NUR 590 Discussion Nursing practices influence the risks for CAUTIs among the patients in ICU
NUR 590 Discussion Nursing practices influence the risks for CAUTIs among the patients in ICU
Nursing practices influence the risks for CAUTIs among the patients in ICU. Therefore, there is need to develop evidence-based practices that will help reduce the burden of CAUTIs among the patients on catheters. The current study appraises the various sources providing recommendations on the best practices to reduce CAUTIs.
Mascret, et al. studied older adults on their acceptance level of a virtual reality headset to determine if this type of technology could be useful in fall prevention. A link for the study is here: https://www.jmir.org/2020/12/e20691/ . The study sample included 271 men and women over the age of 65 who were able to walk independently and had never used the virtual reality headset before. They were given information about the headset. Researchers questioned perceived usefulness, ease of use, and enjoyment using a Likert scale of 1 (strongly disagree) to 5 (strongly agree). This scale is valid as it tests the participants’ opinions toward the device. It may lack reliability as participants may be inclined to give a higher score to appear accepting of technologies (Mascret, et al., 2020). The researchers tested reliability using McDonald omegas, a statistical technique that checks reliability. Participants were also asked to rate their confidence to perform daily tasks without falling and physical activity goals toward fall prevention using similar scales. Participants were found to have less acceptance of the device if they were more confident in daily activities. Participants who had personal goals toward increased physical ability were more likely to accept the headset. All results were self-reported, but the scales remained consistent throughout the testing.
Evaluation Table
| Full APA formatted citation of selected article. | Article #1 | Article #2 | Article #3 | Article #4 |
| Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infections: a pre-post control intervention study. BMC Health Services, 17(314). doi: 10.1186/s12913-017-2268-2. | Ferguson, A. (2018). Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursing,38(6), 273–302. DOI: 10.7257/1053-816X.2018.38.6.273. | Scanlon, K. A. (2017). Saving Lives and Reducing Harm: A CAUTI Reductions Program. Nursing Economics, 35(3):134-141. | Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., Canini, S. R. M. da S., Bakir., M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patient through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheter: A quasi-experimental study. Medicine. 98(8). DOI: 10.1097/MD.0000000000014417 | |
| Evidence Level *
(I, II, or III)
|
II | II | I | I |
| Conceptual Framework
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).** |
No theoretical framework mentioned in the text. | No theoretical or conceptual framework defined. | The study was based on the dry bag Concept”, innovative modifications and root cause analysis concept. | No theoretical framework indicated |
| Design/Method
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). |
The study used the multiple pre-post control intervention design based on the phased mixed method. The sample population included four acute care hospitals from the two Health Districts in NSW. The point data were collected from all the adult inpatient wards in the hospital. | The study involved the use of survey design to assess the effects of offering on-time educational program to enhance nurses’ knowledge about CAUTIs. | The study involved quantitative measures in determining the overall success of standardized infection ratio, rations and catheter days in intensive care unit and non-critical areas in the facility | The study involved a quasi-experimental study conducted in an intensive care unit of hospital for over 12 years. |
| Sample/Setting
The number and characteristics of patients, attrition rate, etc. |
The sample used in the study were obtained from the acute care hospital. A total of 500 patients per Health District were targeted. | The sample population included two units in a 393-bed acute care facility and a total of 59 nurses completed the education program in three months-term | The study was conducted in non-ICU setting. | The study was conducted in the intensive care unit setting. Sample size not defined |
| Major Variables Studied
List and define dependent and independent variables |
The dependent variable was the catheter-associated urinary tract infections (CAUTI) while the dependent variable was appropriate urinary catheter insertion practices. | The dependent variable was education on CUATIs prevention while the independent variable was CAUTIs risk. | The dependent variable was risk for CAUTIs while independent variables included the interventions developed such as standardized infection ratio, rations and catheter days in intensive care unit and non-critical areas in the facility | The independent variables included healthcare workers (HCWs) educational program and a daily checklist for indwelling urinary catheter indications. The dependent variable included CAUTIs. |
| Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done). |
Descriptive statistics were used to determine the trends in the CAUTIs. | Descriptive statistics were used to compare the outcomes before and after the intervention. | The study involved the use of descriptive statistics. | Descriptive statistics were used in the study. |
| Data Analysis Statistical or
Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data). |
No actual data indicated. | The mean value for the knowledge on institutional policies before and after the interventions were 9.71 and 12.3 respectively. Mean for the method to prevent catheter-related infections were 4.59 and 5.24 respectively. | The CAUTIs reduced by h, 2015 reduced by 57% with a SIR of .67, following the intervention. | The study reports that the urinary catheter utilization decreased from phase I to phase IV (73.1%, 74.1%, 54.9%, and 45.6%, respectively). The rate of CAUTI decreased from phase I to phase IV (14.9, 7.3, 3.8, and 1.1 per 1000 catheter-days, respectively |
| Findings and Recommendations
General findings and recommendations of the research |
The study findings indicated that regular evaluation in the clinical practices can significantly help in reducing the burden on CAUTIs. | The study recommends the provision of education to the nurses on CAUTIs prevention. | Healthcare institution should consciously develop measures to minimize CAUTIs. | Providing education to healthcare workers on CAUTIs prevention can be implemented to address the high burden of infections among patients in ICU. |
| Appraisal and Study Quality
Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice? |
The strength of the study is that it used a multifaceted approach where the intervention focused on mixed methods to provide the answer to the research question.
On the other hand, the main weakness in the study is that it fails to provide statistical evidence to the effectiveness of the improvement protocols developed in the hospitals. The findings from the study be supplemented with the results from other study. |
The study’s strength is that it includes a multifaceted nature, interactive program that is consistent with literature on evidence-based care practice. On the other hand, the weakness is that the sample population was not adequate to provide data to be inferred to the general population.
The study findings are feasible and can be used to address CAUTIs issues in hospitals. |
The main strength in the article is that it provides data to show the effectiveness of developing and transferring best practices in all areas of care in the facility, especially in critical. On the other hand, the main weakness is that the study does not define the sample population characteristics.
Findings from the study are feasible and can be used in clinical practice. |
The study has strengths as it was carried out for over ten years and so provides tested and verified results. On the other hand, the weakness is that the study does not provides the approaches used in monitoring the practices in the ICU unit.
Findings from the study are reliable and feasible for clinical practice. |
|
Key findings
|
The critical care nurses can reduce CAUTIs by understanding the effects of indwelling catheters and catheterization. | Education can help reduce the burden of CAUTIs in hospitals. | Continuous education on infection prevention reduces the risk for CAUTIs. | Healthcare workers (HCWs) educational program and a daily checklist for indwelling urinary catheter indications reduced the risk of CAUTIs. |
| Outcomes
|
Reduced CAUTIs | Improved level of knowledge on CAUTIs prevention | Risk for CAUTIs | Risk for CAUTIs |
| General Notes/Comments | Healthcare facilities should engage continuous quality improvement process. | Healthcare facilities should have standard measures to prevent CAUTIs. | The study indicates that generation of data is a critical aspect of improving overall patient delivery and safety, especially in infection control. | The study indicates that effective programs over a duration provides a comprehensive outlook of the benefits of safety interventions focused on improving quality of care delivered to patients. |
Part 3
The burden presented by CAUTIs among the patients in the intensive care units cannot be underestimated. Therefore, healthcare institutions should be deliberate in providing quality improvement and safety protocols for the healthcare workers in the units. The review of literature indicates the need to provide continuous education to the healthcare providers and ensuring that they promote the safety of their patients and minimize the risks of CAUTIs transmission. The role of education in reducing the burden of CAUTIs among the patients in ICU was highly emphasized (Ferguson, 2018).
The education should be provided continuously to the healthcare provider to increase their level of consciousness in promoting safety during the catheter insertion. Besides, the regular insertions and prolonged stay of the catheters were also associated with increased risk for infection. The findings from the studies provide relevant guidelines that can be implemented to promote safe treatment environment for the patients in needs of catheter insertion and they are supported by Durant (2017). It is apparent that some of the healthcare providers are not aware of the safety measures needed for the ICU practice and so may predispose the patients to CAUTIs by failing to observe the aseptic measures.
Finally, the results from the analysis are essential and can be used to promote safety in the ICU departments. The risk for CAUTIs is high among the patients with prolonged catheterizations (Carr, 2017). Therefore, the nurses and healthcare providers must observe aseptic protocols. However, such can only be effective with standardized protocols and procedures for ICU nursing practice.
Conclusion
CAUTIs are significant factors in the delivery of healthcare. Several studies have analyzed the interventions that could help facilities to address them. There is a consensus amongst the studies that education of healthcare providers will play a fundamental role in reducing the incidences of CAUTIs in facilities.
References
Carr, A. N. (2017). CAUTI Prevention: Streaming Quality Care in a Progressive Care Unit. Medsurg Nursing, 26(5).
Durant, D. J. (2017). Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: a systematic review. American journal of infection control, 45(12), 1331-1341. https://doi.org/10.1016/j.ajic.2017.07.020
Ferguson, A. (2018). Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursing, 38(6). DOI: 10.7257/1053-816X.2018.38.6.273.
Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., Canini, S. R. M. da S., Bakir., M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patient through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheter: A quasi-experimental study. Medicine. 98(8). DOI: 10.1097/MD.0000000000014417
Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infections: a pre-post control intervention study. BMC Health Services, 17(314). doi: 10.1186/s12913-017-2268-2.
Scanlon, K. A. (2017). Saving Lives and Reducing Harm: A CAUTI Reductions Program. Nursing Economics, 35(3):134-141.
Topic 4 DQ 1
Description:
Distinguish between reliability and validity in research design. Using a translational research article from your graphic organizer, analyze the methods and results sections to discuss reliability and validity as it relates to the translational research. Include the permalink to the article in your reference.
Topic 4 DQ 2
Description:
Identify a data collection tool you could use for your research. Consider how you could employ translational research to potentially overcome barriers, which may arise during data collection. Identify the best type of translational research to address this barrier and provide rationale for the type you have chosen. What strategies would you employ to provide an understanding of your chosen type of translational research and to gather collaborative support?
Topic 4 Participation
Topic 4: Critical Appraisal of Research
Description
Objectives:
- Distinguish between reliability and validity in research design.
2. Analyze the reliability and validity of methods and results in a translational research article.
3. Describe strategies to maintain the integrity of translational research.
4. Discuss challenges of research design and data collections.
Study Materials
Population Health: Creating a Culture of Wellness
Description:
Read Chapters 1 and 6 in Population Health: Creating a Culture of Wellness.
Evidence-Based Practice in Nursing and Healthcare
Description:
Read Chapters 5 and 6 in Evidence-Based Practice in Nursing and Healthcare.
Work as an Inclusive Part of Population Health Inequities Research and Prevention
Description:
Read “Work as an Inclusive Part of Population Health Inequities Research and Prevention,” by Ahonen et al., from American Journal of Public Health(2018).
Aligning Evidence-Based Practice With Translational Research: Opportunities for Clinical Practice Research
Description:
Read “Aligning Evidence-Based Practice With Translational Research: Opportunities for Clinical Practice Research,” by Weiss et al., from JONA: The Journal of Nursing Administration (2018).
Environmental Health Sciences in a Translational Research Framework: More than Benches and Bedsides
Description:
Read “Environmental Health Sciences in a Translational Research Framework: More than Benches and Bedsides,” by Kaufman and Curl, from Environmental Health Perspectives (2019).
Scoping Implementation Science for the Beginner: Locating Yourself on the “Subway Line” of Translational Research
Description:
Read “Scoping Implementation Science for the Beginner: Locating Yourself on the ‘Subway Line’ of Translational Research,” by Lane-Fall, Curran, and Beidas, from BMC Medical Research Methodology (2019).
Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Benchmark – Evidence-Based Practice Project: PICOT Paper 150.0
Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 70.0%
Population Demographics and Health Concerns 5.0% The demographics and health concerns for the population are not described. The demographics and health concerns for the population are incorrect or only partially described. The demographics and health concerns for the population are summarized. More information and supporting evidence are needed. The demographics and health concerns for the population are described using sufficient evidence. The demographics and health concerns for the population are accurate and thoroughly described using substantial evidence.
Proposed Evidence-Based Intervention 13.0% The proposed evidence-based intervention is omitted. The proposed evidence-based intervention is incomplete. It is unclear how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus. The proposed evidence-based intervention is outlined. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is general. Some aspects are unclear. More information is needed. The proposed evidence-based intervention is described. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is adequate. Some detail is needed for clarity or accuracy. The proposed evidence-based intervention is well-developed and clearly described. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is thorough.
Comparison of Intervention to Current Research 12.0% Comparison of intervention to previous practice or research is omitted. Comparison of intervention to previous practice or research is incomplete. Comparison of intervention to previous practice or research is generally presented. Some areas are vague. Comparison of intervention to previous practice or research is adequately presented. Comparison of intervention to previous practice or research is thorough and clearly presented.
Expected Outcome for Intervention 10.0% The expected outcome is for the intervention is omitted. The expected outcome is for the intervention is incomplete. The expected outcome is for the intervention is summarized. More information and supporting evidence is needed. The expected outcome for the intervention is explained using sufficient evidence. The expected outcome for the intervention is thoroughly explained using substantial evidence.
Time Estimated for Implementing Intervention and Evaluating Outcome 10.0% A description of the timeline is not included. A description of the timeline is incomplete or incorrect. A description of the timeline is included but lacks evidence. A description of the timelines is complete and includes a sufficient amount of evidence. A description of the timeline is extremely thorough with substantial evidence.
Support for Population Health Management for Selected Population (C 4.1) 10.0% Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is omitted. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is incomplete. There are major inaccuracies. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is summarized. More information and support are needed. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is adequate. Some detail is needed for accuracy or clarity. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is thorough. The narrative is insightful and demonstrates an understanding of how the various aspects contribute to population health management for selected populations.
Appendix 5.0% The appendix and required resources are omitted. The APA Writing Checklist and PICOT are attached, but an appendix has not been created. The paper does not reflect the use of the APA Writing Checklist during development. The APA Writing Checklist and PICOT are attached in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality. The APA Writing Checklist and PICOT are attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper. The APA Writing Checklist and PICOT are attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development. Benchmark – Evidence-Based Practice Project: PICOT Paper NUR 550
Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.
Organization and Effectiveness 20.0%
Thesis Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from.
The article by Rankin et al., (2018) was selected for this assignment. The research focused on human experiences within a natural setting. The phenomenon was the barriers and facilitators to taking self-management of diabetes in pre-adolescent children suffering from diabetes type 1. The researchers conducted interviews in the doctor’s office where the participants were encouraged to share their experiences related to self-management tasks related to diabetes type 1. The study was conducted in the natural setting of the participants in that data was obtained in their usual environment. There was also the use of simulations such as drawing to increase the depth of the information that was obtained in the study.
The phenomenon under investigation in the research by Rankin et al., (2018) is relevant to nursing. It explores the patient-related factors that influence the utilization of self-care tasks in the management of diabetes. It also provides insights into the barriers and enablers to the use of self-care tasks by pre-adolescents for the management of diabetes. The information from the article enables nurses and other healthcare providers to identify effective interventions that can enhance the utilization of self-care management techniques in pre-adolescents with diabetes.
Structuring the Study
The research by Rankin et al., (2018) did not explicitly state the research question. However, it can be inferred from the aim of the research to have been; what are the barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes? It can be seen from this question that the researchers specified the distinct process that was under investigation. They identified the focus of the study to be on the perceived barriers and facilitators by the participants. The study also identified the context of the research. It can be seen from the research question that the study targeted pre-adolescents with diabetes mellitus type 1. It also identified the nature of tasks that the target population are expected to engage in the management of diabetes mellitus type 1. Accordingly, the researchers were interested in the self-management tasks for diabetes mellitus type 1. The choice of qualitative method that was utilized in the selected study fitted with the research question. As seen in the study by Rankin et al., (2018), its main aim was to identify barriers and facilitators to self-management tasks for diabetes type 1 in pre-adolescents. The barriers and facilitators could only be identified through unstructured interviews that enabled the participants to express their experiences in detail. The approach to data analysis such as inductive, thematic approach was also appropriate due to its ability to provide a generalized view of the experiences of the participants.
Researchers Perspectives and Sample Selection
The biases of the researchers were reported. They included the use of a homogenous sample and small sample size. The researchers concluded that these factors are likely to influence the reliability, generalizability, and dependability of the reported findings. The researchers also provided structure of ideas that reflected their beliefs. For example, they expressed the fact that the incorporation of health information technologies into self-management tasks would address some of the barriers that were identified in the research. It can also be seen in the study that the sample selection utilized by the researchers lives in the phenomenon of interest. The participants were selected based on an inclusion criterion, which included being on treatment due to diabetes mellitus type 1 and willingness to participate in the research.
Data Collection
The methods of data collection that were utilized in the study by Rankin et al., (2018) were stated clearly. They included the use of unstructured interviews where participatory activities were utilized to prompt discussions. The interviews lasted for an average of 45 minutes and were digitally recorded and transcribed in entirety. There is the evidence that participant consent was an integral part of the data collection process. The parents or guardians and pre-adolescents were given consent forms to demonstrate their voluntary participation in the research.
Data Analysis
The dimensions of data analysis that were utilized in the research by Rankin et al., (2018) can be identified and followed logically. They included data analysis by two analysts, independent data analysis that was followed by joint discussions, development of a coding framework, and thematic analysis using NVIVO software. The researchers painted a clear picture of the participants’ reality. They used direct quotations of their descriptions to increase the readers’ understanding of these experiences. The interpretation of the researchers also captured the meaning of the participants. They utilized the data to come up with shared meanings by the participants concerning their subjective barriers and facilitators on self-management tasks in diabetes. The interpretation of the interpretation of the researchers was however not confirmed by other professionals.
Describing the Findings
The researchers provided an explicit analysis of their findings. They provided themes that represented the shared meanings of the participants’ experiences. They also gave examples of the direct quotations of the participants’ narratives about their experiences. They also compared the different subjective experiences to increase the understanding of the readers concerning the experiences. The researchers linked their findings to existing literature. There was an extensive analysis of the similarities and differences in the findings in the study and those reported by other scholars. This analysis provided insights into areas of further research on the topic.
References
Rankin, D., Harden, J., Barnard, K., Bath, L., Noyes, K., Stephen, J., & Lawton, J. (2018). Barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes: a qualitative study. BMC endocrine disorders, 18(1), 1-9.