PICOT Question and Literature Search.
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. PICOT Question and Literature Search. 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. 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. 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). The PICOT question will provide a framework for your capstone project. 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. PICOT Question and Literature Search. 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. PICOT Question and Literature Search.
Summary of Clinical Issue
Hospital acquired infections (HAIs)are a major public health problem which have continuously resulted in increased morbidity and mortality rates. This clinical condition presents a huge socioeconomic burden to the healthcare system following the associated implications. These include treatment bills, rehospitalization, long hospital stays, disabilities and deaths. Moreover, the increasing rates of antimicrobial resistance (AMR) challenge the management of these infections particularly in the healthcare units with already immune compromised patients. Contaminated hospital environments as well as health care workers are increasingly implicated in the multi‐resistant organisms (MRO) transmission and persistence together with other pathogens. This has triggered the need to reduce these infections through identification of effective measures to reduce and prevent the HAIs. PICOT Question and Literature Search.
Hand hygiene through hand washing has thus been identified as significant prevention measures to HAIs. However, limited research on compliance, techniques and effectiveness exist particularly in the acute care settings. The compliance is also considered minimal which challenges the efforts of reducing HAIs. Proper hand washing entails the use of clean running water and application of soap till lathering occurs. This is followed by vigorous rubbing of hands for at least 20 seconds and scrubbing the surfaces. Soap washes away bacteria and viruses and hence is considered to be a more effective measure to the prevention of HAIs compared to alcohol-based hand sanitizers. This is because, soap washes away bacteria and viruses that cause infections contrary to sanitizers which may be selective to certain pathogens.
Inacute care inpatients (P), does handwashing with soap and water (I) compared to the application of alcohol-based hand sanitizers(C), decrease Hospital Acquired Infection (HAIs) rates (O) within 3 months (T)? PICOT Question and Literature Search.
|Criteria||Article 1||Article 2||Article 3|
|APA-Formatted Article Citation with Permalink||Fernando, S. A., Gray, T. J., & Gottlieb, T. (2017). Healthcare‐acquired infections: prevention strategies. Internal medicine journal, 47(12), 1341-1351.
|Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ handwashing and reducing hospital-acquired infection. Critical care nurse, 37(3), e1-e8.
|Gao, Q. (2020). The Relationship between Hand Washing and Hospital-Acquired Infections.
|How Does the Article Relate to the PICOT Question?||It provides an overview of healthcare‐acquired infections (HAI), their causes and the cost implications they have on the healthcare system.
It also discusses hand hygiene as a significant intervention in the prevention of HAIs.
|It presents the benefits of handwashing and use of sanitizers and their effectiveness in preventing HAIs||It gives the Relationship between Hand Washing and Hospital-Acquired Infections|
|Quantitative, Qualitative(How do you know?)||Qualitative.
It attempts to interpret the status of HAIs, their implications and prevention. It does not use numerical data.
Employs numerical data
Does not use numerical data
|Purpose Statement||The purpose of the paper is to identify health care‐acquired infections and determine the prevention strategies||To promote the use of hand washing with soap and water, hand sanitizer, or both and improve patients’ education to reduce hospital-acquired infections||To determine the relationship between Hand Washing and Hospital-Acquired Infections|
|Research Question||What are the HAIs and their prevention strategies?||Does increased access to hand hygiene products and patient education improve patients’ hand hygiene and reduce the transmission of HAIs?||In hospital staff, how does hand washing education compare to no
handwashing education affect the performance of hand washing and rate of hospital-acquired
infections within 3 months?
|Outcome||Increased awareness of HAIs and prevention strategies||Vancomycin-resistant enterococci (VRE) infections decreased by 70% in a 19-month period after the intervention||There is a strong link between hand washing and nosocomial
(Where did the study take place?)
|Australian healthcare system||an adult 36-bed cardiothoracic surgical step-down unit at the University of Michican Health System||Departments ofcardiology, general surgery, operating room, and intensive care unit (ICU) departments|
|Sample||None||33 Patients||Staff and administration|
|Method||Survey, questionnaire||Observation; survey, questionnaires|
|Key Findings of the Study||200 000 HAI occur annually, of which 50% are preventable
Main drivers of HAIs are suboptimal infection control practices and excessive antimicrobial use
|Significant correlations were found between hand hygiene and rates of infection
After the implementation of hand hygiene interventions, rates ofinfections declined significantly.
|Hand washing education increases hospital-acquired infection and hand washing compliance.|
|Recommendations of the Researcher||Cultural shift, institutional and individual accountability, and engagement with guidelines that promote optimal infection control practices and the judicious use of antimicrobials.
|Further studies should be focused on observations of patients’ hand hygiene before and after interventions are implemented||Synthesis of different methods to educate staff on handwashing in the future research.|
|Criteria||Article 4||Article 5||Article 6|
|APA-Formatted Article Citation with Permalink||O’Donoghue, M., Ng, S. H., Suen, L. K., & Boost, M. (2016). A quasi-experimental study to determine the effects of a multifaceted educational intervention on hand hygiene compliance in a radiography unit. Antimicrobial Resistance & Infection Control, 5(1), 36.
|Sickbert-Bennett, E. E., DiBiase, L. M., Willis, T. M., Wolak, E. S., Weber, D. J., &Rutala, W. A. (2016). Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices. Emerging Infectious Diseases, 22(9), 1628-1630.||Alefragkis, D., Alikari, V., &Kelesi, M. The importance of hand hygiene in health care settings DimitriosAlefragkis.
|How Does the Article Relate to the PICOT Question?||It examines hand washing compliance and the effects of multifaceted educationalintervention.||It presents an evidence-based relationship between hand hygiene compliance and HAIs||Examines the importance of hand washing in hospitals|
|Quantitative, Qualitative(How do you know?)||Quantitative
It uses experimental research design
|Quantitative and qualitative
Uses statistical data and non-statistical
It’s a review
|Purpose Statement||To evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital.||To determine the association between hand hygiene and infection prevention||To investigate the importance of hand hygiene in the hospital|
|Research Question||What are the knowledge, attitudes,and compliance with hand hygiene of HCW in an RUand the effects of an educational intervention accompanied by increased availability of ABHR on theseparameters?||Can an improvement in hand hygiene compliance from a baseline high level (>80%) to an even higher level (>95%) lead to decreases in healthcare-associated infections (HAI).||What is the importance of hand hygiene in health careSettings?|
|Outcome||Increased hand hygiene compliance||HAIs reduction||Reduced hospital infections|
(Where did the study take place?)
|Radiography unit of a district hospital||University of North Carolina Hospitals||Research databasesPubMed database and Google Scholar|
|Sample||76 radiographers, 17 nurses, and ninehealthcare assistants (HCA)||>4,000 healthcare personnel||None|
|Method||A quasi-experimental study design including questionnaires||Longitudinal research study, observation||Systematic Review|
|Key Findings of the Study||Before the intervention, overall hand hygiene compliance was low (28.9 %). Post-intervention, compliance with hand hygiene increased to 51.4 %.||Increased hand hygiene compliance rate (p<0.001)
Significant decreased healthcare-associated infection rate (p = 0.0066).
|Hand Hygiene is the most important measure to prevent the
spread of pathogenic microorganisms and hospital
|Recommendations of the Researcher||Even though compliance increased significantly after the intervention, only half of hand hygiene opportunities were performed suggesting the need for repeated interventions||Achieve and sustain high compliance among personnel who interact with patients and their environment||Proper training of health personnel on hand hygiene|
PICOT Question and Literature Search.