Clinical Issue

Buy Nursing Papers at Custom Writing Service

Buy a nursing paper online at a reliable writing service.

⏰24/7 Support,

☝Full Confidentiality, ✓100% Plagiarism-Free,

Money-Back Guarantee.

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.

ORDER A PLAGIARISM -FREE PAPER NOW

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.

s

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

ORDER A PLAGIARISM -FREE PAPER NOW

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