Evidence-Based Practice Proposal - Section C: Literature Support

Section C: Literature Support
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Section C: Literature Support
The databases involved in the search of the articles are ProQuest, PubMed Central, and Google Scholar. The keywords used in the search included hospital-acquired infections, health-care-associated infections, infections, HAIs, and HCAI. Each of these keywords was repeated in combination with handwashing, hand hygiene, and nursing. The articles that contained covered the problem and had clear methods were included. Many studies fitted my criteria but a few were selected to cover the problem description section.
In the study by Boev and Xia (2015), the authors sought to find out the impact of the collaboration between nurses and physicians on hospital-acquired infections (HAIs). The study carried out a secondary analysis of 671 surveys of nurses’ perception data collected over a period of 4.5 years in 4 ICUs. Furthermore, patient outcome data were gathered on all 3610 patients that were discharged from the 4 ICUs over the course of the study period. The researchers used Collaboration and Satisfaction About Care Decisions (CSACD) to measure the collaboration between nurses and physicians. Demographics data on both the nurses and patients are provided in the study. The researchers found that the collaboration between nurses and physicians was significantly related to HAIs with the implication being that there is a potential to reduce HAIs with improved collaboration between the two.The examination of trends over time increased the internal validity of the research. There is a high external validity of the search because the collaboration between nurses and physicians can easily be applied in other healthcare settings.
In their study, Ceballos, Waterman, Hulett, and Makic (2013) carried out nurse-driven QI interventions to reduce HAIs in the newborn intensive care unit (NICU) over a two year period. The goal of the study was to reduce HAIs infection rate with a focus on CLASBI and Ventilator-associated pneumonia (VAP). Strategies to improve the CLASBI and VAP were deliberated twice monthly by a team comprised of a clinical nurse manager, charge nurses, medical director, respiratory therapy clinical supervisor, clinical nurse specialist, and infection-prevention nurse. Nurses were empowered to be leaders in the interventions. The subjects of the study were neonates with umbilical lines and venous catheters. Strict hand hygiene was among the strategies used to improve the conditions. Over the two year period, the study managed to attain significant and sustained decreases in CLASBI and VAP that resulted in noteworthy cost savings. There is high internal validity in the research with interventions clearly stipulated and outcomes quantified. The external validity is average given that the intervention requires a multidisciplinary team employing several strategies, meaning its application in other healthcare settings require time and planning.
Haque, Sartelli, McKimm, and Bakar (2018) was a non-analytic source that provided an overview of HAIs. The article was necessary for providing information on the background of the problem. It provided the statistics to justify why the problem of HAIs requires attention. The study examined 192 sources to provide relevant information about HAIs. The article describes the responsible causative organisms noting that 80%-87% of HAIs are caused by about 12-17 microorganisms. The article also describes the types of HAIs including surgical site infections (SSIs), CLASBIs, VAP, and Catheter-associated urinary tract infections (CAUTIs). The article, therefore, was useful in providing background information and statistics to justify the need for intervention.
Magill, et al. (2014) carried out a prevalence survey of HAIs in ten states to find out its prevalence in acute care hospitals. The states were geographically diverse. The researchers performed one-day surveys of inpatients that were selected in the participating hospitals while medical records were reviewed to determine the HAIs that were active during survey time. With 11, 282 patients spread across 183 hospitals being surveyed, 4% were found to have at least one HAI. The study also found that C. difficile was the most common pathogen and was associated with 61 HAIs. It was the conclusion of the article that on any one given day, about 1 of 25 patients in acute hospitals in the US has at least one HAI. The article was useful in providing background information on the prevalence of the problem. The research has high external validity given that the survey can easily be conducted in other hospitals.
Scott (2009) is a CDC supported source that used information from economic and medical literature to estimate the direct cost of HAIs in the US. The costs covered in the report included the indirect costs ...