Evidence-Based Practice Proposal- Section C: Literature Review

EVIDENCE- BASED PRACTICE PROPOSAL- SECTION C: LITERATURE
REVIEW
Evidence-Based Practice Proposal- Section C: Literature Review
Jennifer Enriquez
Grand Canyon University: NUR 699
Date

Search strategy
The systematic review was performed using PRISMA guidelines, (Moher, Liberati,
Tetzlaff, & Altman, 2009). It involves databases searchers in Cochrane, Medline and Pub
med databases. The review involves research articles done between the last five 10 years. The
keywords used in this research involved; patients and patients diagnosed with CRE, Cultural
assessment of CRE and recurrent CRE during the treatment phase. None of the studies found
had a well reliable validity assessment measures.
Inclusion and exclusion criteria
The studies were included if they evaluated outcomes of CRE assessment and their
outcomes, length of stay at the hospital, recurrent CRE and management of CRE in hospital
setups. The search excluded studies which were less than 5 months of duration, used
surveillance cultures obtained from nonsterile bodies and not obtained from original data.
Literature review
The study by Barnes et al, (2014), has pointed on how prevention of multidrug-resistant
organisms can be modeled through hand hygiene and environmental cleanliness. The study
developed an agent-based model of conducting patient to patient transfusion through hands.
The model involved both nurses and physicians on hand hygiene. Simulations were done for
one year based on various micro bacteria. From the simulated scenarios, hand hygiene
practice performance outperformed the overall cleanliness. Thus making hand hygiene to be a
priority practice for infection control coupled with adequate environmental hygiene. This
study reflects the level II evidence level.
In a prospective cohort interventional study on prevention of the spread of CRE in post-
acute hospitals designed in a setting of 13 post-acute care hospitals, the intervention was
undertaken between 2008-2011. The intervention methodology involved periodic on-site
assessments on infection control and policies and resources, assessment of risks factors,
developing national guidelines and cross-sectional surveys. The results of the study showed
that the infection control score rose from 6.8 to 14.0 at p<.001. The carrier prevalence
declined from 16.8% to 12.5% at p=0.013. Hand hygiene using alcohol-based washing;
gloves usage and CRE surveillance policy were crucial for lower carrier prevalence, (Ben
David et al., 2014).
Bonten, (2012), conducted a literature assessment on usage and utilization of
colonization pressures as a risk factor of antibiotic resistance in intensive care units. The key
benefit of colonization pressure underpins the function of cross-transmission in antibiotics
resistance at the ICU which has major consequences on infection control effectiveness. The