NRS 433 PICOT Question and Literature Search SOLUTION

Grand Canyon University NRS 433 PICOT Question and Literature Search SOLUTION-Step -By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University NRS 433 PICOT Question and Literature Search SOLUTION assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NRS 433 PICOT Question and Literature Search SOLUTION

Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 433 PICOT Question and Literature Search SOLUTION depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NRS 433 PICOT Question and Literature Search SOLUTION

The introduction for the Grand Canyon University NRS 433 PICOT Question and Literature Search SOLUTION is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NRS 433 PICOT Question and Literature Search SOLUTION

After the introduction, move into the main part of the NRS 433 PICOT Question and Literature Search SOLUTION assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NRS 433 PICOT Question and Literature Search SOLUTION

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NRS 433 PICOT Question and Literature Search SOLUTION

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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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.

Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:

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.
Following the PICOT format, write a PICOT question in your selected 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).
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. Note: This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology.

Articles must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. The PICOT question will also provide a framework for your capstone project.

Sample Answer for NRS 433 PICOT Question and Literature Search SOLUTION

Clinical Problem-Shortage of nurses in the ICU

The increase in the number of patients in need of healthcare has caused crisis in healthcare systems in U.S and the world in general, especially the shortage of nurse workers in the ICU. This challenge is witnessed in many forms. For instance, most healthcare organizations requires that nurses to be assigned four patients to care for at once. However, high acuity may become a problem because it adds burden to the available nurses. The circumstance leads to the shortage of staff; therefore, the charge nurse could face a difficult task. If one nurse calls off from the ICU, the charge nurse is compelled to point someone to cover the shift during their day off. Therefore, she may be forced to give the nurse a total of more than four patients due to the absence of one nurse worker. When this happens, the available nurse becomes overburdened. The nurse workload increases due to the excessive patient care demands placed on the assigned nurse, whi

ch compromises patient care. Nonetheless, the situation raises the occurrence of medical errors. The increasing volume of medical needs among the patients poses different challenges to the nurses including developing back injuries. In addition, due to severe workloads, nurses are frequently obliged to hold urination for extended periods of time, which can lead to urinary tract infections. Furthermore, the nurse workers experience significant stress and emotional damage. When faced with challenges caused by a heavy workload, having adequate nursing staff in the intensive care unit and other departments in a facility is the best solution. It significantly improves the well-being of nurses at work by increasing their job satisfaction and it prevents instances of poor health such as sickness and mortality rates.

PICOT Question

In the ICU departments, does sufficient nurse workers (I) prevent the occurrence of medical errors, infections and stress among patients and nurses themselves (O) within one year (T) compared to inadequate nurse workers (C)?

Population (P) – The target population is the patients in the ICU.

Intervention (I) – Sufficient nurse workers

Comparison (C) – Inadequate nurse workers.

Outcome (O) -Prevents infections, stress, and medical errors among the patients and nurses

Time (T) – The duration is one year.

Literature Evaluation Table

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Fagerstrom, L., Kinnunen, M., & Saarela, J. (2018). Nursing workload, patient safety incidents, and mortality: An observational study from Finland. BMJ Open, 8(4), e016367 https://www.researchgate.net/publication/324739031_Nursing_workload_patient_safety_incidents_and_mortality_An_observational_study_from_Finland	Nogueira, T. D. A., Menegueti, M. G., Perdoná, G. D. S. C., Auxiliadora-Martins, M., Fugulin, F. M. T., & Laus, A. M. (2017). Effect of nursing care hours on the outcomes of Intensive Care assistance. PloS one, 12(11), e0188241. https://journals.plos.org/plosone/article/file?type=printable&id=10.1371/journal.pone.0188241	Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study. BMC health services research, 19(1), 1-9. https://pubmed.ncbi.nlm.nih.gov/31752859/
How Does the Article Relate to the PICOT Question?	The article identifies how nurses’ daily workloads relate to patients’ safety. It reveals that the nurses’ workload increases the health risks among patients. However, a reduced workload reduces the health risks.	It examines the ratio of nurse care hours delivered to patient needs.	It investigates the relationship between inpatient mortality and nursing staff ratios in the surgical and medical wards.
Quantitative or Qualitative (How do you know?)	The study is quantitative since the investigators employed an observational study as a research method to collect quantitative data.	This study is quantitative based on the nature of the research’s data.	The research is quantitative because it uses actual data from the selected hospital’s admission
Purpose Statement	The study seeks to determine if every nurse’s workload relates to patient safety issues and death.	To compare nursing care indicators with the typical number of nursing hours spent caring for patients in intensive care units (ICUs).	To ascertain how staffing numbers in surgical and medical wards affect patient mortality.
Research Question	Do patient safety incidents and mortality connect with individual nurses’ daily workload?	What is the relationship between patient care indicators and the amount of time spent on them during nursing care?	Is in-hospital mortality affected by the mean nursing hours per patient?
Outcome	A medical error and mortality likelihood was almost 25% lower if OPC/nurse was below the limit. Compared to the traditional patient-to-nurse measure, a workforce measure based on daily measurements of individual patient care needs and the required NWL (OPC/nurse) was marginally better at forecasting incidents and fatality rates.	Nursing care hours impact the health outcomes among patients.	The investigation determined that a higher nurse staffing level determines the low levels of patient mortality
Setting	The study included 36 units from four hospitals in Finland, one of which was a tertiary acute care hospital while the other three were secondary acute care hospitals.	An ICU in one of the private hospitals in Sao Paulo, Brazil	The study was conducted in seven Belgian Hospitals’ Medical and Surgical wards
Sample	36 units	The selected hospital’s ICU patients between January 1, 2011, and December 31, 2013	The research involved 34,267 patients admitted to both medical and surgical wards
Method	The researchers employed the studying of safety incidents through observation. Also, they are based on collecting information from the reporting system in healthcare institutions.	The researchers based on the daily schedule of the nursing staff and the electronic records system, which provided them with information on the number of nurses working in the surveyed ICU daily and monthly. The investigators then utilized the Generalized Linear Models to analyze it	The research included all admitted patients, excluding children under seven and pregnant women. The researchers employed a randomized controlled trial and conducted an observational study to collect data from the medical and surgical wards.
Key Findings of the Study	The increased workload of hospital nurses increases the danger of patient fatalities and safety problems.	According to the study, giving patients additional hours per day decreased the incidences of pneumonia and phlebitis, which are related to using a ventilator.	Understaffing among nurses results in higher patient mortality. The researchers reached this conclusion since there were negative outcomes concerning the nurses’ proportion of hours per patient and mortality rate.
Recommendations of the Researcher	Investigators, in this case, recommended that future researchers confirm the study’s findings. It showed a link between the daily workload for each nurse and patient safety issues and mortality.	Health care providers should focus on assessing the hazards which result from inadequate nurse staffing in the ICU because patient safety is impacted massively by the number of nursing care hours. They achieve this goal by including indicators to monitor healthcare services. In essence, there is a need to negotiate nurse staffing and promote patient safety using various indicators that monitor healthcare services.	According to the inquiry, creating a method for calculating the ideal nurse staffing level to provide care for each patient during the proper daily hours is crucial.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Pazokian, M., & Borhani, F. (2017). Nurses’ perspectives on factors affecting patient safety: A qualitative study. Evidence Based Care, 7(3), 76-81. https://ebcj.mums.ac.ir/article_9382.html	Banda, Z., Simbota, M., & Mula, C. (2022). A qualitative study of nurses’ perceptions of the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi. BMC nursing, 21(1), 1-7. https://pubmed.ncbi.nlm.nih.gov/35650646/	Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: an observational study. BMJ quality & safety, 28(9), 706-713. https://pubmed.ncbi.nlm.nih.gov/30918050/
How Does the Article Relate to the PICOT Question?	The article identifies how different elements, for instance, nurse staffing, affect patient safety.	The study investigates nurses’ perspectives on the issue of heavy workloads in the ICU.	The authors successfully carried out an observational study to comprehend how patients feel about their satisfaction with the care they receive, both when it is high and when it is low.
Quantitative or Qualitative (How do you know?)	It is a qualitative study because it used structured interviews during the data collection process	Since interviews are conducted as part of the data collection procedure, the research is qualitative.	The research is qualitative because analyzing the patients’ provided feedback is involved.
Purpose Statement	The research seeks to determine nurses’ perspectives on the elements that influence patient safety	To investigate and describe how Malawian nurses perceive the effects of a heavy nursing burden in the ICU.	The study aims to look into how patients engage with nursing and staffing in terms of both quality and quantity.
Research Question	What elements, according to nurses, affect patient safety?	What impact do heavy workloads have in ICU nursing?	Is there a link between patient outcomes and high nurse staff?
Outcome	Improving nurses’ skills, ensuring adequate staffing, and improving nursing equipment and facilities are key to better health care services.	Because of their heavy workloads, nurses provided patients with subpar treatment, endangering their safety. High workloads also jeopardized the safety of the nurses.	Negative relationships occasionally prevented satisfaction
Setting (Where did the study take place?)	Five educational healthcare facilities in Tehran	Queen Elizabeth Central Hospital, Blantyre, Malawi.	England, NHS Hospital Trust
Sample	The study involved 32 nurses from different units: critical care, intensive care, emergency, gastroenterology, and nephrology.	12 nurses	The research involved 270 patients and 13800 staff members
Method	The research involved a qualitative study design involving semi-structured interviews of between 30 and 45 minutes. Before the interviews, the researchers obtained consent from the nurses who participated in the research.	The researchers conducted a purposive sampling to choose research volunteers depending on how long they had previously worked at the hospital. After that, they gave their informed consent. To gather the research data, the researchers then conducted ten in-depth interviews. They used Braun & Clarke’s thematic analysis technique to assess the data after the data collection phase.	The investigators observed the patient outcomes based on varied staff ratios for one year. Then they used regression analysis to analyze the gathered data about the quality of care for patients.
Key Findings of the Study	The outcomes for patient safety are enhanced when nurses’ skills are increased, staffing levels are met, and facilities and equipment are upgraded. These actions encourage motivation and job satisfaction.	The excessive nurse workload impacts critically ill patients and ICU nurses. It compromises patient safety and prevents effective care. It also hurts the health of nurses.	From the study, the nurses with at least eight patients displayed poor interaction with them compared to those who handled a lower number.
Recommendations of the Researcher	Adequate staffing should be implemented in nursing to prevent stress among them and promote better patient outcomes	Nurse managers and policymakers should concentrate on increasing the number of ICU nurses and implementing various measures to solve the problem of high workloads and the impacts it causes on patient care.	The authors advise looking into why there is a poor relationship between nurses and patients when there is a low staffing ratio.

References

Banda, Z., Simbota, M., & Mula, C. (2022). Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: a qualitative study. BMC nursing, 21(1), 1-7. doi: 10.1186/s12912-022-00918-x.

Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: an observational study. BMJ quality & safety, 28(9), 706-713. DOI: 10.1136/bmjqs-2018-008948

Fagerstrom, L., Kinnunen, M., & Saarela, J. (2018). Nursing workload, patient safety incidents, and mortality: An observational study from Finland. BMJ Open, 8(4), e016367 DOI: 10.1136/bmjopen-2017-016367

Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study. BMC health services research, 19(1), 1-9. DOI: 10.1186/s12913-019-4688-7

Nogueira, T. D. A., Menegueti, M. G., Perdoná, G. D. S. C., Auxiliadora-Martins, M., Fugulin, F. M. T., & Laus, A. M. (2017). Effect of nursing care hours on the outcomes of Intensive Care assistance. PloS one, 12(11), e0188241. doi.org/10.1371/journal.pone.0188241

Pazokian, M., & Borhani, F. (2017). Nurses’ perspectives on factors affecting patient safety: A qualitative study. Evidence Based Care, 7(3), 76-81. DOI:10.22038/EBCJ.2017.24174.1520

Sample Answer 2 for NRS 433 PICOT Question and Literature Search SOLUTION

Falls among patients, especially older patients in nursing homes, are a critical healthcare concern because of their adverse effects on outcomes. Falls lead to increased cost of care due to lengthened stay in hospital, adverse events like head injuries and even death. Older patients, 65 years and above, are susceptible to falls due to different reasons that include loss of muscle mass, a condition known as sarcopenia, cognitive impairment or due to certain types of dementia and failing eye sight. Medications can also increase one’s susceptibility to due to their side effects like confusion and dizziness. According to the Centers of Disease Control and Prevention (CDC) (2023), fall pose a threat to the health of older adults and reduces their ability to remain independent. The CDC says that over 36,000 deaths occurred in 2020 associated with falls among the elderly with another 3 million emergency department visits due to falls. The Centers for Medicare and Medicaid Services (CMS) consider falls as a never event because they are preventable when hospitals implement evidence-based practice (EBP) interventions. Evidence-based practice interventions like tailoring interventions for patient safety (TIPS) can help providers reduce and prevent falls and their adverse effects in diverse healthcare settings. The purpose of this paper is to review articles on TIPS based on the formulated PICOT question. The paper reviews both qualitative and quantitative research articles on TIPS as an effective intervention to reduce falls among the elderly in nursing homes.

PICOT Question: Among older adults aged 65 years and above in nursing homes and residences (P), does the implementation of TIPS framework (I) compared to normal safety measures (C), reduce and prevent fall by 60% and associated effects (O) within six months (T)?

Criteria	Article 1	Article 2	Article 3
APA-formatted article citation with permalink	Vincenzo, J. L., Patton, S. K., Lefler, L. L., McElfish, P. A., Wei, J., & Curran, G. M. (2022). A qualitative study of older adults’ facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics, 99, 104610. https://doi.org/10.1016/j.archger.2021.104610	Carter, E. J., Khasnabish, S., Adelman, J., Bogaisky, M., Lindros, M. E., Alfieri, L., … & Dykes, P. (2020). Adoption of a patient-tailored fall prevention program in academic health systems: a qualitative study of barriers and facilitators. OBM Geriatrics, 4(2), 1-21. doi:10.21926/obm.geriatr.2002119	Rogers, C., Shamley, D., & Amosun, S. (2021). Older adults’ experience of an exergaming intervention to improve balance and prevent falls: a nested explanatory qualitative study. Applied Sciences, 11(24), 11678. https://doi.org/10.3390/app112411678
How does the article relate to the PICOT question?	The article supports the PICOT as it demonstrates the efficacy of using different interventions that focus on improving patient safety among patients	The article relates to the PICOT question as it demonstrates that fall TIPS can have significant impact on patients and staff when implemented in any setting.	The article relates to the PICOT as it shows that using better tailored interventions can reduce falls among patients in different settings.
Is the article qualitative, quantitative, or mixed methods? Justify your selection.	Qualitative The article is qualitative based on the method that the researchers apply informed grounded theory and focus groups based on semi-structured interviews	Qualitative The researchers use qualitative approaches like observation and interviews to gather perceptions and opinions about the implemented Fall TIPS aspects.	Qualitative The researchers uses focus groups and analyze the results using content analysis.
Purpose statement	The purpose of the study was to gather views and perceptions from older patients about ways to prevent falls	The purpose of the article was to identify the barriers and facilitators to Fall TIPS adoption.	The purpose of the article was to explore the efficacy of a large-scale randomized control trial that compared an exergaming intervention and gold-standard one as well as no intervention.
Research question(s)	Does engagement in fall prevention activities reduce and prevent falls?	What are the barriers and facilitators to Fall TIPS adoption in healthcare organizations?	What is the effects of using tailored interventions to improve patient safety through reduction and prevention of falls?
Outcome(s)	The outcomes demonstrate that using fall prevention activities focused on patient safety reduce falls among elderly patients in diverse settings	The researchers identified both facilitators and barriers to Fall TIPS implementation. The outcome also show that Fall TIPS enhanced collaboration between staff and patients since they were tailored to each patient needs and preferences	The outcomes show an improvement in different aspects related to fall prevention. The study also explored attitudes toward fall and fall prevention.
Setting (Where did the study take place?)	The setting was a community dwelling of older adults with average age of 78 years.	The setting entailed 11 hospitals representing three academic health systems.	The setting comprised of different areas based on the origin of participants.
Sample	The sample comprised of 27 older adults living in a community dwelling.	The sample comprised of 50 patients and focus groups with 71 staff	The sample comprised of 14 participants in the OEP framework and 16 on the WBB model
Method	Informed grounded theory and focus groups	The researchers used interviews and focus groups	The researchers used focus groups and interviews.
Key findings of the study and implications for nursing practice	The findings from the study show that individuals do not engage in fall prevention activities due to different reasons like severity and susceptibility. The findings also demonstrate diverse facilitators in engaging in fall prevention. The implications for nursing practice from this study is that providers should engage in tailored interventions based on the unique setting of the patients.	The use of Fall TIPS led to increased motivation among nurses, improved patients’ understanding of their roles and integration of the intervention into the workflow processes. The researchers also identified barriers like poor engagement practices, use of residual fall prevention strategies; especially one-size-fits-all approach. The implication of the study is that nurses should adopt Fall TIPS to improve safety in their settings.	The findings from the study show that those engaged through exergaming model enjoyed the applied intervention but did not comply with the provisions. The focus groups showed barriers and facilitators to implementation of TIPS in their areas or facilities.
Recommendations of the researcher	The researchers recommend the need for people to engage in fall prevention behaviors by addressing the barriers like limited knowledge and perceived self-severity and susceptibility to falls.	The researchers recommend the use of Fall TIPS adoption and enhancement of staff engagement of patients to develop trusting partnerships to improve safety among them.	The article recommends increased engagement of patients and implementation of strategies that are tailored to meet patient needs.

Criteria	Article 4	Article 5	Article 6
APA-formatted article citation with permalink	Guo, X., Wang, Y., Wang, L., Yang, X., Yang, W., Lu, Z., & He, M. (2023). Effect of a fall prevention strategy for the older patients: A quasi‐experimental study. Nursing open, 10(2), 1116-1124. https://doi.org/10.1002/nop2.1379	Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (2019). Assessing the effectiveness of engaging patients and their families in the three-step fall prevention process across modalities of an evidence-based fall prevention toolkit: an implementation science study. Journal of medical internet research, 21(1), e10008. DOI: 10.2196/10008	Dykes, P. C., Khasnabish, S., Burns, Z., Adkison, L. E., Alfieri, L., Bogaisky, M., … & Adelman, J. S. (2022). Development and validation of a fall prevention efficiency scale. Journal of patient safety, 18(2), 94. DOI: 10.1097/PTS.0000000000000811
How does the article relate to the PICOT question?	The article relates to the PICOT as it illustrates the effectiveness of using a fall prevention approach tailored to patient needs.	The article relates to the PICOT question as it shows that Fall TIPS framework is effective in reducing and preventing the occurrence of falls among diverse patients even in their homes.	Using a mixed method approach, the article related to the PICOT question as it shows that Fall TIPS model is effective in reducing falls
Is the article qualitative, quantitative, or mixed methods? Justify your selection.	Quantitative The article is quantitative since it employs a quasi-experimental design	Quantitative The article analyzes the outcomes through quantitative approaches like conducting risk assessments.	Mixed Methods The article incorporates both qualitative and quantitative approaches.
Purpose statement	The purpose of the article was to explore the impact of a fall prevention strategy among older patients founded on the patient engagement design.	The purpose of the article was to assess the effects of Fall TIPS modality on patient engagement in a three-step fall prevention process and gauge efficacy.	The purpose of the study was to learn the benefits and burdens associated with Fall TIPS program.
Research question(s)	Does engagement of patients reduce and prevent the occurrence of falls among elderly patients or individuals?	Does the Fall TIPS modality affect patient engagement using a 3-step fall prevention process and efficacy?	Does the implementation of Fall TIPS improve nurses’ ability to reduce and prevent falls?
Outcome(s)	The outcomes show that the intervention reduces falls among the targeted population.	The outcomes show that patient engagement is essential for implementing Fall TIPS interventions.	The outcomes show that learning about providers’ beliefs in the use of time related to Fall TIPS implementation is essential to enhance results that include a reduction in falls.
Setting (Where did the study take place?)	The study occurred in a hospital with two groups or cohorts to demonstrate the efficacy of the intervention.	The researchers conducted the study in healthcare settings in Boston and New York, Bronx and Manhattan	Three hospitals in Massachusetts and 3 in New York
Sample	The sample comprised of 116 subject with the intervention group having 58 and control with 58.	The sample comprised of nurses at the selected facilities.	The sample comprise of 72 nurses who participated in two phases of group interviews.
Method	The researchers used a longitudinal quasi-experimental quantitative design	Three modalities that included laminated Fall TIPS poster, electronic Fall TIPS poster and paperless patient safety displays at the bed side.	The methods included initial qualitative, second qualitative and psychometric evaluation.
Key findings of the study and implications for nursing practice	The key findings include effectiveness of the intervention, and need to engage patients when implementing the strategy. The implications of the study for nursing practice is that nurses should implement strategies that are patient-centered to improve their overall safety. The implication for nursing practice is each intervention works differently based on patient’s overall condition.	The findings show that these interventions are Fall TIPS that lead to improved safety and management of falls among patients. The implication of the article to nursing practice is that nurses should embrace these interventions to improve safety by preventing and reducing falls in their settings.	The key findings for the article include learning about the facilitators and burdens that nurses encounter when implementing falls in their settings, especially through Fall TIPS. The implications for nursing practice is that nurses should understand organizational barriers that can hinder the implementation of Fall TIPS.
Recommendations of the researcher	The researchers recommend more studies to understand the efficacy and effectiveness of engaging patients to develop a patient safety tool to reduce and prevent falls.	The researchers recommend implementation of the Fall TIPS to enhance patient safety and quality care for the affected patients.	Learning of these barriers allows organizations to improve areas of weakness and correct problems that waste time.

Conclusion

Falls are a concern for nurses and other providers in diverse settings. Falls lead to adverse events and a rise in the cost of care. The use of evidence-based practice approaches is essential in preventing and reducing these events. As such, nurses, patients and other providers should develop Fall TIPS to reduce their occurrence and improve overall safety. The evaluation table shows that researchers can use diverse methodologies to demonstrate the effects of implementing Fall TIPS in their facilities for better management of these events.

References

Albasha, N., Ahern, L., O’Mahony, L., McCullagh, R., Cornally, N., McHugh, S., & Timmons, S. (2023). Implementation strategies

to support fall prevention interventions in long-term care facilities for older persons: a systematic review. BMC geriatrics, 23(1), 47. DOI: https://doi.org/10.1186/s12877-023-03738-z

Centers for Disease Control and Prevention (CDC) (2023). Older Adult Fall Prevention. https://www.cdc.gov/falls/index.html

Ziegl, A., Hayn, D., Kastner, P., Löffler, K., Weidinger, L., Brix, B., … & Schreier, G. (2020). Quantitative falls risk assessment in

elderly people: results from a clinical study with distance based timed up-and-go test recordings. Physiological measurement, 41(11), 115006. DOI 10.1088/1361-6579/abc352

Sample Answer 3 for NRS 433 PICOT Question and Literature Search SOLUTION

al., (2020), nurses commit most of the medication errors when compared to any other professional in healthcare. The high rate of prevalence of medication errors they commit is attributed to their large number in the healthcare workforce and them undertaking most of the medical orders. In addition, they spend most of their time in the hospital setting administering medicines to patients. Medication errors can result in a wide range of adverse health outcomes to the patient, nurses, and the health institution as a whole. They can result in substandard or unsuccessful treatment, adverse events, increase in hospital stays and even death. Medication errors can also result in new health problems that demand the use of new treatments. Medication errors also increase the legal issues in an institution of healthcare. Patients tend to sue their nurses as well as healthcare institutions for negligence. The reputation of the nurses and the hospital are also threatened by the rise in the incidences of medication errors. A decline in reputation also translates into mistrust among the patients on the safety of care they receive. Educational programs have proven effective in reducing the incidences of medication errors in nursing. They increase the situational awareness among the nurses alongside their ability to identify and respond to errors (Mostafa et al., 2020). Despite this evidence, there is little utilization of educational strategies to prevent medication errors in nursing in most of health institutions. Therefore, the proposed project aims at utilizing educational programs to reduce the rates of medication errors committed by the nurses.

PICOT Question: In medical and surgical units nurses, does the use of educational programs reduce the rates of medication errors committed by nurses when compared to its no use in 10 weeks? Please contact me on the Private Forum with this PICOT question as it has errors. Who is the population? The nursing practice change is too vague. Time frame is longer than the Capstone class which is only 10 weeks. The project cannot extend past the end of the Capstone class.

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Mostafa, L. S., Sabri, N. A., El-Anwar, A. M., & Shaheen, S. M. (2020). Evaluation of pharmacist-led educational interventions to reduce medication errors in emergency hospitals: a new insight into patient care. Journal of Public Health, 42(1), 169-174. Retrieved from https://academic.oup.com/jpubhealth/article/42/1/169/5273174	Schnock, K. O., Dykes, P. C., Albert, J., Ariosto, D., Cameron, C., Carroll, D. L., … & Husch, M. (2018). A Multi-hospital Before–After Observational Study Using a Point-Prevalence Approach with an Infusion Safety Intervention Bundle to Reduce Intravenous Medication Administration Errors. Drug safety, 41(6), 591-602. Retrieved from https://link.springer.com/article/10.1007/s40264-018-0637-3	Lapkin, S., Levett‐Jones, T., Chenoweth, L., & Johnson, M. (2016). The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews. Journal of nursing management, 24(7), 845-858. https://doi.org/10.1111/jonm.12390
How Does the Article Relate to the PICOT Question?	It provides insight into the importance of educational programs in addressing medication errors committed by nurses in hospital settings	The article shows that the introduction of educational interventions can be effective in preventing medicine administration errors in hospitals	The article shows that educational interventions are part of the strategies that can be adopted in the clinical settings to address the issue of medication errors.
Quantitative, Qualitative (How do you know?)	Quantitative. It was a prospective pre-post interventional research. Quantitative methods of data collection and analysis were used.	Quantitative. It was a pre and post observational study. Quantitative and qualitative methods of data analysis were used.	Quantitative. It was a quantitative systematic review of existing articles on the different strategies that can be utilized to prevent medication errors in healthcare
Purpose Statement	To examine the effect of pharmacist-led educational program in reducing medication errors committed by nurses in an emergency department	To determine the effectiveness of infusion safety educational bundle on medication errors	To investigate the effectiveness of interventions used to reduce medication administration errors
Research Question	What is the effect of pharmacist-led educational interventions on reducing medication errors in emergency hospital?	What is the effect of the infusion safety intervention bundle on medication administration errors?	What is the effectiveness of the interventions used to reduce medication administration errors?
Outcome	The outcome was a reduction in the medication errors in pre and post interventional groups	Reduction in medication administration errors and rates of harmful errors	The outcome of focus was the reduction of medication administration errors with the use of different strategies
Setting (Where did the study take place?)	Emergency hospital in Cairo, Egypt	Selected hospitals in the US	Not applicable since it was a systematic review
Sample	1024 patients in pre-interventional group and 1025 patients in post interventional group	418 patients during the pre-intervention period and 422 patients in the post intervention period	16 systematic reviews
Method	Nurses were trained on correct administration of medications. They were then assigned full responsibility of carrying out all the drug-related tasks such as medication administration.	The data was obtained during pre-intervention period, during intervention development, and after the intervention. Observation of the nurses while administering medications was done to identify any errors. The errors were used to develop infusion safety intervention that nurses were trained about its use in medication administration.	Methodological quality of the selected articles was done. The scores of the articles were computed using Assessment of Multiple Systematic Reviews. This allowed the characterization of the quality of each of the selected systematic review
Key Findings of the Study	The program resulted in the reduction in medication errors from 34.2% in the pre-intervention phase to 15.3% in the post-intervention group.	The error rates dropped from 146 per 100 medications to 123 per 100-medication administration. There a decline in the error rate from 39 to 29 in every 100 medication administrations.	The analyzed evidence revealed that combination of education as well as risk management strategies are effective in reducing the risk of medication errors
Recommend-ations of the Researcher	Educational intervention programs such as that used in this research is effective in reducing the severity as well as rate of medication administration errors.	Educational interventions can be utilized to develop policy guidelines to be used in preventing medication errors.	There is a need to explore the effectiveness of combining education and risk management strategies in the prevention of medication errors.
Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Rishoej, R. M., Lai Nielsen, H., Strzelec, S. M., Fritsdal Refer, J., Allermann Beck, S., Gramstrup, H. M., … & Almarsdóttir, A. B. (2018). Qualitative exploration of practices to prevent medication errors in neonatal intensive care units: a focus group study. Therapeutic advances in drug safety, 9(7), 343-353. doi: 10.1177/2042098618771541	Dyab, E. A., Elkalmi, R. M., Bux, S. H., & Jamshed, S. Q. (2018). Exploration of nurses’ knowledge, attitudes, and perceived barriers towards medication error reporting in a tertiary health care facility: A qualitative approach. Pharmacy, 6(4), 120. https://www.mdpi.com/2226-4787/6/4/120	Alharbi, W., Cleland, J., & Morrison, Z. (2019). Addressing medication errors in an adult oncology department in Saudi Arabia: A qualitative study. Saudi Pharmaceutical Journal, 27(5), 650-654. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598207/
How Does the Article Relate to the PICOT Question?	It shows the efficacy of utilizing educational programs in combination with other strategies in reducing medication errors	The article shows that nurses understand the existence of medical reporting errors in their practice. However, they face significant barriers that limit their ability to report them. Therefore, educational strategies should be utilized to raise their level of awareness and respond to issues related to medication errors.	It provides insights into the effectiveness of the different evidence-based strategies that can be used to prevent medication errors. The use of educational programs is among the interventions that was explored.
Quantitative, Qualitative (How do you know?)	Qualitative. This can be seen from its methods such as the use of focus groups.	Qualitative. Data methods such as inductive thematic analysis were used.	Qualitative. Data was collected using audio-taped focused group discussions.
Purpose Statement	To find out the current as well as future practices that can be used to prevent medication errors in neonatal intensive care units.	To explore the knowledge, perceived barriers, and attitudes of nurses towards error reporting in a tertiary health care facility	To find out the strategies that can be used to address medication errors in oncology department in Saudi Arabia
Research Question	What are the current and future practices utilized to prevent medication errors in neonatal intensive care units?	What are the nurses’ knowledge, perceived barriers, and attitudes towards error reporting in a tertiary health care facility	What strategies that can be used to address medication errors in oncology department in Saudi Arabia?
Outcome	Effect of the interventions on medication errors	Knowledge, attitude and barriers towards medical error reporting	Reduction in medication errors
Setting (Where did the study take place?)	Three neonatal ICUs in Denmark	Malaysia	Saudi Arabia
Sample	Physicians and nurses Missing population number	23 nurses	27 healthcare providers
Method	Focus group interviews were performed with physician and nurses. Thematic analysis of their information was done.	Semi-structured interviews were conducted and audio-taped for transcription and thematic analysis	A stratified purposive sampling was used to select the participants. The participants took part in focused group discussions that provided the data needed for the research. Thematic analysis of data was done using NVIVO pro software.
Key Findings of the Study	There exist several practices that can be utilized in preventing medication errors. However, future practices should focus on standardizing processes, training nurses and other care providers, and encouraging teamwork in the utilization of pharmacy services.	The nurses were aware of the existence of medical errors in reporting. However, they did not express them due to barriers such as workload and fear of investigation. therefore, there is a need for educational programs to stress the need for reporting harmless errors in medical error reporting.	Improving staff education, organizational support, and communication can help in reducing the risk of medication errors in the department.
Recommend-ations of the Researcher	Technical and non-technical approaches should be utilized to address the issue of medication errors in the clinical settings.	Educational support programs should be provided to address issues related to medication errors.	Multiple strategies, including the use of educational programs should be utilized to improve medication safety in oncology departments.

References

Alharbi, W., Cleland, J., & Morrison, Z. (2019). Addressing medication errors in an adult oncology department in Saudi Arabia: A qualitative study. Saudi Pharmaceutical Journal, 27(5), 650-654.

Dyab, E. A., Elkalmi, R. M., Bux, S. H., & Jamshed, S. Q. (2018). Exploration of nurses’ knowledge, attitudes, and perceived barriers towards medication error reporting in a tertiary health care facility: A qualitative approach. Pharmacy, 6(4), 120.

Lapkin, S., Levett‐Jones, T., Chenoweth, L., & Johnson, M. (2016). The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews. Journal of nursing management, 24(7), 845-858. https://doi.org/10.1111/jonm.12390

Mostafa, L. S., Sabri, N. A., El-Anwar, A. M., & Shaheen, S. M. (2020). Evaluation of pharmacist-led educational interventions to reduce medication errors in emergency hospitals: a new insight into patient care. Journal of Public Health, 42(1), 169-174.

Rishoej, R. M., Lai Nielsen, H., Strzelec, S. M., Fritsdal Refer, J., Allermann Beck, S., Gramstrup, H. M., … & Almarsdóttir, A. B. (2018). Qualitative exploration of practices to prevent medication errors in neonatal intensive care units: a focus group study. Therapeutic advances in drug safety, 9(7), 343-353. doi: 10.1177/2042098618771541

Schnock, K. O., Dykes, P. C., Albert, J., Ariosto, D., Cameron, C., Carroll, D. L., … & Husch, M. (2018). A Multi-hospital Before–After Observational Study Using a Point-Prevalence Approach with an Infusion Safety Intervention Bundle to Reduce Intravenous Medication Administration Errors. Drug safety, 41(6), 591-602. Retrieved from https://link.springer.com/article/10.1007/s40264-018-0637-3

Sample Answer 4 for NRS 433 PICOT Question and Literature Search SOLUTION

Summary of Clinical Issue

The clinical issue identified is hospital acquired infection. There is a growing concern about hospital acquired infection (HAI). This is an infection that a patient contracts while staying in the hospital for another condition. HAIs can cause serious complications and even death. The Centers for Disease Control and Prevention (CDC) estimates that there are one million HAIs in the US each year. This is a serious clinical issue that needs to be addressed. One of the most important things that hospitals can do to reduce the risk of HAIs is to encourage patients and their families to practice good hand hygiene. Everyone who enters a patient’s room should wash their hands with soap and water or use an alcohol-based hand sanitizer. Hospital acquired infections (HAIs) are a significant problem in the United States healthcare system, and they can have a serious impact on the quality of care that patients receive. HAIs are infections that patients acquire while they are hospitalized, and they can be caused by a variety of different pathogens, including bacteria, viruses, and fungi. HAIs can cause a wide range of symptoms in patients, from mild respiratory illnesses to life-threatening sepsis. HAIs are a leading cause of death in hospitalized patients in the United States, and they account for billions of dollars in healthcare costs each year. In addition, HAIs can often delay the recovery of patients and increase their risk of hospital readmission.

PICOT Question: In critically ill patients, does using a daily chlorhexidine bath prevent acquisition of methicillin-resistant Staphylococcus aureus (MRSA) within 30 days?

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Schuetz, C. R., Hogan, P. G., Reich, P. J., Halili, S., Wiseman, H. E., Boyle, M. G., … & Fritz, S. A. (2021). Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates. Journal of Perinatology, 41(6), 1285-1292. Permalink: https://www.nature.com/articles/s41372-021-00944-8	Lowe, C. F., Lloyd-Smith, E., Sidhu, B., Ritchie, G., Sharma, A., Jang, W., … & Romney, M. G. (2017). Reduction in hospital-associated methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus with daily chlorhexidine gluconate bathing for medical inpatients. American journal of infection control, 45(3), 255-259. Permalink: https://doi.org/10.1016/j.ajic.2016.09.019	Pratt, N., Heishman, C., Blizard, K., & Cissell, J. (2022). Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus Aureus Hospital-acquired Infections in Critical Patients. American Journal of Infection Control, 50(7), S31. Permalink: https://doi.org/10.1016/j.ajic.2022.03.048
How Does the Article Relate to the PICOT Question?	The article analyzes factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized among critically ill neonates. The information provided in this article is critical in answering different aspects of the PICOT question.	The article address a conflicting evidence on the efficacy of using a daily chlorhexidine bath to prevent acquisition of methicillin-resistant infections. Some studies suggest that daily bathing with chlorhexidine can reduce the rate of these infections, while others have found no significant difference. This information can be applied in answering different aspects of the PICOT question and to address the clinical issue under consideration.	This article relate to the PICOT question because it analyzes the intervention That have been defined in the PICOT. The Intervention is; The application of Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus.
Quantitative, Qualitative (How do you know?)	This article is quantitative. There is the application of primary numerical data to determine research outcomes.	This is a quantitative; there is the application of quantitative deign and the primary data to determine address the research objectives.	This article is quantitative. There is the application of inferential statistical approaches such as t-test to analyze the Numerical data that have been collected.
Purpose Statement	To find out what causes symptomatic contamination in newborns with methicillin-resistant Staphylococcus aureus (MRSA) colonization in the neonatal intensive care unit (NICU)	To ascertain whether daily washing for CHG on inpatient medical units reduced MRSA and VRE hospital-associated infections	This study’s objective was to assess the efficiency of a general decolonization approach in a significant academic medical center’s critical care population.
Research Question	What are some of the factors that cause symptomatic contamination in newborns with methicillin-resistant Staphylococcus aureus (MRSA) colonization in the neonatal intensive care unit?	Does daily washing for CHG on inpatient medical units reduced MRSA and VRE hospital-associated infections?	Does bathing in chlorhexidine gluconate [CHG] and using an alcohol-based nasal decolonization agent help minimize hospital-acquired laboratory-identified (LabID) Blood infections caused by methicillin-resistant Staphylococcus aureus?
Outcome	Critically ill neonates were found to have a significantly higher risk of progression to infection than those who were not colonized by the bacteria (Schuetz et al., 2021).	From the study, there is evidence that daily chlorhexidine gluconate (CHG) bathing can reduce the incidence of hospital-associated methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) (Lowe et al., 2017).	Alcohol-based nasal decolonization and chlorhexidine bathing have both been shown to significantly reduce methicillin-resistant Staphylococcus aureus (MRSA) hospital-acquired infections in critical care units.
Setting (Where did the study take place?)	The study was conducted at St. Louis Children’s Hospital’s NICU.	A Canadian academic hospital’s four medical inpatient units were used for the investigation.	The study was conducted in the intensive Care units
Sample	The sample size used was 168. In other words, there were 168 neonates considered in the study.	The sample size used was 10,000	The sample size used in the study was 421. In other words, there was consideration of 421 patients in the ICU.
Method	case-control study design was used in the study	A prospective crossover method was applied in the study.	This was a cohort study where there was a Follow-up.
Key Findings of the Study	According to the study, the following factors are associated with progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) – colonized, critically ill neonates: – gestational age <37 weeks – birth weight <1,500 grams – mechanical ventilation for >48 hours – history of MRSA colonization or infection – receipt of total parenteral nutrition (TPN) for >14 days – concurrent diagnosis of necrotizing enterocolitis (NEC) or sepsis. Also, Critically ill neonates were found to have a significantly higher risk of progression to infection than those who were not colonized by the bacteria.	The study found that CHG bathing was associated with a 69% reduction in MRSA infections and a 37% reduction in VRE infections. CHG bathing is thought to work by reducing the skin colonization by these bacteria.	Chlorhexidine has a broad-spectrum of antibacterial activity and is effective against both gram-positive and gram-negative bacteria. It is also highly effective against MRSA, making it an ideal agent for use in preventing hospital-acquired infections. Alcohol-based nasal decolonization involves rinsing the nose with a 70% ethanol solution three times per day for 5 days (Pratt et al., 2022). From the study, Decolonization techniques have been linked in the literature to better results and a decrease in MRSA infections.
Recommendations of the Researcher	In critically ill colonized babies, the emergence of symptomatic MRSA infection is complex. Undeveloped skin and mucous membrane barriers can serve as points of entry for colonization that leads to symptomatic illness.	On inpatient medical units, daily bathing for CHG is useful in lowering MRSA and VRE that are connected to the hospital.	It is thought that the increased effectiveness of chlorhexidine bathing is due to its ability to remain on the skin for longer periods of time, as well as its ability to penetrate into hair follicles and other hidden areas where bacteria can reside.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Bail, K., Willis, E., Henderson, J., Blackman, I., Verrall, C., & Roderick, A. (2021). Missed infection control care and healthcare associated infections: A qualitative study. Collegian, 28(4), 393-399. Permalink: https://doi.org/10.1111/jan.14909	Lowe, H., Woodd, S., Lange, I. L., Janjanin, S., Barnett, J., & Graham, W. (2021). Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study. Conflict and Health, 15(1), 1-10. Permalink: https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-021-00428-8	Mann, M., Wright, C. H., Jella, T., Labak, C. M., Shammassian, B., Srivatsa, S., … & Selman, W. (2021). Cranial Surgical Site Infection Interventions and Prevention Bundles: A Systematic Review of the Literature. World neurosurgery, 148, 206-219. ttps://doi.org/10.1016/j.wneu.2020.12.137
How Does the Article Relate to the PICOT Question?	The study focuses on the healthcare associated infections and their controls which is the main clinical issues under consideration. The article can therefore be applied in addressing different aspects of the PICOT question.	The article dwells on the opportunities and challenges for the infection prevention and control in conflict affected healthcare settings. This relates to the clinical issue under consideration and different aspects of the PICOT question.	The study’s findings support the PICOT Questions. In other word, the findings helps In the understanding of different aspects of the PICOT question.
Quantitative, Qualitative (How do you know?)	The article is qualitative; there is the application of published literature review and different secondary data to answer the research question.	This article is qualitative, which means that it addresses the research questions and research objectives using published literature reviews and their main studies.	This article is qualitative, there is the application of Published literature reviews to determine study’s findings.
Purpose Statement	The purpose of this article is to Investigate nurse perceptions of missed infection control.	To determine challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings.	Identifying and describing therapies or bundled interventions aiming at lowering the prevalence of cranial surgical site infections was the goal of the study.
Research Question	How does nurses perceive missed infection control in healthcare settings?	What are some of the challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings?	What are some of the therapies or bundled Interventions aim at lowering the prevalence of cranial surgical site infections?
Outcome	Both at the organizational and individual clinician levels, infection control care is neglected. Neither standard safeguards nor fundamental caregiving tasks were performed, according to nurses.	The study found the following challenges and opportunities for infection prevention and control: Challenges: -Lack of resources, including personnel, supplies, and infrastructure -Inadequate training for healthcare workers -Poor hygiene and sanitation practices -Limited access to laboratory services for diagnosis and surveillance Opportunities: -Creating or reinforcing national policies and standards for infection prevention and control -Providing training on infection prevention and control for healthcare workers at all levels of care -Improving hygiene and sanitation practices through education and provision of supplies and infrastructure support -Strengthening epidemiological surveillance systems.	The results of this study showed that there is moderate evidence for the effectiveness of chlorhexidine sponge dressing and silver impregnated dressings in reducing the incidence of SSI. There is also low evidence for the use of Snoop nasal packing, oral antibiotics, door-to-door interventions, or negative pressure wound therapy in reducing SSI incidence.
Setting (Where did the study take place?)	The study was undertaken in different healthcare organizations in the United States.	The study was conducted in hospitals within conflicts-affected countries including Mali, Nigeria, and Lebanon.	The study was conducted in clinical settings.
Sample	The sample size used was 11. In other word, 11 infection control nurse experts were interviewed.	The sample size used was 9. ü 3 program managers ü 2 hospital administrators ü 2 head nurses ü 1 theatre nurse ü 1 ward nurse	The sample size used was 21. There were 21 literature sources where the information was drawn
Method	Qualitative in-depth interviews approach was applied.	Semi-structured interviews were used in the study.	A systematic review was used in line With the PRISMA approach
Key Findings of the Study	From the article, it is clear that missed infection control care and healthcare associated infections are major problems in the healthcare industry. There are a number of factors that contribute to this problem, including understaffing, lack of resources, and insufficient training (Bail et al., 2021).	Hospitals in conflict-affected settings face a number of challenges when it comes to infection prevention and control. One of the biggest challenges is the lack of access to safe water and sanitation facilities. This can lead to serious outbreaks of waterborne diseases, such as cholera. In addition, there is often a shortage of trained staff, supplies and equipment. This can make it difficult to implement infection control measures effectively. Another challenge is violence against healthcare workers (Lowe et al., 2021). This can result in staff shortages, as well as difficulty in accessing or providing care. Finally, people displaced by conflict often have limited access to healthcare services. This can create a significant burden on hospitals, which are often already struggling with overcrowding and scarce resources.	ü There is moderate evidence for the effectiveness of chlorhexidine sponge dressing and silver impregnated dressings in reducing the incidence of SSI (Mann et al., 2021) ü There is also low evidence for the use of Snoop nasal packing, oral antibiotics, door-to-door interventions, or negative pressure wound therapy in reducing SSI incidence.
Recommendations of the Researcher	It is essential that healthcare facilities take steps to ensure that infection control measures are followed consistently and effectively. This includes providing adequate staffing levels, ensuring staff are properly trained in infection control procedures, and having sufficient resources available. Failure to do so puts patients at risk of potentially life-threatening infections.	Clearly, addressing challenges and opportunities for infection prevention and control is crucial in these types of settings. Hospitals need to be able to properly triage patients, have adequate supplies of clean water and disinfectants, implement safe injection practices, and train staff on infection prevention and control measures.	Various approaches to preventing SSIs have been successful in reducing infection rates, especially when multiple Bundles were implemented together. The most effective bundles were found to include measures such as video monitoring of incisions, tighter control of blood sugar levels during and after surgery, using chlorhexidine for skin preparation prior to surgery,

Conclusion

References

Bail, K., Willis, E., Henderson, J., Blackman, I., Verrall, C., & Roderick, A. (2021). Missed infection control care and healthcare associated infections: A qualitative study. Collegian, 28(4), 393-399. https://doi.org/10.1111/jan.14909

Lowe, C. F., Lloyd-Smith, E., Sidhu, B., Ritchie, G., Sharma, A., Jang, W., … & Romney, M. G. (2017). Reduction in hospital-associated methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus with daily chlorhexidine gluconate bathing for medical inpatients. American journal of infection control, 45(3), 255-259. https://doi.org/10.1016/j.ajic.2016.09.019

Lowe, H., Woodd, S., Lange, I. L., Janjanin, S., Barnett, J., & Graham, W. (2021). Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study. Conflict and Health, 15(1), 1-10. https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-021-00428-8

Mann, M., Wright, C. H., Jella, T., Labak, C. M., Shammassian, B., Srivatsa, S., … & Selman, W. (2021). Cranial Surgical Site Infection Interventions and Prevention Bundles: A Systematic Review of the Literature. World neurosurgery, 148, 206-219. ttps://doi.org/10.1016/j.wneu.2020.12.137

Pratt, N., Heishman, C., Blizard, K., & Cissell, J. (2022). Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus Aureus Hospital-acquired Infections in Critical Patients. American Journal of Infection Control, 50(7), S31. https://doi.org/10.1016/j.ajic.2022.03.048

Schuetz, C. R., Hogan, P. G., Reich, P. J., Halili, S., Wiseman, H. E., Boyle, M. G., … & Fritz, S. A. (2021). Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates. Journal of Perinatology, 41(6), 1285-1292. https://www.nature.com/articles/s41372-021-00944-8