NRS 433V GCU Wk 1 MRSA Infection Control in Healthcare Settings Research

NRS 433V GCU Wk 1 MRSA Infection Control in Healthcare Settings Research NRS 433V GCU Wk 1 MRSA Infection Control in Healthcare Settings Research 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 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. final_picot_research_week_1.docx final_rough_draft_quantitative_research_critique.docx article_american_journal_of_infection_control.pdf article_jamda.pdf final_rough_draft_qualitative.docx ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Literature Evaluation Table Student Name: Aynur Kabota Summary of Clinical Issue (200-250 words): Patients admitted to hospitals face the risk of infection from different hospital-acquired infections. These patients interact with nurses, physicians, other patients, and other healthcare workers hence being exposed to various diseases and infections whose risk is high in hospitals. Hospital-acquired infections (HAIs) present a significant problem for healthcare and healthcare workers in the United States. Every year, many patients acquire infections that could have been prevented while in the hospital. One of the most challenging HAIs is Methicillin-resistant Staphylococcus aureus (MRSA), a stubborn staph bacterium that is resistant to most current antibiotics. This infection is harmful to the patient as it may lead to various complications, including bloodstream infection and affecting multiple organs in the body, it may also lead to sepsis and death. Protecting people in the healthcare system is a priority for the nursing profession since the care-based approach of nursing is based on the welfare of patients. Moreover, various methods are used by healthcare workers to control infection spread in the healthcare system, contact isolation and precautions as well as hand hygiene. The evidence-based practice seeks to come up with the most effective means of providing care to patients through research. This research project, therefore, aims to compare contact isolation precautions with hand hygiene in controlling MRSA infections in the healthcare system. PICOT Question: In patients with MRSA infections (P), how does contact isolation precautions (I) compared to hand hygiene (C) affect prevention of healthcareassociated infections (O) during a one-month hospital stay (T) Criteria Article 1 Article 2 Article 3 APA-Formatted Article Citation with Permalink McKinnell, J. A., Eells, S. J., Clark, E., Rand, D. D., Kiet, G. T., Macias-Gil, R., … & Miller, L. G. (2017). Discontinuation of contact precautions with the introduction of universal daily chlorhexidine bathing. Epidemiology & Infection, 145(12), 2575-2581. Morgan, D. J., Zhan, M., Goto, M., Franciscus, C., Alexander, B., Vaughan-Sarrazin, M., … & Pineles, L. (2019). The Effectiveness of Contact Precautions on MethicillinResistant Staphylococcus aureus in Long-term Care Across the United States. Clinical Infectious Diseases, Sun, J., Chow, B., Hanowski, B., & Henderson, E. A. (2016). Correlation between hand hygiene compliance and methicillinresistant Staphylococcus aureus incidence. Canadian Journal of Infection Control, 31(4), 215-220. ner.pdf © 2019. Grand Canyon University. All Rights Reserved. DOI: 10.1017/S095026881700112 1 How Does the Article Relate to the PICOT Question? The article presents an investigation of whether discontinuation of MRSA contact isolation increases infection rates with the adoption of hand hygiene procedures. Quantitative, Quantitative- The methods used to Qualitative (How measure the rate of MRSA do you know?) infections and define these outcomes statistically. Purpose Statement Research Question Outcome Setting (Where did the study take place?) Sample Method To investigate hospital policy change from contact isolation to chlorhexidine bathing for MRSA infection control. Does discontinuation of contact precautions for MRSA after the introduction of universal chlorhexidine bathing affect the rate of MRSA infections in hospitals? Rate of MRSA acquisitions XX(XX):1–8. DOI: 10.1093/cid/ciz1045 The research looks into the impact of contact isolation precautions in reducing MRSA acquisitions. The precautions are the intervention of the PICOT question. The research investigates the correlation between hand hygiene and MRSA acquisition. It focuses on the comparison (hand hygiene) in the PICOT question. Quantitative- The study was an effectiveness pre-post study with controls and generalized estimating equations statistical analysis was used To evaluate whether contact isolation precautions reduce MRSA acquisition in long-term care facilities. Do contact isolation precautions reduce MRSA acquisition in longterm care facilities? Quantitative- Data analysis used Pearson correlation coefficient which is a statistical approach Rate of MRSA acquisition Correlation rates between MRSA and hand hygiene compliance. NRS 433V GCU Wk 1 MRSA Infection Control in Healthcare Settings Research The province of Alberta, Canada Intensive care units of Torrance Memorial Medical Center, in Torrance, California United States Department of Veterans Affairs (VA) health care system 453 ICU patients Change of cleaning procedure for patients and contact isolation as well as patient infection surveillance 75,414 patient admissions Retrospective effectiveness study with pre-post and controls testing using data from four years in the VA health care system 2 To determine the correlation between hospital-acquired MRSA and hand hygiene compliance in hospitals. Is there a correlation between hospitalacquired MRSA and hand hygiene compliance in hospitals? Acute facilities from five zones in Alberta Pearson correlation of MRSA acquisition rates and hand hygiene compliance data Key Findings of the Study Recommendatio ns of the Researcher Criteria APA-Formatted Article Citation with Permalink How Does the Article Relate to the PICOT Question? Quantitative, Qualitative (How do you know?) There was no significant evidence that discontinuing contact isolation procedures with chlorhexidine bathing increased rates of MRSA infections Chlorhexidine bathing could be used instead of contact isolation precautions because it is equally effective in infection control, and it reduces cost. Active surveillance and contact precautions did not affect the rate of MRSA acquisition Hospital-acquired MRSA rates were strongly negatively correlated to hand hygiene compliance Interventions should focus on highrisk patients and activities to reduce MRSA acquisitions Compliance to hand hygiene policies is recommended for effective prevention of MRSA in hospitals Article 4 Article 5 Article 6 Schmidt, P., HartensteinPinter, A., Wager, J., Hasan, C., & Zernikow, B. (2020). Addressing multidrugresistant pathogens in pediatric palliative care patients—the nurse’s point of view: A qualitative study. Palliative Medicine, 34(3), 349-357. DOI: 10.1177/0269216319883981 The article looks into multidrug-resistant pathogens, the class which MRSA belongs to. The healthcare problem researched in the PICOT question is MRSA. Qualitative- The study aimed to establish attitudes and opinions of nurses Albrecht, J. S., Croft, L., Morgan, D. J., & Roghmann, M. C. (2017). Perceptions of gown and glove use to prevent methicillinresistant Staphylococcus aureus transmission in nursing homes. Journal of the American Medical Directors Association, 18(2), 158-161. DOI: Esfandiari, A., Rashidian, A., Asl, H. M., Foroushani, A. R., Salari, H., & Sari, A. A. (2016). Prevention and control of healthcare-associated infections in Iran: A qualitative study to explore challenges and barriers. American Journal of Infection Control, 44(10), 1149-1153. DOI: The study looked into the current perceptions of gown and glove use to prevent MRSA acquisition. These precautions are part of the contact isolation precautions in the intervention part of the PICOT question. The study looks into the prevention of HAIs, and the PICOT question’s general focus is the prevention of HAI acquisition in the healthcare system. Qualitative- The article focuses on perceptions of staff, residents, and administrators Qualitative- Thematic qualitative framework analysis was used to analyze data 3 Purpose Statement Research Question Outcome Setting (Where did the study take place?) Sample To identify the attitudes and opinions of nurses towards multidrug-resistant pathogens. What is the viewpoint of nurses regarding multidrugresistant pathogens in the healthcare system? Attitudes and opinions towards pathogen control Pediatric Palliative Care Centre at Witten/Herdecke University 14 nurses from the pediatric palliative care unit Method Topic-based, semistructured interviews for data collection Key Findings of Ambivalences were the Study observed among nurses in the topics of safety, effort, quality of care, and participation Recommendations New hygiene concepts for of the Researcher nurses require addressing ambivalences in nurses attitudes and opinions regarding infection control To determine current use and perceptions of To determine the challenges and barriers of gowns and gloves for MRSA acquisition HAI prevention and control in the Iranian prevention health system. What value do residents, administrators, and staff assign to gloves and gowns for MRSA acquisition control? What are the current challenges and barriers to the prevention and control of HAIs in Iran? Attitudes and perceptions towards gown and gloves Three nursing homes in Maryland Barriers and challenges in implementing HAI prevention and control National Committee of Hospital Infections, Ministry of Health, universities of medical sciences, private and public hospitals in Iran 24 participants from the different institutions Semi-structured interviews were used to collect opinions and views 19 staff from the nursing homes Focus group study and semi-structured interviews for data collection Gowns and gloves were used primarily as self-protection from bodily fluids and not MRSA prevention.NRS 433V GCU Wk 1 MRSA Infection Control in Healthcare Settings Research Challenges included governance and stewardship, resources, a culture of safety, monitoring and surveillance systems, and prescription of antibiotics Contact isolation precautions were not There is a need for a more robust effectively used in preventing MRSA hence framework for surveillance and reporting requiring improvement in practices. HAIs in the health system. 4 Running head: QUANTITATIVE RESEARCH CRITIQUE Quantitative Research Critique Aynur Kabota Grand Canyon University 05/24/2020 1 QUANTITATIVE RESEARCH CRITIQUE 2 Quantitative Research Critique Quantitative research complements qualitative research by producing numerical results as proof for observations. The reliance on data for quantitative analysis is crucial in providing accurate definitions and measurements of different aspects of healthcare. Quantification of phenomena helps in planning interventions and effectively monitoring outcomes of those interventions. The research problem of comparing contact precautions to hand-washing can be effectively analyzed through quantitative research, which will produce results on how effective both interventions are in preventing MRSA acquisition. This paper presents a critique of two quantitative research articles that contribute to more knowledge on a comparison between contact isolation precautions and hand-washing in preventing MRSA acquisition. Background The first study is titled “Discontinuation of Contact Precautions with the Introduction of Universal Daily Chlorhexidine Bathing” by McKinnell et al. (2017), and it presents a comparison of contact precautions with chlorhexidine bathing. This study focuses on the problem of contact precautions as in their effectiveness and compliance levels. The researchers identify gaps in practice and hence present a study to explore an alternative, chlorhexidine bathing. The significance of this problem to nursing is that controlling infections is a crucial role for nurses. Additionally, the researchers sought to determine whether discontinuation of contact precautions increased MRSA when universal chlorhexidine bathing was introduced. The second study is by Morgan et al. (2019), and it is titled “The Effectiveness of Contact Precautions on Methicillin-Resistant Staphylococcus aureus in Long-term Care Across the United States.” In this study, the main problem identified is the prevalence of MRSA in longterm care facilities. Therefore, the researchers seek to establish whether or not contact QUANTITATIVE RESEARCH CRITIQUE 3 precautions impacted the rates of MRSA acquisition in long-term care facilities (LTCFs). The significance of this study to nursing is in the role of nurses in LTCFs. Nurses in every healthcare facility have a responsibility to reduce the risk of healthcare-acquired infections (HAIs), and hence this problem affects their work. The research question was, therefore, whether contact precautions, compared to standard procedure, reduced MRSA acquisition. Support to Nurse Practice Issue McKinnell et al. (2017) compare contact isolation precautions with hygiene, and hence the structure of their study is generally the same as the PICOT question. The PICOT question compares contact isolation precautions to hand hygiene. Therefore, the intervention is contact isolation, and the comparison group is hand hygiene. In the study, the intervention is contact isolation, and the comparison is body hygiene using chlorhexidine bathing. Although the comparison groups are a bit different, they include hygiene practices. The study will be used to answer the PICOT question by presenting an evaluation of the effectiveness of body hygiene and how it works as well as contact isolation precautions. On the other hand, Morgan et al. (2019) compare contact isolation precautions to standard procedures. The intervention considered is similar to McKinnell et al. (2017) and also to the PICOT question. However, the comparison is standard procedures, and hence it differs from the hygiene comparison groups of the previous study and the PICOT question. By looking at standard procedures, the researchers still present an overview of the effectiveness of contact isolation precautions. Generally, this study will be used to determine whether contact isolation precautions are much better than standard procedures hence comparing the same with hand hygiene. QUANTITATIVE RESEARCH CRITIQUE 4 Methods of the Study The two studies are very similar in the methods used because they both used interventions through policy changes as the main experimental approaches. Morgan et al. (2019) collected data from veteran affairs LTCFs before and after implementation of a contact isolation precaution policy. NRS 433V GCU Wk 1 MRSA Infection Control in Healthcare Settings Research Similarly, McKinnell et al. (2017) collected data before and after implementation of policy change where contact isolation precautions were eliminated and replaced with chlorhexidine bathing. The only difference between the methods is that in the policy change. At the same time, Morgan et al. (2019) observed the introduction of a new policy, McKinnell et al. (2017) observed the discontinuation of one policy and the introduction of another. The advantage of the experimental methods used in both studies is that they provide a basis for comparing outcomes, and hence the impact is well-measured. On the other hand, the ethical implications of discontinuing a healthcare policy may be observed by the impact on the health of the patients. Nevertheless, the studies maintained an ethical approach to experimentation. Results of the Study The studies presented no significant differences in MRSA acquisition with the policy change. McKinnell et al. (2017) found that discontinuing contact isolation precautions and introducing daily chlorhexidine bathing was not significantly correlated to an increase in MRSA acquisition. Therefore, they concluded that daily chlorhexidine bathing is as effective as contact isolation precautions in preventing MRSA acquisitions. In comparison, daily chlorhexidine bathing is more economical than contact isolation precautions, and hence it is recommended by this study. The ability to prevent MRSA acquisitions while managing the costs of healthcare are QUANTITATIVE RESEARCH CRITIQUE 5 advised, as in this study’s outcomes. This study implies that contact isolation precautions in ICUs could be replaced with daily chlorhexidine bathing, which is less expensive. Similarly, Morgan et al. (2019) found no significant difference in rates of MRSA acquisition correlated with the introduction of contact isolation precautions in LTCFs for veterans. Primarily, the researchers found that contact isolation precautions did not have a significant effect on MRSA acquisition rates. The implications for these outcomes are connected to alternatives to contact isolation. The studies have shown no added advantage of contact isolation precautions in MRSA acquisition reduction. Therefore, in healthcare interventions, contact isolation precautions specifically for MRSA may not be required if hand standard hygiene procedures are in place. These studies suggest that the process may be an expensive redundancy in healthcare organizations. Outcomes Comparison The anticipated outcomes of the PICOT question problem were that contact isolation precautions are more effective than standard procedures and hand hygiene when preventing MRSA acquisition. However, the studies reviewed in this critique suggest otherwise. As compared to daily chlorhexidine bathing, contact isolation precautions are no better. Similarly, when compared to standard health procedures, isolation produces no added advantage. Therefore, the studies suggest that contact isolation precautions create no significant benefit in preventing MRSA. The intervention and comparison groups in the PICOT question, therefore, may have no significant differences in their outcomes. Although the studies do not directly address hand hygiene, the standard procedures in healthcare organizations also include hand hygiene. Therefore, Morgan et al. (2019) are nearly similar to the PICOT question, and it highlights the lack of significant difference between the comparison and intervention groups. QUANTITATIVE RESEARCH CRITIQUE 6 Conclusion The article review shows that in the PICOT question, intervention and comparison groups may have no significant difference. This research has explored how contact isolation precautions compare to hand hygiene in MRSA prevention. The outcomes suggest that neither the intervention nor the comparison is more or less effective. The implications for practice are that the less economic interventions may be avoided due to extra spending by healthcare organizations. Contact isolation precautions should be used, but they are no better than hand hygiene in MRSA prevention. It is necessary to note that these findings are not final, and more research in different healthcare settings needs to be performed to assert the claim. It is also crucial to evaluate the potential sources of error and weakness in the studies. Nevertheless, contact isolation precautions present no significant advantage over standard health procedures in MRSA prevention. QUANTITATIVE RESEARCH CRITIQUE 7 References McKinnell, J. A., Eells, S. J., Clark, E., Rand, D. D., Kiet, G. T., Macias-Gil, R., … & Miller, L. G. (2017). Discontinuation of contact precautions with the introduction of universal daily chlorhexidine bathing. Epidemiology & Infection, 145(12), 2575-2581. DOI: 10.1017/S0950268817001121 Morgan, D. J., Zhan, M., Goto, M., Franciscus, C., Alexander, B., Vaughan-Sarrazin, M., … & Pineles, L. (2019). The Effectiveness of Contact Precautions on Methicillin-Resistant Staphylococcus aureus in Long-term Care Across the United States. Clinical Infectious Diseases, XX(XX):1–8. DOI: 10.1093/cid/ciz1045 ARTICLE IN PRESS American Journal of Infection Control ?? (2016) ??-?? Contents lists available at ScienceDirect American Journal of Infection Control American Journal of Infection Control j o u r n a l h o m e p a g e : w w w. a j i c j o u r n a l . o r g Major Article Prevention and control of health care–associated infections in Iran: A qualitative study to explore challenges and barriers Atefeh Esfandiari PhD a, Arash Rashidian MD, PhD a, Hossein Masoumi Asl MD b, Abbas Rahimi Foroushani PhD c, Heda … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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