Infection Control Among Hospitalized Patients
Added on 2020-05-16
21 Pages4791 Words58 Views
Running head- RESEARCH PROPOSALResearch proposal on infection control among hospitalized patientsName of the StudentStudent IDName of the UniversityAuthor Note
1RESEARCH PROPOSALExecutive summaryNosocomial or hospital acquired infections (HAIs) develop due to bacterial, fungal or viralpathogens and are most commonly manifested in the form of blood stream infections, urinarytract infection, pneumonia and surgical site infection. These occur due to contraction ofinfections during stay at the hospital. Intensive care units are the most common regions wherethese infections are found to prevail. This increases morbidity and mortality rates, and associatedhealthcare costs. Chlorhexidine gluconate (CHG) is an effective antibiotic, usually applied fordisinfection of the skin before any surgery. This report encompasses a research proposal thatintends to determine the effectiveness of chlorhexidine in reducing such nosocomial infections inICUs.
2RESEARCH PROPOSALTable of Contents3. Research question/hypothesis and its purpose.............................................................................24. Literature review..........................................................................................................................35. Methodology, data collection and analysis method.....................................................................76. Validity......................................................................................................................................117. Ethical considerations................................................................................................................128. Dissemination............................................................................................................................139. Reflection...................................................................................................................................13References......................................................................................................................................14Appendix A- Proposed timeline....................................................................................................17Appendix B- Research Budget......................................................................................................18
3RESEARCH PROPOSAL3. Research question/hypothesis and its purpose3.1 “Effect of chlorhexidine bathing treatment in reducing hospital acquiredinfections”.3.2 Evidence based practice (EBP) refers to the interdisciplinary approach that focuses onthe conscientious use of recent, relevant and best available evidence that contribute to decisionmaking in patient care (Melnyk et al. 2012). This approach integrates several components,namely, clinical expertise, values and preferences of the concerned patients, and a systematicsearch along with critical analysis of the evidences that are considered to be most relevant to theclinical context (Greenhalgh, Howick and Maskrey 2014). In the current scenario, effect ofchlorhexidine bathing in reducing infections in hospital setting will be based upon best availableevidences.EBP involves 6 steps that assist nurses to enhance their clinical knowledge, therebyenhancing their capabilities of participating in clinical decision making process. The first stepinvolves a thorough assessment of the patient by identifying the clinical problem. The secondstep encompasses formulation of the clinical question after gaining a sound understanding of thecase scenario. The clinical question generally involves utilizing information on the risk factors,diagnosis, management, prevention of the disorder in the healthcare setting. This is followed byacquiring best available evidences by conducting an extensive database search, which forms thethird step. Several key terms and boolean operators are used to retrieve relevant articles. Thefourth step involves a critical appraisal of the selected articles by evaluating the strength andweakness of each, followed by correlating them to the clinical question. This helps indetermining the way by which the findings of the evidences can be applied in clinical practice for
4RESEARCH PROPOSALimproving patient outcomes. The previous step is succeeded by returning to the patient in orderto correlate the collected evidences with preferences of the patient and clinical expertise, whileapplying it to nursing practice. The final step focuses on evaluating the outcome in terms of theexpected results, and identification of factors that might act as a barrier in this context(Guides.mclibrary.duke.edu 2018).3.3 The results of the intended research proposal will positively contribute to EBP owingto the fact that it will facilitate easy understanding the effectiveness of chlorhexidine bathing inpreventing infections, which will help healthcare professionals to implement its use in clinicalsetting, thereby reducing the rates of HAIs, and improving health and wellbeing of the patients.3.4 Proper evaluation of effectiveness of the antiseptic chlorhexidine will help allhealthcare professionals administer it upon the concerned patients, thereby reducing theprevalence and incidence of HAIs. This in turn will improve patient safety and help in deliveringbest healthcare services. The research will also add to the existing evidence that will facilitatebetter clinical judgment and decision making (Loveday et al. 2014).3.5 The infection control nurse will play an essential role in the present research. Thenurse will determine presence of bacteria and other pathogens in the body of the patient thatmight have contributed to the infection. She will also help in collection and analysis of data uponimplementation of chlorhexidine supplement bathing treatment (Sopirala et al. 2014).4. Literature review4.1 Hospital acquired infections (HAIs) are developed during the course ofhospitalization. Thus, the primary objective of the healthcare administration is adoption ofstrategies that help in infection control and hygiene maintenance (Tong et al. 2015).
5RESEARCH PROPOSALA multicentered, randomized and non-blinded crossover trial was conducted by Climo etal. (2013) in order to evaluate the effectiveness of daily bathing with washcloths that wereimpregnated with chlorhexidine, on incidence of hospital acquired infections and acquisition ofmultidrug resistant organisms (MDROs). The research was based on previous findings thatsuggested the endemic nature of MDROs such as, vancomycin-resistant enterococcus (VRE) andStaphylococcus aureus(MRSA)with methicillin resistance. The authors considered the fact thatclinical guidelines proposed by the Centers for Disease Control and Prevention (CDC)encompassed adherence of strategies related to isolation precautions and hand hygiene, whichwere difficult to sustain during frequent encounters with patients. Thus, the authors based theirresearch on the use of the antiseptic chlorhexidine that had previously demonstrated actionagainst enterococcus and S. aureus. The research was conducted among patients hospitalized inbone transplantation units and across 6 ICUs, during 2007-2009. This was followed byrandomization of bathing units with washcloths that were impregnated using 2% chlorhexidinegluconate (sample), and nonmicrobial washcloths (control) during a 6 month initial period. Thefollowing 6 months contained administration of an alternate bathing product. The manufacturer’sinstructions were followed during bathing. The effects of intervention on the patients weredetermined by personal monitoring of the skin conditions by nurse, which were later on gradedon a scale of 1-4. A statistical analysis of the VRE and MRSA acquisition and HAIs wasperformed using the PROC GENMOD method. Result findings suggested presence of 165 newcases of VRE or MRSA among controls, upon comparison with sample group. The interventiongroup demonstrated a 23% reduction in overall infection acquisition (P=0.03). There was a 25%reduction in the overall VRE acquisition rates during the intervention period. Similar reductionswere also demonstrated in the sample group regarding MRSA acquisition (19%). Furthermore,
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