NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Name

Capella university

NURS-FPX 8030 Evidence-Based Practice Process for the Nursing Doctoral Learner

Prof. Name

Date

Critical Appraisal of Evidence-Based Literature

Hospital-Acquired Infections (HAIs) are an important safety issue due to their high mortality rate, extended hospital stay, and financial impact. HAIs endanger patient safety at Memorial Regional Hospital, notably in the Intensive Care Units (ICUs), leading to elevated death, disability, and medical expenses. HAI exposes patients to hazards like antimicrobial resistance and microflora imbalance, jeopardizing patient safety. In the United States, HAI-related expenses are $ 28.3 to $ 45.2 billion, causing financial strain (Gidey et al., 2023). This paper is based on a critical literature analysis concentrating on HAI problems.

PICO(T) Question

In ICU patients at Memorial Regional Hospital (P), how does the implementation of Hand Hygiene (HH) protocol (I), as compared to current practices (C), affect the rate of HAIs (O) over 12 weeks (T)? This PICO(T) aims to assess whether introducing HH protocols can reduce HAIs among ICU patients. It is concerned with patients who are hospitalized in an ICU setting. It compares a standardized HH protocol with present preventative measures to determine its efficacy in reducing HAI rates during 12 weeks. The HH protocol entails washing hands with soap or using an alcohol-based sanitizer before touching patients. The results will be determined by decreased HAI frequency and increased patient security, including reduced HAI-related complications, length of stay, and care expenses.

Thesis Statement

Employing a standardized HH protocol in ICU settings is crucial to HAI avoidance within 12 weeks, enhancing patient safety and improving medical outcomes. The intervention boosts the quality of care and positively impacts organizational performance and reputation. An extensive analysis of recent evidence will exhibit the efficacy of HAI control interventions. The HAI issue underscores the need for rigorous research evaluation to inform healthcare practices to improve patient safety.

Critical Appraisal and Selection of Tool

The CASP (Critical Appraisal Skills Programme) checklist is employed to evaluate the quality and relevance of the selected studies. The CASP tool is intended to systematically identify the legitimacy, relevance, and findings of published studies. The tool entails a set of inquiries that help the assessment of multiple facets of a study, such as its methods, validity, and relevance to practice (Long et al., 2020). Critical assessment aims to evaluate the quality of the methodology used in research and determine how effectively it handled bias during design, execution, and assessment.

The CASP checklists comprise criteria for determining study validity, findings, and usefulness in practice, ensuring an accurate assessment of the flaws and strengths of research. The CASP tool is utilized because it presents a structure to assess peer-reviewed publications common in HAI control research, ensuring that the literature synthesis on HAI preventive strategy is effective and applicable to healthcare settings, improving patient results.

Annotated Bibliography

Buković, E., Kurtović, B., Rotim, C., Svirčević, V., Friganović, A., & Važanić, D. (2021). Compliance with hand hygiene among healthcare workers in preventing healthcare associated infections–A systematic review. Journal of Applied Health Sciences, 7(1), 57-69. https://doi.org/10.24141/1/7/1/6

The study delivered a systematic review of the importance of medical staff’s HH compliance with World Health Organization (WHO) guidelines. The study is remarkable for its comprehensive and methodical approach. Its rigorous research methods used databases such as PubMed to complete procedures for gathering information based on inclusion criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study offered valuable suggestions for HAI avoidance by boosting HH compliance. For example, adhering to multimodal WHO guidelines like providing staff training, using reminders for HH, and improving infrastructure boost compliance.

Based on the CASP tool analysis, the article demonstrates exceptional quality in several areas, including a well-defined research subject, study design, and solid evidence to support its results, showing reliability. This study is pertinent to the issue of HAI because comprehending the approaches to enhance compliance among staff is essential to executing HAI prevention efforts through HH guideline compliance effectively. For instance, HH guidelines are based on the HH method of surgical hand preparation, HH agents and gloves, proper skin care, and staff education on HH practices. Offering literature on HAI prevention studies helps staff understand methods that can aid them in minimizing HAI.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Chen, N., Arbogast, J. W., Henry, D., Allen, T. T., O’Hara, S., & Xia, C. H. (2024). A simulation study of touch-free automatic alcohol-based handrub dispensers on hand hygiene disruption in healthcare settings. Computers & Industrial Engineering, 193(1), 110312. https://doi.org/10.1016/j.cie.2024.110312

The authors conducted a simulation-based study to determine the effect of automated Alcohol-Based Handrub (ABHR) dispensers on HH functioning. The study found that the percentage of missed HH chances due to refill deficiency ranged from 403.2 to 1232.5, with total unavailability ranging from 0 to 96.4 hours in hospitals. Maintenance initiatives like service refill reminders can minimize the likelihood of ABHR depletion, leading to an 81.7% reduction in HH delays for one dispenser with substantial usage. Scholar evidence for the study’s trustworthiness derives from its rigorous research design, discrete event simulation model use, and statistical analysis.

Using the CASP checklist, this study displays credibility and quality in various ways, including a clear explanation of the research question, purpose of the study, and findings. The article adds to the literature and promotes patient safety by assisting in interventions using automated sanitizer dispensers to reduce HAIs by identifying shortcomings with automated sanitizers. For example, the study suggests that novel solutions, like refill maintenance reminders, successfully decrease HH misses. The study is useful because it recommends that hospitals evaluate dispenser usage trends and develop optimum procedures and regulations for dispenser refilling service to boost HH compliance and avoid HAI events.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Clancy, C., Delungahawatta, T., & Dunne, C. P. (2021). Hand-hygiene-related clinical trials reported between 2014 and 2020: A comprehensive systematic review. Journal of Hospital Infection, 111, 6-26. https://doi.org/10.1016/j.jhin.2021.03.007

The authors conducted an in-depth systematic review of clinical trials to evaluate HH solutions for preventing HAIs in care settings. The study displays exceptional quality through its comprehensive literature selection technique, which incorporates databases such as CINAHL, Embase, Cochrane, and PubMed, and specific inclusion standards. Scholastic evidence for the research’s trustworthiness stems from its critical appraisal of studies included for review and assimilation of data from numerous studies conducted in various clinical settings. Using the CASP critical analysis checklist, the article meets the requirements in several areas, showing its credibility: it explicitly explains its research objectives and employs data-gathering procedures.

The vigilant study of the results contributes to the legitimacy of the study. The research is relevant and valuable as it sheds light on clinical guidelines for HH, which are crucial to extensive HAI management programs. For instance, guidelines include an HH protocol based on My Five Occasions for HH. The protocol encourages staff to conduct HH before contacting a patient, prior to aseptic operations, following body fluid contact, after contacting a patient, and their surroundings. The article contributes to the evidence that delivers clinical guidelines for HAI mitigation through HH and boosts patient safety, suggesting that this protocol can be implemented and effective in diverse therapeutic settings.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Wang, C., Jiang, W., Yang, K., Yu, D., Newn, J., Sarsenbayeva, Z., & Kostakos, V. (2021). Electronic monitoring systems for hand hygiene: Systematic review of technology. Journal of Medical Internet Research, 23(11), e27880. https://doi.org/10.2196/27880

The paper offered a systematic review of the latest innovations used in digital hand hygiene surveillance systems and an analysis of their capabilities and limits. The authors disclose their eligibility criteria and systemic procedures for examining electronic hand hygiene compliance monitoring systems, which shows clarity and validity. Scholarly confirmation of the study includes adherence to the PRISMA framework. Using the CASP checklist, the publication exhibits credibility in various areas, including explicitly defining its purpose and study question and examining the capabilities of tools for HH compliance for HAI avoidance.

For example, the study showed that these monitoring systems offer real-time HH compliance data to avoid HAIs. However, such systems face accuracy issues, data deployment, data security concerns, related expenses, and the need of improved infrastructure. Research is relevant to HAI concerns because it investigates the benefits and limitations of technological options for HAI avoidance. It offers opportunities for HAI mitigation monitoring, such as a camera or sensor-assisted tracking of rate HH events. Contributing to the systematic literature on technological solution reviews encourages stakeholders to implement innovative tools to prevent HAI by improving HH compliance, which leads to improved patient security.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Zhang, Y., Chen, X., Lao, Y., Qiu, X., Liu, K., Zhuang, Y., & Wang, P. (2023). Effects of the implementation of intelligent technology for hand hygiene in hospitals: Systematic review and meta-analysis. Journal of Medical Internet Research, 25(2023), e37249. https://doi.org/10.2196/37249

The study used a meta-analysis and systematic review approach to demonstrate the influence of intelligent technologies on HH in medical settings. The study is noteworthy as evidenced by its detailed research methods, which used databases like Medline and CINAHL, and rigorous gathering processes. The authors thoroughly reveal their study inclusion criteria and procedures for data analysis and statistical evaluation to assess the tool’s influence on HH. Scholarly assurance of the study’s comprehensiveness involves adhering to established criteria for systematic reviews, as indicated by the PRISMA standards. Utilizing the CASP critical analysis checklist, the study meets higher standards in several areas, particularly a well-defined research topic, methodology, rigorous data gathering and analysis, and solid evidence of its findings.

This article is highly relevant to the issue of HAI prevention by providing evidence of the efficacy of technology in preventive efforts. For example, intelligent tools, like electronic counters and pressure sensors on dispensers, enhance HH compliance among staff (risk ratio 1.57, P<.001) and lower HAI incidence (risk ratio 0.24). Recognizing the impact of intelligent tools on HH and compliance practices is critical for developing effective HAI mitigation plans. Supplying literature on HAI avoidance through tools for HH reviews assists stakeholders in executing EBP to lower HAI rates, improving patient security.

Interventions Used to Improve or Solve the Patient Safety Problem

Numerous EBP interventions can successfully tackle the patient safety issue of HAI in ICU patients at Memorial Regional Hospital, which is exacerbated by inadequate HAI preventive measures. First, establishing thorough HH protocols, such as frequent hand washing with soap, utilizing alcohol-based sanitizers and hand rubs, and staff education on basic HH techniques, can lower the risk of HAIs in hospitals (Buković et al., 2021). HH protocol with staff education is consistent with HAI prevention guidelines of the WHO and Centers for Disease Prevention and Control (CDC), highlighting the necessity of hand cleanliness and staff training on hygiene standards in reducing HAIs in hospitals (CDC, 2024). Secondly, employing automated sanitizer systems like AHBR to avoid the risks of HAI by boosting HH compliance (Chen et al., 2021).

Automated systems limit touch locations that prevent cross-contact occurrences and contamination of dispensers with microorganisms, avoiding HAIs. Lastly, adopting advanced tools like the HH surveillance system is vital for improving hospital compliance with hygiene protocols. They track HH events in real-time, provide immediate feedback, and analyze data to identify trends and areas needing improvement (Wang et al., 2021). Surveillance systems utilize sensors or cameras to monitor hand hygiene compliance and send quick reminders to medical staff when hand hygiene chances are missed. By integrating EBP hand hygiene protocol with advanced tools, medical facilities can improve patient safety and HAI prevention.

Summary

Solving the patient security and care quality problem of HAI with EBP is crucial for enhancing the standard of services and patient results. Memorial Regional Hospital can employ effective approaches such as HH protocols for HAI avoidance and enhance patient security by critically assessing the research and implementing EBP. Hospitals can minimize HAIs and establish secure settings by developing comprehensive HH protocols, providing staff education, and utilizing automated AHBR dispensing systems and HH monitoring tools. By reviewing and modifying HAI avoidance strategies, medical settings can boost patient security and care levels.

References

CDC. (2024). Clinical safety: Hand hygiene for healthcare workers. Centers for Disease Prevention and Control.gov. https://www.cdc.gov/clean-hands/hcp/clinical-safety/index.html

Chen, N., Arbogast, J. W., Henry, D., Allen, T. T., O’Hara, S., & Xia, C. H. (2024). A simulation study of touch-free automatic alcohol-based handrub dispensers on hand hygiene disruption in healthcare settings. Computers & Industrial Engineering, 193(1), 110312. https://doi.org/10.1016/j.cie.2024.110312