Identifying Research Methodologies Discussion Paper

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Identifying Research Methodologies Discussion Paper

Matrix Worksheet Template

 

Use this document to complete Part 1 of the Module 2 Assessment, Evidence-Based Project, Part 1: Identifying Research Methodologies

 

Full citation of selected article Article #1 Article #2 Article #3 Article #4
Meddings, J., Manojlovich, M., Ameling, J. M., Olmsted, R. N., Rolle, A. J., Greene, M. T., … & Saint, S. (2019). Quantitative results of a national intervention to prevent hospital-acquired catheter-associated urinary tract infection: a pre-post observational study. Annals of Internal Medicine, 171(7_Supplement), S38-S44. https://doi.org/10.7326/M18-3534  Identifying Research Methodologies Discussion Paper

 

 

 

 

 

 Saharman, Y. R., Aoulad Fares, D., El-Atmani, S., Sedono, R., Aditianingsih, D., Karuniawati, A., … & Severin, J. A. (2019). A multifaceted hand hygiene improvement program on the intensive care units of the National Referral Hospital of Indonesia in Jakarta. Antimicrobial Resistance & Infection Control, 8(1), 1-10. https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0540-4 Roshan, R., Feroz, A. S., Rafique, Z., & Virani, N. (2020). Rigorous hand hygiene practices among health care workers reduce hospital-associated infections during the COVID-19 pandemic. Journal of primary care & community health, 11, 2150132720943331. https://doi.org/10.1177/2150132720943331 Esfandiari, A., Salari, H., Rashidian, A., Asl, H. M., Foroushani, A. R., & Sari, A. A. (2018). Eliminating healthcare-associated infections in Iran: a qualitative study to explore stakeholders’ views. International journal of health policy and management, 7(1), 27. Doi: 10.15171/ijhpm.2017.34
Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest) The article evaluated the effect of multimodal intervention on CAUTI. Hence, it was selected since it relates to the clinical issue of interest, prevention of hospital-acquired infections (HAIs). Ethics of research relating to relating to the prevention of HAIs involves voluntary participation. The respondents volunteer to participate in the study without being forced. The article assessed the effectiveness of multifaceted hand hygiene improvement program in reducing infections in the targeted hospital. On the other hand, the clinical issue of interest involves prevention of hospital-acquired infections (HAIs). Hence, this article was selected since it relates to the clinical issue of interest. The article evaluated the impact of practicing hand hygiene measures among health care workers on reducing HAIs during the COVID-19 pandemic. On the other hand, the selected clinical issue prevention of hospital-acquired infections (HAIs). Therefore, this article was selected since it aligns with the clinical issue of interest. This article is about eliminating HAIs in Iran. It was selected since it aligns with the clinical issue of interest, prevention of hospital-acquired infections (HAIs).
Brief description of the aims of the research of each peer-reviewed article The aim of this study is to assess the impact of a multimodal initiative in improving CAUTI in hospitals with a high prevalence of HAIs. The study was conducted in 387 hospitals based in the District of Columbia and 23 states. Three cohorts were conducted from November 2016 to May 2018.The respondents provided CAUTI data at the beginning and end of the study. Identifying Research Methodologies Discussion Paper

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 The aim of this study was to evaluate hand hygiene knowledge and hand hygiene compliance before (pre-intervention) and after implementing a multifaceted improvement program (post-intervention). Additionally, the authors aimed at re-evaluating the findings three years later to determine the effectiveness of the implemented multifaceted improvement program in improving hand hygiene knowledge and hand hygiene compliance among healthcare workers. This study was mainly conducted to understand the connection between practicing rigorous hand hygiene among HCWs and HAIs during COVID-19 pandemic. In their study, the authors focused on answering these questions; “Why have hospital-associated infections (HAIs) reduced during COVID-19 pandemic?” and Would it be appropriate to say that rigorous hand hygiene practices among health care workers (HCWs) have reduced HAIs in a tertiary care hospital of Pakistan? This qualitative study aimed at evaluating strategies for eliminating HAIs in Iran. The authors collected data from 24 participants via face-to-face interviews. The participants reported various factors that hinder elimination of HAIs in the Iran. The study findings indicated that a multidisciplinary approach, including strengthening governance and stewardship; strengthening policies regarding human resources; prescribing and using antibiotics appropriately; and maintaining personal hygiene and environmental sanitation should be adopted to eliminated HAIs.
Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific. The authors used quantitative research methodology. They conducted prospective, nonrandomized, clustered, national, and pre- post observational study to collect CAUTI data from 387 participants, including hospitals based in the District of Columbia and 23 states. The respondents provided CAUTI data at the beginning and end of the study.

 

 

 

 

 

 

 Quantitative research methodology was utilized in this study. The authors conducted a prospective, an observational, and before-and-after intervention. The first study was conducted between May and September 2014, while the second study was conducted from February to April 2017. During the studies, the authors conducted data from physicians and nurses who were working in the Dr. Cipto Mangunkusumo Hospital’s ICUs. Hand hygiene knowledge questionnaires were administered to 97 respondents at baseline and 72 participants at post-intervention. The authors used qualitative research methodology in this study. During the study, the researchers observed consumption of hand sanitizers after COVID-19 outbreak in tertiary care hospital of Pakistan. Change in hand sanitizers’ consumption would reflect hand hygiene compliance in the selected hospital. The authors utilized qualitative research method in studying their topic of interest. The study participants were elected via a purposive sampling approach. Face-to-face interviews were used to collect data from the participants, including policy-makers, technical officers, and health professionals.
A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected. The most significant strength of quantitative research methodology involves supporting analysis of collected data using statistical methods. The authors conducted a prospective, nonrandomized, clustered, national, and pre- post observational study. Identifying Research Methodologies Discussion Paper Questionnaires were used to collect data from the participants. Hence, this data collection method is highly reliable and valid. Questionnaires give consistent results if they are used repeatedly to measure a particular variable. Additionally, they accurate results when used to measure a particular variable during the study.

 

 The authors administered hand hygiene knowledge questionnaires to collect data from 97 respondents at baseline and 72 participants at post-intervention. This data collection methodology is highly reliable and valid.

Hence, results obtained via questionnaires during the study can be replicated. Additionally, the reliability of questionnaires contributes to its validity; hence giving accurate results.

 The authors collected data by observing trends in hand sanitizer consumption during the COVID-19 pandemic. The most significant strength of using observation involves collecting and recording data directly as it occurs.

Using observation as research methodology has high validity since it allows the researcher to collect detailed data about a particular the phenomenon of interest. However, data collected via observation lacks reliability; hence cannot be generalized.

 Data was collected from the participants via face-to-face interviews using interview guides. Twenty four (24) participants, including policy-makers, technical officers, and health professionals participated in the study. Face-face interviews are highly reliable since they support accurate screening. However, data collected through this method lacks validity, limiting generalizability of study findings.
General Notes/Comments The study findings did not indicate substantial improvements in CAUTI after implementing multimodal intervention in the selected hospitals. These results indicate that multimodal intervention is ineffective in preventing CAUTI in hospitals. Therefore, the multimodal intervention should not be adopted as an evidence-based approach for reducing CAUTI in hospitals.

 

 

 

 

 

 

 Study findings indicated a statistically significant improvement in hand hygiene knowledge score at post-intervention in the two ICUs. The overall hand hygiene compliance increased from 27% at pre-intervention to 77% at post-intervention. Additionally, improvement in hand hygiene compliance was reported among nurses and physicians at post-intervention. However, a significant decline in hand hygiene compliance rate was reported among physicians and nurses three years later. Therefore, healthcare organization should improve hand hygiene knowledge and advocate for hand hygiene among physicians and nurses to prevent HAIs. The study findings indicated four times increase in hand sanitizer consumption during the COVID-19 pandemic. This trend portrayed improved hand hygiene practices among HCW, reducing HAIs in the hospital. Therefore, healthcare organizations should advocate for hygiene practices, including using hand-rub sanitizers among nurses and physicians to prevent and reduce HAIs in their medical facilities. Identifying Research Methodologies Discussion Paper The study findings reported effectiveness of a multidisciplinary approach, including strengthening governance and stewardship; strengthening policies regarding human resources; prescribing and using antibiotics appropriately; and maintaining personal hygiene and environmental sanitation in eliminating HAIs. Therefore, hospitals should adopt these approaches to prevent HAIs.

 

References

 

Esfandiari, A., Salari, H., Rashidian, A., Asl, H. M., Foroushani, A. R., & Sari, A. A. (2018). Eliminating healthcare-associated infections in Iran: a qualitative study to explore stakeholders’ views. International journal of health policy and management, 7(1), 27. Doi: 10.15171/ijhpm.2017.34.

Haque, M., Sartelli, M., McKimm, J., & Bakar, M. A. (2018). Health care-associated infections–an overview. Infection and Drug Resistance, 11, 2321. Doi: 10.2147/IDR.S177247.

Meddings, J., Manojlovich, M., Ameling, J. M., Olmsted, R. N., Rolle, A. J., Greene, M. T., … & Saint, S. (2019). Quantitative results of a national intervention to prevent hospital-acquired catheter-associated urinary tract infection: a pre-post observational study. Annals of Internal Medicine, 171(7_Supplement), S38-S44. https://doi.org/10.7326/M18-3534 Identifying Research Methodologies Discussion Paper

Roshan, R., Feroz, A. S., Rafique, Z., & Virani, N. (2020). Rigorous hand hygiene practices among health care workers reduce hospital-associated infections during the COVID-19 pandemic. Journal of primary care & community health, 11, 2150132720943331. https://doi.org/10.1177/2150132720943331

Saharman, Y. R., Aoulad Fares, D., El-Atmani, S., Sedono, R., Aditianingsih, D., Karuniawati, A., … & Severin, J. A. (2019). A multifaceted hand hygiene improvement program on the intensive care units of the National Referral Hospital of Indonesia in Jakarta. Antimicrobial Resistance & Infection Control, 8(1), 1-10. https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0540-4

Description of Clinical Issue of Interest and Development of a PICOT Question

Catheter-Associated Urinary Tract Infection (CAUTI) among hospitalized patients is a pertinent issue that healthcare organizations are facing. It is important to note that CAUTI is among the most common hospital-acquired infections whose rates continue to increase leading to increased hospital stays, patient discomfort, and excess healthcare costs thus contributing to patient morbidity and high mortality rates (Connor, 2018). There are various causes of this condition that include poor hygiene and prolonged use of the catheter and therefore, it is important to ensure that preventive measures are followed by nurses to reduce CAUTI cases. Prevention of CAUTI cases in healthcare organizations helps in achieving improved patient experience, patient satisfaction, patient safety, and patient outcomes (Clarke et al., 2019). The use of a picot question is effective in developing an evidence-based nursing intervention that can be used to solve a healthcare problem. Additionally, it is important to note that a PICOT question is a problem-solving approach/strategy used by nurses and healthcare providers to establish a long-term solution for problems like CAUTI. This, therefore, leads to improvement of service quality because the interventions used are evidence-based and were derived from the research findings of the PICOT question. Identifying Research Methodologies Discussion Paper

Engaging in various research activities by nurses and healthcare practitioners has greatly helped in reducing the rate of infections. Critically looking at the risk factors for developing CAUTI and incorporating clinical guidelines as well as nurse-driven protocols like the use of anti-microbial catheters will play a significant role in reducing the number of CAUTI cases in healthcare facilities (Al-Qahtani et al., 2019). Therefore, I formulated a picot question as follows:

 

PICOT QUESTION

Among hospitalized patients, how does the nurse-driven protocol of using anti-microbial catheters as compared to the use of the normal catheters effective in preventing catheter-associated urinary tract infections in six months?

Search Terms and Databases

The Walden University Library, MEDLINE, EMBASE, PubMed, Cochrane, and CINAHL are some of the databases that I used to search for important information for my research question. Some of the search terms that I used include catheter-associated urinary tract infections, hospitalized patients, catheter insertion, and aseptic techniques. Nine articles were found from the search and after refining the search further by adding other search terms like prevention of CAUTI using nurse-driven protocols like the use of anti-microbial catheters; the search resulted in 1580 articles. Upon adding the year 2016-2021, it was reduced to 289 articles and much less as 94 articles after prevention of CAUTI, AND nurse-driven protocols, AND aseptic technique of catheter insertion were added thus narrowing the language to English. Identifying Research Methodologies Discussion Paper

Strategies to Increase the Rigor and Effectiveness of Database Search

For researchers to increase the rigor and the effectiveness of database search, using the appropriate vocabulary while combining concepts and search terms by incorporating Boolean operators is an essential strategy (Foell, & Pitzer, 2020). Additionally, evaluation of search strategies, using more than one database to search for information on the topic in question, and learning the search rules to bring out uniqueness are other important strategies that can improve the rigor and effectiveness of database search. Identifying Research Methodologies Discussion Paper

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References

Al-Qahtani, M., Safan, A., Jassim, G., & Abadla, S. (2019). Efficacy of anti-microbial catheters in preventing catheter-associated urinary tract infections in hospitalized patients: A review on recent updates. Journal of infection and public health, 12(6), 760-766. https://doi.org/10.1016/j.jiph.2019.09.009

Clarke, K., Hall, C. L., Wiley, Z., Tejedor, S. C., Kim, J. S., Reif, L., … & Jacob, J. T. (2019). Catheter-associated urinary tract infections in adults: diagnosis, treatment, and prevention. J. Hosp. Med, 14, E1-E5. 10.12788/jhm.3292

Connor, B. (2018). Best practices: CAUTI prevention. American Nurses Association.

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.

Foell, A., & Pitzer, K. A. (2020). Geographically targeted place-based community development interventions: A systematic review and examination of studies’ methodological rigor. Housing Policy Debate, 30(5), 741-765. Identifying Research Methodologies Discussion Paper