Literature Evaluation Table: Clinical Issue

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Literature Evaluation Table: Clinical Issue

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the \"Literature Evaluation Table\" to complete this assignment.

1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
3. The PICOT question will provide a framework for your capstone project.
4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

HAIs (Healthcare Associated Infections) are among the most significant healthcare quality indicators of the care provided   during the period of hospitalization.    HAIs have a huge impact on morbidity and mortality rates, prolong   hospital stay, threaten the safety of patients and increase the costs of care.Literature Evaluation Table: Clinical Issue .Therefore, HAIs remain   a vital issue   in   the treatment and monitoring processes of hospitalized patients across the globe. According to a 2016 report by the Centers for Disease Control and Prevention (CDC), HAIs are the most vital preventable healthcare issue. Based on this report, close to 4% of USA patients   had a HAI with whose overall incidence rate   ranges between 3.1% -14.1% (Goyal & Chaudhry, 2019).

Lack of knowledge on HAIs, non-compliance to   infection control practices, and ineffective education programs play a significant role in the spread of HAIs. Goyal & Chaudhry (2019) explains that, education programs that purpose to   provide    affordable and highly qualified nursing care and prevent errors/accidents by guaranteeing patient safety help to decrease HAIs. Education should include hand hygiene measures of infection control, risks and consequences of HAIs, quality and outcome measures. Education is an inexpensive   intervention and helps to increase the knowledge level, awareness, and compliance of healthcare providers, patient visitors and patients to infection control practices.

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PICOT Question: Among hospitalized patients in acute care settings (P) does educating healthcare providers about HAIs (I) compared to no education(C) decrease HAI rates and increase hand hygiene  compliance(O) within 12 weeks?(T)Literature Evaluation Table: Clinical Issue .

 

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Birnbach, J., Taylor C., Rosen, Lisa F., Fitzpatrick, M., Arheart, Kristopher L. (2020). A new approach to infection prevention: A pilot study to evaluate a hand hygiene ambassador program in hospitals and clinics. American Journal of Infection Control. Retrieved from http://dx.doi.org.lopes.idm.oclc.org/10.1016/j.ajic.2019.11.007 Jeanes, A., Pietro G., Drey, S., Dinah J. (2020). Moving beyond hand hygiene monitoring as a marker of infection prevention performance: Development of a tailored infection control continuous quality improvement tool. American journal of infection control. Retrieved fromhttp://dx.doi.org.lopes.idm.oclc.org/10.1016/j.ajic.2019.06.014 Shea, G., Smith, W., Koffarnus, K., Knobloch, M., Safdar, N.(2019). Kamishibai cards to sustain evidence-based practices to reduce healthcare–associated infections.American Journal of Infection Control. Retrieved from http://dx.doi.org.lopes.idm.oclc.org/10.1016/j.ajic.2018.10.004
How Does the Article Relate to the PICOT Question? The article discusses the control and prevention of cross-infections in hospitals through handwashing using a HHA (Hand Hygiene Ambassador). This study discusses    how increase compliance in hospitals by monitoring   healthcare providers compliance to hand hygiene.

 

 This study emphasizes the need of   nursing staff and nurse leaders   to comply with hand hygiene   for the prevention of HAIs.
Quantitative, Qualitative (How do you know?) Since this study illustrates most participants’ belief of hand hygiene to decrease the risk of HAIs, it is   a qualitative study.

 

 

 

 Quantitative study-the study assesses and explores the measures of an infection control target tool and compliance to hand washing.

 

 

 

 Qualitative-the study used a quality improvement design to obtain outcomes. Besides, the  methods  exempted approval by the institutional review board  and the researchers  obtained consent  from  participants at the time of   conducting the interviews.
Purpose Statement Since there is a strong correlation between   compliance  with hand hygiene and  HAIs,  using  a HHA   can   influence a decrease  in  HAIs

 

 

 

 Strategies such as   training, improving knowledge on infection control and education can help to decrease HAIs although there is a dispute in the value and impact of this intervention. To monitor compliance with infection control practices, healthcare providers can measure compliance to hand hygiene. Although an ancient  art among Japanese, the use of Kamishibai cards (K-cards) is today recognized as an effective  tool  in manufacturing  environments   since it promotes  active interaction between  frontline staff and leaders  to prevent HAIs.
Research Question How do patients, visitors, and staff   perceive the presence of a hand hygiene ambassador?

 

 

 Is hand hygiene   the most significant infection prevention intervention?

 

 

 Do K-cards promote   effective communication and constant reminders   to leaders and staff with regards to compliance with infection control?
Outcome Most visitors, staff and patients   perceived that having HHA was a good idea. The HHA can help by placing ABHRs on an entrant’s hand. Literature Evaluation Table: Clinical Issue .

 

 Organizations can locally adapt a target tool that helps staff to monitor ad prioritize significant issues at the workplace. The most immediate outcome was increased staff awareness on HAIs. Besides, compliance to safety   also increased (70%-90%) after the implementation of K cards.
Setting

(Where did the study take place?)

Clinics and hospitals Acute teaching hospital in London, UK Spectrum Health Helen DeVos Children’s Hospital in Grand Rapids, Michigan.
Sample 225 participants from a specialty hospital, surgical center, public hospital, private hospital and a cancer hospital that were affiliated to an academic medical center. More than 1,200 inpatient bed, 8,000 staff who were spread across 7 hospitals and provided surgery, maternity, cancer, neonatal, emergency, general medicine, and critical care. The researchers recorded and observed 14 interactions with K cards with 6 weeks. The researchers also conducted interviews with 20   nurses and 2 nurse leaders.
Method 225 participants from different   healthcare institutions took a survey.  Participants who   did not clean   their   hands   at the point of entry using an ABHR were given an ABHR application by a HHA. The HHA also assessed their attitudes   on   the presence of a HHA at the entry point.

 

 

 

 The researchers used IC-CQI data input system, questionnaires, IC-CQI training sessions, daily contacts, and group discussions to collect feedback   about the target tool with regards to meeting operational needs, and time constraints. The feedback obtained was used to implement change and modify the tool. The researchers used the Hexagon framework, Pronovost cycle, Barriers and Mitigation tool to review current monitoring system and develop a data collection tool to improve quality in healthcare delivery. The researchers assessed the extent of acceptability of K-Cards in a children’s unit. The findings were analyzed using the Health Belief Model (HBM) and the outcomes that were examined included the utilization of central lines, HAIs rates, and compliance to HAI bundles.

 
Key Findings of the Study When asked whether having a HHA   to place ABHRs on the hands of an entrant is a good idea, most participants agreed that it was a good idea (86.1%). The researchers also found some statistical significance between   genders (91.3% male versus 81% female). No participant declined ABHRs by the HHA. Only monitoring compliance to hand hygiene has no additional impact   on promoting compliance to infection control.

 

 

 

 

 Providers  need to change how they describe sustainability  from  a linear process to an  integrative  process of communication, adaptation, learning, environment and  continuous development of staff.

 
Recommendations of the Researcher Healthcare providers should evaluate the significant role of    visitors in transmitting HAIs.  When   organizations fail to emphasize on hand hygiene among visitors before entering patients’ rooms, they promote    direct spread of pathogens to patients. Although the researchers    monitored hand hygiene compliance, they failed to systematically monitor infection control practices. Therefore, healthcare providers should identify other   barriers   within the workplace environment   to   hand hygiene compliance with their potential solutions. Although most interactions on the K-cards   were conducted  during daytime when  there were flexible  schedules, a similar study should be conducted  on the night shift  staff  to determine if there   can be any  differences  in the outcomes.

 

 

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Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink Allegranzi, B., Aiken, A.,Zeynep K., Nthumba, P., Barasa, J., Okumu, G., Mugarura, R., Elobu, A., Jombwe, J., Maimbo, M., Musowoya, J., Gayet-Ageron, A., Berenholtz, S. (2018). A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before-after, cohort study.Lancet Infectious Diseases. Retrieved from http://dx.doi.org.lopes.idm.oclc.org/10.1016/S1473-3099(18)30107-5 Hang T., Hang Thi Thuy Tran, Hanh Thi My Tran, Anh Pham Phuong Dinh, Ha Thanh Ngo, Jenny Theorell-Haglow and Christopher J. Gordon. (2018). An educational intervention to improve hand hygiene compliance in Vietnam. Retrieved from https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/4cf9-47cd-b62d-1c559af02965%40pdc-v-sessmgr02 Hong, T., Bush, E., Hauenstein, M., Lafontant, A., Li, C., Wanderer, J., Ehrenfeld, J. (2015). A Hand Hygiene Compliance Check System: Brief Communication on a System to Improve Hand Hygiene Compliance in Hospitals and Reduce Infection. Journal of Medicine Systems. Retrieved from https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=1&sid=818e31dd-f7fe-4a6e-8f6f-0b0e214793d3%40pdc-v-sessmgr05

 
How Does the Article Relate to the PICOT Question? The study assesses   the prevention of SSIs and how to improve patient satisfaction.

 

 

 This study determines   is an education program   can help to improve   compliance to hand hygiene    in healthcare settings.

 

 This article    describes how to develop a system to improve compliance to hand hygiene    in hospitals to   decrease HAIs rates and incidences.

 

 
Quantitative, Qualitative (How do you know?) Both Quantitative and Qualitative.  Since the study assesses   the prevention measures of SSIs and quantifies the impact of standard processes on surgeries.

 

 

 Qualitative- this study assesses   the effects of an education program on increasing awareness about hand hygiene and hand washing compliance to improve patient safety and   promote infection control.

 

 

 

 Quantitative- this study describes the implementation of a system   to improve clinical outcomes and decrease HAIs in healthcare settings.
Purpose Statement SSIs comprise the most    significant HAIs in developing nations. Most institutions have implemented specific measures to prevent them but   through poor implementation measures.  The researchers    determined the impact of multimodal interventions on SSIs. HAIs have a huge healthcare burden whose estimates are approximated   to be 15% of hospitalized patients. Despite the   essence of   hand hygiene, most healthcare professionals   have difficulty improving and maintaining   the practice. Compliance to hand hygiene is a modified cause of HAIs whose national averages remain unsatisfactory.  Therefore, the researchers   created a prototype system to track  staff   compliance to hand hygiene
Research Question Can a multimodal intervention decrease the incidences and rates of SSIs? Can knowledge and education   improve    hand hygiene compliance   among healthcare providers in developing nations? Can a   tracking system   for hand hygiene   improve   compliance to hand hygiene in hospitals and decrease HAIs?
Outcome There was a significant improvement   in the   indicators of compliance post implementation of the SSI prevention measures. SSI incidences also decreased during the 30-day post-operative   period.

 

 

 

 There was a significant increase   in compliance to hand hygiene post implementation (p < 0.0001).

There was immense improvement    in the   knowledge scores post education intervention (SD): 1.5 (2.5); p < 0.001).

 Post implementation of a tracking system, the researchers noted an increase in   the rates of hand hygiene compliance and a decrease in HAIs and re-hospitalization rates.

 

 
Setting

(Where did the study take place?)

Five hospitals in Africa

 

 

 

 Hung Vuong Hospital Vanderbilt University Medical Center (VUMC)
Sample 4322 operations whereby, the most common procedures were CS (25·8%), herniorrhaphy (7·9%), and open reduction fractures (49·6%). 206 health care providers    underwent the education program. The researchers simulated 40 compliant and 40 noncompliant events during the pilot test.
Method The researchers conducted a pre and post    cohort study   in five hospitals in Africa using a multimodal intervention to strengthen and implement several measures to prevent SSIs together with   an adaptive   approach   of improving teamwork.

 

 

 

 Healthcare providers   from NICU and surgical ward in a hospital in Vietnam. The participants underwent a four-hour education program on hand hygiene and afterwards monitored    the compliance of staff   to hand hygiene for six months.  The researchers further conducted a pre and post   hand hygiene knowledge assessment after six months. Vanderbilt Institutional Review Board reviewed   the study protocol and in the design phase, the researchers identified several goals, assumptions, and constraints of implementation.

 

 

 
Key Findings of the Study The researchers followed up 4322 operations. They   found a significant decrease in the SSI cumulative incidence post-implementation (8.0%-3.8%).

 

 

 

 The findings of the study demonstrated that     an education intervention can improve   compliance to hand hygiene   in organizations with   a high   patient turnover. There was an overall steady increase   in compliance    over 6 months. During the pilot period,   the researchers simulated 40 compliant and 40 non-compliant   incidences.  The  tracing system  managed to detect   97.5% (compliant incidence) and  100% (non-compliant incidences) with an accuracy of 98.75%.
Recommendations of the Researcher The researchers recommend   the development of more innovative   complex interventions and tools for SSIs prevention. Interventions on   hand hygiene education   should purpose   to   measure compliance to hand hygiene for a longer period to determine its effectiveness.

 

 

 Future systems should   incorporate   more complex situations   such as   recovery and preoperative rooms, and trauma bays. The   system attained the researchers’ goals and   demonstrated a lot of potential for future development.

 

References

Allegranzi, B., Aiken, A.,Zeynep K., Nthumba, P., Barasa, J., Okumu, G., Mugarura, R., Elobu, A., Jombwe, J., Maimbo, M., Musowoya, J., Gayet-Ageron, A., Berenholtz, S. (2018). A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before-after, cohort study.Lancet Infectious Diseases. Retrieved from http://dx.doi.org.lopes.idm.oclc.org/10.1016/S1473-3099(18)30107-5

Birnbach, J., Taylor C., Rosen, Lisa F., Fitzpatrick, M., Arheart, Kristopher L. (2020). Literature Evaluation Table: Clinical Issue .A new approach to infection prevention: A pilot study to evaluate a hand hygiene ambassador program in hospitals and clinics. American Journal of Infection Control. Retrieved from http://dx.doi.org.lopes.idm.oclc.org/10.1016/j.ajic.2019.11.007

Goyal, M., & Chaudhry, D. (2019). Impact of Educational and Training Programs on Knowledge of Healthcare Students Regarding Nosocomial Infections, Standard Precautions and Hand Hygiene: A Study at Tertiary Care Hospital. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 23(5), 227–231. https://doi.org/10.5005/jp-journals-10071-23166

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Hang T., Hang Thi Thuy Tran, Hanh Thi My Tran, Anh Pham Phuong Dinh, Ha Thanh Ngo, Jenny Theorell-Haglow and Christopher J. Gordon. (2018). An educational intervention to improve hand hygiene compliance in Vietnam. Retrieved from https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/4cf9-47cd-b62d-1c559af02965%40pdc-v-sessmgr02

Hong, T., Bush, E., Hauenstein, M., Lafontant, A., Li, C., Wanderer, J., Ehrenfeld, J. (2015). A Hand Hygiene Compliance Check System: Brief Communication on a System to Improve Hand Hygiene Compliance in Hospitals and Reduce Infection. Journal of Medicine Systems. Retrieved from https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=1&sid=818e31dd-f7fe-4a6e-8f6f-0b0e214793d3%40pdc-v-sessmgr05

Jeanes, A., Pietro G., Drey, S., Dinah J. (2020). Moving beyond hand hygiene monitoring as a marker of infection prevention performance: Development of a tailored infection control continuous quality improvement tool.Literature Evaluation Table: Clinical Issue .  American journal of infection control. Retrieved from http://dx.doi.org.lopes.idm.oclc.org/10.1016/j.ajic.2019.06.014

Shea, G., Smith, W., Koffarnus, K., Knobloch, M., Safdar, N.(2019). Kamishibai cards to sustain evidence-based practices to reduce healthcare–associated infections.American Journal of Infection Control. Retrieved from http://dx.doi.org.lopes.idm.oclc.org/10.1016/j.ajic.2018.10.004

 PICOT Question:

 

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink  

 

    
How Does the Article Relate to the PICOT Question?      
Quantitative, Qualitative (How do you know?)      
Purpose Statement      
Research Question      
Outcome      
Setting

(Where did the study take place?)

     
Sample      
Method      
Key Findings of the Study      
Recommendations of the Researcher      

 

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink  

 

    
How Does the Article Relate to the PICOT Question?      
Quantitative, Qualitative (How do you know?)      
Purpose Statement      
Research Question      
Outcome      
Setting

(Where did the study take place?)

     
Sample      
Method      
Key Findings of the Study      
Recommendations of the Researcher      

Literature Evaluation Table: Clinical Issue