitative articles are significant to the PICOT since they provide critical trends of healthcare-associated infections, as well as the procedures that can be used to reduce the increasing cases of longer hospital stay. The articles also highlight essential steps that can be applied to enable nurses and the entire medical professional teams to manage the cases of hospital-associated infections. The two qualitative research articles relate directly to the PICOT question. The findings of these research articles are critical when it comes to the understanding of hospital-acquired infections.
Proposed Evidence-Based Practice Change
From the PICOT statement, there is a close link between the PICOT question and the research articles that were presented. Both the qualitative and quantitative articles were mainly about healthcare-associated infections. The quantitative research articles took quantitative approaches to determine the associated healthcare questions. The result was valid in relation to the PICOT statements. The qualitative articles are significant to the PICOT since they provide critical trends of healthcare-associated infections, as well as the procedures that can be used to reduce the increasing cases of longer hospital stay. The articles also highlight essential steps that can be applied to enable nurses and the entire medical professional teams to manage the cases of hospital-associated infections. The two qualitative research articles relate directly to the PICOT question. The findings of these research articles are critical when it comes to the understanding of hospital-acquired infections. The PICOT statement about hospital-acquired infections borrows a lot of ideas and concepts from the two qualitative articles presented, including the interventions and other mechanisms of managing healthcare infections among the patients. The authors of the qualitative articles elaborate succinctly on the preventive measures and approaches that can be used to reduce HAI (Wattal & Oberoi, 2016). Therefore, there are strong links between the PICOT question and the qualitative research articles used in the study. In other words, they provide alternative view approaches on how to answer the PICOT question; they also provide elaborate models and theories that can be used to link the problems of hospital-acquired infections with evidenced-based practices in the healthcare settings. From the literature reviews of these articles, there are numerous theories elaborating on hospital-acquired infections, including historical trends. The articles provide evidence-based practices that may lead to the solution to increasing hospital-associated infections. There is also the presentation of the best practices that can be undertaken to enhance or to promote evidence-based practices in healthcare settings.
Also, quantitative research articles relate directly to the PICOT question. The two articles mainly concentrate on hospital decongestion in the aim of reducing the cases of hospital-acquired infections. In other words, the two quantitative articles investigate the impacts of hospital decongestion on the reduction of hospital-acquired infections. There is a direct relationship between the results from these two articles with the expected outcome of the PICOT question. The main objectives of all the above articles directly relate to the PICOT questions. The main aim of the two is to show ways of reducing hospital-acquired infections through the use of scientific approaches or evidence-based practices. Also, the two four articles, both quantitative and qualitative, directly provide a solution to the nursing practice problem that was identified in the PICOT, i.e., the hospital-acquired infections.
The quantitative research articles apply the methodology whereby there is a collection of raw data, which were analyzed to show the impacts of bed spacing on the number of hospital-associated infections. The approach enhanced the validity and authenticity of the outcome. Meaning the study was critical in addressing the PICOT question. In other words, the ideals and findings from the study are suitable while addressing the problem of hospital-acquired infections.
The information provided in the PICOT statement and in the article analysis can be used to formulate evidence-based practice changes in the healthcare settings. For instance, these approaches can be used to enhance practices aimed at reducing the spread of contagious diseases. Given the data and trends provided in both the qualitative and quantitative articles, a hospital can formulate evidenced-based strategies to reduce or eradicate the spread of infections from one patient to the other. In many healthcare settings, the last thing that patients want is further infections from hospitals. Nurses and other healthcare professionals play critical roles when it comes to the prevention of the illnesses associated with healthcare settings. They are able to achieve this through the application of evidence-based practices on infection control policies. Keeping data from every patient and analyzing them to find the ideal information is critical when it comes to processes of infection control in healthcare settings. Infection control is beneficial to both the patients and the healthcare workers.
The two quantitative articles provide steps and procedures in the hospital decongestion, the activities that are always conducted to reduce the spread of hospital-acquired infections. The information about decongestion and the procedures that can be followed is critical when it comes to the implementation of evidence-based practices. In most cases, hospitals and healthcare institutions lack professionals who are able to conduct research and establish findings that will enable medical organizations to perfect their operational processes in an attempt to ensure positive patient outcomes. The lack of human resources is also evidenced where there is a lack of enough medical professionals, including nurses and doctors. Training more medical experts are therefore needed to ensure the achievement of evidence-based practices. However, with these resources and the expected research outcome, healthcare workers to adopt many concepts in an attempt to establish best practices that can reduce the rate of hospital-acquired infections.
The application of evidence-based practices often requires a lot of research to find some of the best approaches that can be used to impact the treatment processes. The eradication of hospital-associated infections needs the collection of data from the patients. Currently, most hospitals are using the concepts or approaches that are not ideal in reducing cases of hospital-acquired infections. Thus, through research involving the collection of data, there is a need for changes in the evidenced-based practices so as to reduce the ever-increasing numbers of HAI. The concepts applied in reducing HAI depend on the healthcare setting and the number of medical professionals and nurses involved. Also, the system may depend on the nature of practices undertaken in a given healthcare facility. What works for one facility may not be relevant to other hospitals. While trying to eradicate hospital-acquired infections, there is always the need for the hospitals to collect individual data, analyze them, and use them in the decision making processes to decide on the appropriate evidence-based practices.
References
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.
Nanda, A., Maiti, T. K., & Savardekar, A. R. (2019). Complications in Vascular Neurosurgery—Overview. In Complications in Neurosurgery (pp. 31-36). Content Repository Only!.
Percival, S. L., Williams, D., Cooper, T., & Randle, J. (Eds.). (2017). Biofilms in infection prevention and control: A healthcare handbook. Academic Press.
Wattal, C., & Oberoi, J. K. (2016). A Four-Step Approach to Antibiotic Stewardship in India: Formulation of Antibiotic Policy. In Hospital Infection Prevention (pp. 77-78). Springer, New Delhi.
Widmer, M. K., & Malik, J. (Eds.). (2015). Patient safety in dialysis access. Karger Medical and Scientific Publishers.
Assessment Description
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 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.
Refer to “Research Critiques and PICOT Guidelines – Final Draft.” 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
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 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.
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.
Attachments
NRS-433V-RS5-ResearchCritiquePICOTGuidelines.docxNRS-433V-RS5-Research-Critique-PICOT-
Research Critiques and PICOT Statement Final Draft – Rubric
Criteria Description
Evidence of Revision
5. 5: Excellent
26 points
Evidence of incorporation of research critique feedback and revision is comprehensive and thoroughly developed.
4. 4: Good
24.44 points
Evidence of incorporation of research critique feedback and revision is clearly provided.
3. 3: Satisfactory
21.58 points
Incorporation of research critique feedback and evidence of revision are present.
2. 2: Less Than Satisfactory
19.5 points
Incorporation of research critique feedback or evidence of revision is incomplete.
1. 1: Unsatisfactory
0 points
Final paper does not demonstrate incorporation of feedback or evidence of revision on research critiques.
Criteria Description
Nursing Practice Problem and PICOT Question
5. 5: Excellent
13 points
PICOT question clearly articulates a nursing practice problem using substantial supporting information from numerous reliable sources.
4. 4: Good
12.22 points
PICOT question articulates a nursing practice problem using supporting information from reliable sources.
3. 3: Satisfactory
10.79 points
PICOT question describes a nursing practice problem and includes a few reliable sources.
2. 2: Less Than Satisfactory
9.75 points
PICOT question describes a nursing practice problem but lacks reliable sources.
1. 1: Unsatisfactory
0 points
A nursing practice problem is not clearly described or a PICOT question is not included.
Criteria Description
Background of Studies
5. 5: Excellent
13 points
Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is thorough with substantial relevant details and extensive explanation.
4. 4: Good
12.22 points
Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is complete and includes relevant details and explanation.
3. 3: Satisfactory
10.79 points
Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is partially complete and includes some relevant details and explanation.
2. 2: Less Than Satisfactory
9.75 points
Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is included but lacks relevant details and explanation.
1. 1: Unsatisfactory
0 points
Background of studies, including problem, significance to nursing, purpose, objective, and research questions, is incomplete.
Criteria Description
Method of Studies
5. 5: Excellent
13 points
Discussion of method of studies, including discussion of conceptual/theoretical framework, is thorough with substantial relevant details and extensive explanation.
4. 4: Good
12.22 points
Discussion of method of studies, including discussion of conceptual/theoretical framework, is complete and includes relevant details and explanation.
3. 3: Satisfactory
10.79 points
Discussion of method of studies, including discussion of conceptual/theoretical framework, is partially complete and includes some relevant details and explanation.
2. 2: Less Than Satisfactory
9.75 points
Discussion of method of studies, including discussion of conceptual/theoretical framework, is included but lacks relevant details and explanation.
1. 1: Unsatisfactory
0 points
Discussion of method of studies, including discussion of conceptual/theoretical framework, is incomplete.
Criteria Description
Results of Studies
5. 5: Excellent
13 points
Discussion of studies results, including findings and implications for nursing practice, is thorough with substantial relevant details and extensive explanation.
4. 4: Good
12.22 points
Discussion of studies results, including findings and implications for nursing practice, is complete and includes relevant details and explanation.
3. 3: Satisfactory
10.79 points
Discussion of studies results, including findings and implications for nursing practice, is partially complete and includes some relevant details and explanation.
2. 2: Less Than Satisfactory
9.75 points
Discussion of studies results, including findings and implications for nursing practice, is included but lacks relevant details and explanation.
1. 1: Unsatisfactory
0 points
Discussion of studies results, including findings and implications for nursing practice, is incomplete.
Criteria Description
Ethical Considerations
5. 5: Excellent
13 points
Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation.
4. 4: Good
12.22 points
Discussion of ethical considerations associated with the conduct of nursing research is complete and includes relevant details and explanation.
3. 3: Satisfactory
10.79 points
Discussion of ethical considerations associated with the conduct of nursing research is partially complete and includes some relevant details and explanation.
2. 2: Less Than Satisfactory
9.75 points
Discussion of ethical considerations associated with the conduct of nursing research is included but lacks relevant details and explanation.
1. 1: Unsatisfactory
0 points
Discussion of ethical considerations associated with the conduct of nursing research is incomplete.
Criteria Description
Conclusion
5. 5: Excellent
13 points
Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice.
4. 4: Good
12.22 points
Conclusion summarizes utility of the research from the critical appraisal and the importance of the findings to nursing practice.
3. 3: Satisfactory
10.79 points
Conclusion summarizes utility of the research and importance to nursing practice.
2. 2: Less Than Satisfactory
9.75 points
Conclusion is vague and does not discuss importance to nursing.
1. 1: Unsatisfactory
0 points
Conclusion does not summarize a critical appraisal and applicability of findings.
Criteria Description
PICOT Question, Research Articles, and Nursing Practice Problem Relationship
5. 5: Excellent
26 points
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.
4. 4: Good
24.44 points
Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is complete and includes relevant details and supporting explanation.
3. 3: Satisfactory
21.58 points
Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation.
2. 2: Less Than Satisfactory
19.5 points
Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is incomplete or incorrect.
1. 1: Unsatisfactory
0 points
Discussion of the relationship between the PICOT question, research articles, and nursing practice problem is not included.
Criteria Description
Proposed Evidence-Based Practice Change
5. 5: Excellent
26 points
The proposed evidence-based practice change is extremely thorough and includes substantial supporting explanation and numerous relevant details.
4. 4: Good
24.44 points
The proposed evidence-based practice change is complete and includes supporting explanation and relevant details.
3. 3: Satisfactory
21.58 points
The proposed evidence-based practice change is included but lacks supporting explanation and relevant details.
2. 2: Less Than Satisfactory
19.5 points
The proposed evidence-based practice change is incomplete or incorrect.
1. 1: Unsatisfactory
0 points
The proposed evidence-based practice change is not included.
Criteria Description
Thesis Development and Purpose
5. 5: Excellent
26 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
4. 4: Good
24.44 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
3. 3: Satisfactory
21.58 points
Thesis is apparent and appropriate to purpose.
2. 2: Less Than Satisfactory
19.5 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. 1: Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Criteria Description
Argument Logic and Construction
5. 5: Excellent
26 points
Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
4. 4: Good
24.44 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
3. 3: Satisfactory
21.58 points
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.
2. 2: Less Than Satisfactory
19.5 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
1. 1: Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. 5: Excellent
26 points