Research Critiques and PICOT Statement Essay Paper.

Hospital-acquired infections (HAIs) affect many inpatients in hospitals across the US. HAIs are caused by bacterial, fungal, and viral pathogens that are mostly spread within the healthcare setting. Examples of HAI’s are urinary tract infections (UTIs), catheter-associated UTIs, Bloodstream infections (BPIs), surgical site infections among others (Al-Tawfiq & Tambyah, 2014).Research Critiques and PICOT Statement Essay Paper.

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These infections contribute significantly to disease burden and mortality. HAIs can be managed using hygienic interventions such as handwashing using soap and running water or alcohol-based sanitizers. However, more research still needs to be done, in order to develop more robust interventions for curbing HAIs. In this paper, we develop a PICOT question that guides our analysis of various research articles on HAIS as well as their significance in nursing practice.Research Critiques and PICOT Statement Essay Paper.

PICOT Question 

For this study, we developed the following appropriate PICOT question.

In acute care inpatients (P), does hand hygiene (I) compared to no intervention (C) reduce the rate of hospital-acquired infections (O) within 6 months (T)?

Our focus is on acute care patients admitted to hospitals. Inpatients are at higher risk of developing HAI’s due to the longer periods that they spend in hospital. Hand washing is the most basic hygienic strategy that can reduce the transfer of pathogens causing HAIs. Although there are other interventions such as proper ventilation and regular disinfection of surfaces, we decided to stick with hand washing since it is the most basic. Our goal is to find out whether hand washing would reduce the rate of HAIs qt the hospital within 6 months.Research Critiques and PICOT Statement Essay Paper.

Research Critiques

To identify the best evidence, it is important to critique the research studies to see if they are useful and produce sufficient quality to be applied in practice (LoBiondo-Wood & Wood, 2014). For this study, we investigated two qualitative articles (Herbeć et al., 2020; Staniford & Schmidtke, 2020) and two quantitative articles (Haverstick et al., 2017; Nekkab et al., 2017). The articles were selected based on how they align with the PICOT question.Research Critiques and PICOT Statement Essay Paper.

Both qualitative studies focused on how hygiene practices including handwashing can help to reduce the rate of infections among children. Herbeć et al. (2020) focused the attention of their study on neonates while Staniford and Schmidtke (2020), investigated the importance of handwashing on children as a general group. Herbec and colleagues (2020), conducted their study in a low-income setting (Zimbabwe) and hence purposed to show how alternative and cheaper means of hygienic can be applied by doctors and patients in the hospitals to reduce HAIs among neonates. The study by Herbeć et al. Research Critiques and PICOT Statement Essay Paper.(2020) was based on interviews and ethnographic observations to get the desired results. Staniford and Schmidtke (2020), sought to explore previous publications on behavior change interventions designed to increase hand hygiene and environmental disinfecting. Both studies were significant in that they showed that hand hygiene is crucial in reducing the incidences of HAIs in healthcare settings.Research Critiques and PICOT Statement Essay Paper.

Furthermore, we investigated two quantitative studies. The study by Haverstick et al. (2017) was based on the question, whether hand washing reduces HAIs in healthcare environments.  Haverstick et al. (2017) identify hand hygiene as an important practice for preventing HAI. However, Haverstick and his colleagues focused on handwashing among medical personnel. Medical personnel may transmit pathogens from one patient to the other given that they handle multiple cases. Yet, Nekkab et al. Research Critiques and PICOT Statement Essay Paper.(2017) note that multi-drug resistant organisms have become a concern in the health care industry owing to the difficulty in eliminating the organisms once an infection occurs. The presence of these organisms creates concerns about HAI with the potential for epidemic spread. Research Critiques and PICOT Statement Essay Paper.Also, it notes that this is not a concern for a single hospital facility and is in fact a concern for whole networks since it is not uncommon for patients to be transferred between medical facilities. Hence, Nekkab et al. (2017) et al investigated how HAIs can be transferred from one healthcare facility to the other thus affecting wider populations. The two quantitative studies provided practical evidence that reinforces the findings of qualitative studies.Research Critiques and PICOT Statement Essay Paper.

The reviewed articles support the nursing issue of HAI to a big extent. Nurses operate in a wide range of environments. While working in remote areas where access to expensive means of reducing the risk of HAIs is limited nurses can use soap and water as shown by Herbeć et al. (2020).Research Critiques and PICOT Statement Essay Paper. Neonates and generally children usually have lower immunity. Hence these groups of patients are susceptible to HAIs (Hassan et al., 2017). The qualitative results focus on children, which is a lesson that pediatric nurses can learn from in order to protect themselves and their patients. Haverstick et al. (2017), suggests that handwashing among practicing medical professions including nurses is necessary to prevent the spread of HAIs. The risk of HAIs is a concern for a network of hospitals (Nekkab et al., 2017).Research Critiques and PICOT Statement Essay Paper. Therefore, while transferring patients to other healthcare facilities nurses are mandated to maintain high standards of hygiene including handwashing to reduce the risk of HAIs in the second hospital. Therefore, all the studies are highly relevant to the nursing issue identified by the PICOT question.Research Critiques and PICOT Statement Essay Paper.

Methods of Studies

The reviewed articles were based on either qualitative or quantitative methods. Herbeć et al. (2020) used qualitative methods of interviews and ethnographic observations involving a total of 15 participants (4 physicians, 4 general nurses, 6 midwives, and 1 cleaner). On the other end, Stanford and colleagues conducted non-statistic reviews of past research articles. Haverstick et al. Research Critiques and PICOT Statement Essay Paper.(2017), used a quantitative approach whereby, anonymous 6-questionnaire were used to survey staff and patients. Haverstick and colleagues collected data from a sample size of 88 subjects (54 patients, 33 staff. Nekkab et al. (2017), conducted extensive quantitative research to determine the spread of HAI among hospital networks.  The methodology involved perusing data from hospital discharge summaries databases in France as presented in 2014. The data was evaluated and assigned to three patient networks that were compared for clustering and HAI spread networks.Research Critiques and PICOT Statement Essay Paper.

Results of Studies

The study by Herbec and colleagues (2020), found out several barriers to hand washing that increased the risk of HAIs among neonates in Zimbabwe.Research Critiques and PICOT Statement Essay Paper. These barriers include limited resources to establish hygiene systems, unavailability of feedback on performance mechanisms, poor hygienic habits, and limited knowledge on better hygienic practices. Hence, neonates in the country are at high risk of contracting HAIs especially from medical officers handling their cases. Staniford and Schmidtke (2020), found out that most studies focused on hand washing as the best intervention against HAIs. Only two of the studies focused on constant disinfection of the environment and hand hygiene as strategies to reduce the spread of HAI.Research Critiques and PICOT Statement Essay Paper.

The quantitative studies had various outcomes that showed the relationship between hand washing and the spread of HAI in healthcare settings. According to Haverstick and colleagues (2017), the rates of HAIs decreased significantly with increased handwashing practices.Research Critiques and PICOT Statement Essay Paper. However, to promote handwashing, the respondents suggested that providing patients with sanitizers and hygiene education was the key to promote handwashing behaviors. Nekkab et al. (2017), showed that the spread of HAI is constant for all the patient networks studied (HAI-specific network, suspected HAI network, and general patient network). As shown by Nekkab and colleagues, interventions against HAI in one network are applicable in all the others since they all share the same properties.Research Critiques and PICOT Statement Essay Paper.

Haverstick et al. (2017) report that if patients are provided with hand sanitizer and hand hygiene education by medical personnel, then they are more likely to actively engage in hand hygiene practices with the result being reduced rates/incidences of HAI. The rates of infection decline significantly. The study implies that increased hand hygiene compliance among patients would significantly reduce HAI rates and incidences. Also, it shows that medical personnel can encourage hand hygiene practices among patients through providing hand sanitizer and education on hand hygiene. Research Critiques and PICOT Statement Essay Paper.

Ethical Considerations

Various ethical implications were noted throughout the investigated studies. Herbec and colleagues performed their research after obtaining clearance from respective institutional review boards. Participants were made are of what the study entailed before giving informed consent to participate. Staniford and Schmidtke (2020) obtained all their research papers following due protocols. Citations and references were made for all sources of data. Haverstick et al. (2017), indicated that they were approved by the hospital ethical board and they also obtained consent from the individual participant before the study. Nekkab and colleagues used verified data to determine the incidence of HAIs in the studied hospital networks. Therefore, all researchers conformed to the required ethical considerations before and during the process of respective studies.Research Critiques and PICOT Statement Essay Paper.

Proposed Evidence-Based Practice Change

There was a remarkable link between the research articles, our PICOT question, and definitely nursing practice. The studies answered the PICOT question by showing that handwashing reduces the rate of HAIs among inpatients. The data used to deduce conclusions for the studies was obtained from inpatients, medical professionals. Hence, the objectives of PICOT to investigate inpatients were attained. The results are highly applicable in nursing. Nurses handle multiple patients in a single session. Therefore, they are at higher risk of being infected or infecting those around them with HAIs. The studies provide a good basis for the development of evidence-based practices. Nurses can practice handwashing as a strategy to protect themselves and their patients from HAIs. Furthermore, nurses should offer basic education to their patients on the importance of washing hands as a means of curbing the spread of HAI in wards.Research Critiques and PICOT Statement Essay Paper.

Conclusion

HAIs are well studied, with multiple research papers on the topic readily available. This particular study reveals that there are various means of controlling HAIs in hospital settings with handwashing being the easiest intervention. Although the study is promising, more practical research needs to be done to obtain tested results. Some of the sample sizes used for the research papers were small and cannot be generalized to the entire health care industry. However, the finding of this study is a challenge for nurses who should implement handwashing practices in their work environments.Research Critiques and PICOT Statement Essay Paper.