Nursing Practice Problem and PICOT Question

Research Critique and PICOT Question
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Research Critique and PICOT Question
Postoperative surgical site infections (SSIs) remain a significant problem in healthcare. In orthopedic clinics or departments, approximately 335,500 patients develop SSIs (Jusino-Leon et al., 2019). Various studies have examined the use of chlorhexidine gluconate (CHG) perioperative as an effective technique of reducing SSIs. The paper provides an analysis of two quantitative and two qualitative studies examining the phenomena. Specifically, the articles show that CHG perioperative use lowers the risk of SSIs, how CHG usage impacts the nursing practice, ethical considerations, outcomes comparison, and proposed evidence-based practice change.
Nursing Practice Problem and PICOT Question
In many orthopedic surgical departments, postoperative surgical site infections (SSIs) pose serious problems. SSIs are infections near the surgical procedure site but are the most common preventable infections. However, 2 to 4 percent of all patients in orthopedic patients undergoing a surgical procedure suffer an SSI (PSNet, 2019). While SSIs are treatable, they remain the main concern for morbidity and mortality following surgery. They are associated with increased readmissions after a surgical procedure, while about 3 percent of patients who suffer SSI die (PSNet, 2019). In this case, finding measures to reduce SSI risk remains a fundamental goal of most healthcare facilities. One of these measures is the use of chlorhexidine gluconate (CHG) perioperative to reduce the risk of contracting an infection. The PICOT question states:
For orthopedic patients (P), does chlorhexidine gluconate (CHG) wash perioperative (I), compared to usual care (c), reduce the risk of post-surgical site infection (SSI) (O) a month after the procedure (T)?
Background
The articles reveal CHG perioperative and not otherwise lowers the likelihood of SSIs after orthopedic surgery. In the article, "Presurgical Skin Preparation with a Novel 2% Chlorhexidine Gluconate Cloth Reduces Rates of Surgical Site Infection in Orthopaedic Surgical Patients," Eiselt argues patients undergoing joint surgery have a high risk of developing an SSI. The article's objective is to evaluate the efficiency of 2% CHG without rinsing the night before a surgical procedure (Eiselt, 2009). Eiselt's research question is: Does rinsing with CHG before surgery lower an infection's risk after the operation? The article is significant to nursing because it can help patients prepare effectively before a surgical procedure and improve their health outcomes.
Makhni et al. article “No Clear Benefit of Chlorhexidine Use at Home Before Surgical Preparation” claims that bacterial infections pose severe threats to patients after surgery. The purpose of the article was to investigate the efficacy of using CHG wipes the night and morning before the surgery in decreasing bacterial infection around the neck (Makhni et al., 2018). The research question is: Does the use of CHG wipes the night before surgery decrease bacterial infection growth on the neck? Makhni et al. study is significant to nursing because it helps determine whether CHG is valid or not before surgery.
In the qualitative studies, Markström et al. study “Operating room nurses' experiences of skin preparation in connection with orthopaedic surgery: A focus group study” explores the experiences of OR nurses when preparing the skin before a surgical operation. The requestion is: Do the OR nurses understand the implications of proper skin preparation before, during, and after surgery? Nurses can use the article to determine safety procedures in skin preparation before and after surgery (Markström et al., 2020). Similarly, Jusino-Leon et al. article "Chlorhexidine Gluconate Baths: Supporting daily use to reduce central line–associated bloodstream infections affecting immunocompromised patients" evaluates whether CHG baths can reduce healthcare-associated infections (HAIs). The research question is: Can adherence to existing CHG bath lower infections in orthopedic surgical operations? Nurses can incorporate better strategies when using CHG baths and eliminate potential barriers to CHG baths.
How the Articles Support the Nurse Practice
Eiselt's article will answer the PICOT question by investigating whether incorporating CHG the night before a surgical procedure minimizes post-surgical site infection risk. The comparison group was patients at Lakeview Hospital, Minnesota, undergoing joint surgery. The use of this comparison group matches the PICOT question’s study group. Makhni et al. article will answer the PICOT question because it seeks to examine the effectiveness of CHG in reducing bacterial infections around the neck, often done during spine surgery. The comparison group was the medical staff volunteering to use CHG wipes the night and morning before the surgery to check for bacterial growth. The comparison group matches the PICOT question because it helps support or dispute CHG cleaning use as one goes for surgery.
Markström et al. study answers the PICOT question because it evaluates whether nurses should embrace skin preparation before a surgical procedure. The comparison group was OR nurses working in an orthopedic setting. Similar to the PICOT question, the comparison group uses local cleansing with CHG before surgery. Jusino-Leon et al. article also answers the PICO...