Evidence Based Nursing Research on Nosocomial Infection
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This article discusses the problem of nosocomial infection, its current practices, main focus, scope, PICO components, and initial EBP questions. It also provides evidence-based solutions to reduce the rate of nosocomial infections.
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Running head: EVIDENCE BASED NURSING RESEARCH EVIDENCE BASED NURSING RESEARCH Name of the Student Name of the University Author Note
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1EVIDENCE BASED NURSING RESEARCH Q1. What is the problem and why is it important? Ans: In health care industries there are lots of problems that needs to be addressed. One of those is the hospital acquired infections. Recently the name has been updated to- The Nosocomial Infection. People are now very much concerned about the nosocomial infection. The word nosocomial means an infection or a toxin that is present in certain location. The infection is itself acquired after the patient gets admitted in the hospital. Study shows that the common cause of infection is the intensive care unit (ICU) (Eveillard et al., 2013). It is a relief that the nosocomial infection is curable and does not cause any complicated situation. Thecommonmicrobeswhichcontributesinnosocomialinfectionareseentobe Staphylococcus aureus, Escherichia coliandPseudomonus sp. This type of infection mainly spread by person to person contact and due to hygiene issues. The patients with longer hospital stay are main target of this problem. The lack of immune strength can also be a major problem in this scenario (Rosenthal et al., 2014). This problem is a very important and need addressing. It will be a fatal risk for the patients with chronic illness to acquire the nosocomial infection The present scenario suggests an increasing evidence ofdrug resistance of the nosocomial infection causing bacteria and microbes.It complicates the matter further more for the clinical practitioner. The longer use of drugs also increase the complication of the infection. All this provide a ground of difficulties for the patient life and the health of the medical industry as well. Besides these factors like the noschomial infection and the individual disaster also contributes strongly in the debate for the hospital hygiene. Additionally these problems are also affecting the financial sector of the hospital industry.. Q 2. What is the current practise?
2EVIDENCE BASED NURSING RESEARCH Ans: The current status suggests the need of the current practices to reduce the rate of nosochomial infections. The discussed guide lines are taken froma evidence based clinical suggestions written by the clinicians, in order to prevent hospital acquired infection. These guidelines suggest that the mortality rate and the morbidity rate of the patients admitted to hospitals are highly dependent on hospital acquired infection. The guidelines for controlling such disease are mainly focused on the measurements of the patients risk of that nosochomial disease. Measurements are taken such as: Observing the hand washing and hygiene maintenance. A standard precaution need to be applied, in order to reduce the infection, such as VAP, CR-BSI and CAUTI. (Khan, Ahmad&Mehboob, 2015). Environmental factors of the hospitals and the architecturalconcerns also need to be highlighted which contributes as a cause for the nosochomial infection. Special notice should be brought upon the special patient cases of burn outs and the patients with lower immunity (Zimlichman et al., 2013). The source of infection needed to be identified. Post transplantation patients are more prone to get infections. Those patients need to be more specified when supervising. Room hygiene, ventilating, protecting clothing and decontaminating should be in the first priority. Q 3. What is themainfocus of the problem? Ans: The main focus of the problem is to provide clinical approach to solve the problem. The problem initiates with the hygiene maintenance of the patient. In addition there should be a evidence based practice to resolve the problem before starting (Cristina et al., 2014). Like sometime the patient who goes through transplantation, have the higher possibilities of getting lung infection. Clinical approaches can be done by educating the staffs about the
3EVIDENCE BASED NURSING RESEARCH possibilities of the nosochomial infection. The infection can be caused by hygiene disorders like hand washing, taking special care of the patients with possibilities, decontaminating the patient’s room and by separating the infected patients from others. This type of clinical trial can minimize the rate of mortality in the patients and eventually help the patient and even the hospital. In order to provide the clinical assessment of the specific problem, the practitioners should avoid the specific drugs which can be resisted by the microbes. The multi-resistance power of some microbes is becoming a challenge for hospitals (Cornejo-Juárez et al., 2015). Q 4. How was the problem identified? Ans: The problems are identified as a most emerging health concerns for the safety risk management. It also raises a major concern about the negative health outcomes of the patient, staffs and nurses. It has a huge financial concern as the problem is affecting the economic sector of both patient and the hospital industry. There are several evidences regarding the various approaches of different health care industry about this problem. Q 5. What is the scope of the problem? Ans: The diversity and scope of the nosochomial infection in US is spread in a vast region. Nevertheless, to provide a perfect solution to this problem accurately, is a great challenge. However the scope of such factors will impact the hospitals and the patients both in a negative way. The effect goes both on the morbidity rate and also the mortality rate. In addition, the financial and economic section of the hospital and patient also gets negatively affected. It is a growing problem not only n the US but also in worldwide scenario specially for the case of ICU(Van Nguyen et al.,2013). With increasing amount of the concern relating to this problem, the issues are getting worse. However, the management is getting more and more responsible for reducing the problem. Q 6. What are the PICO components of the problem?
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4EVIDENCE BASED NURSING RESEARCH Ans: Can hand washing and taking extra measurement among the health care workers help in reducing hospital acquired infection? Description P (Problems or Patient or Population)Hospital acquired infection I (Interventions/ indicators)Handwashing(Dasguptaetal., 2015)Separatingthepossible infectedpatientfromtheother uninfected patients Identifyingthesourceofthe infection. Takingpropermeasurementfor preventingtheoccurrenceofthe infection. C (Comparisons)Separating the possible infected patients from the other patients who are not infected is not an important factor if the measure multitudes the hygiene maintenance of the patients room and decontaminatingtheroom.Identifyingthe source of the infection can also be a helpful factor with comparison to the other solution s. O (Outcomes)The possible outcome for the problem is that there can be reduction in the emerging issue and the patients and the care givers can also take possible measurements to reduce the risk. Q 7. Initial EBP question:
5EVIDENCE BASED NURSING RESEARCH Ans: The EBP questions for nosocomial infections are: 1.What is the problem related to the nosocomial infection and why is it a problem? 2.What are the interventions of the nosochomial infection? 3.What is the significant and effective solution to the problemwhen comparing all others solution all together? 4.What can be the possible outcomes of the problem? Q 8. List of possible databases to search and search engines. Ans: All the data are collected from the following set of database and search engines: 1.NCBI 2.PUBMED 3.MeSH 4.CINAHL Q 9. What evidence must be gathered? Ans: The evidences that must be gathered are mentioned below: Literature searches that are related to the nosocomial infection. Guidelines are included for the evidence based search results. Clinical expertise are noted down for the evidence gathering.
6EVIDENCE BASED NURSING RESEARCH References: Cornejo-Juárez, P., Vilar-Compte, D., Pérez-Jiménez, C., Namendys-Silva, S. A., Sandoval- Hernández, S., &Volkow-Fernández, P. (2015). The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit.International Journal of Infectious Diseases,31, 31-34. Cristina, M. L., Spagnolo, A. M., Casini, B., Baggiani, A., Del Giudice, P., Brusaferro, S., ...& Orlando, P. (2014). The impact of aerators on water contamination by emerging gram-negative opportunists in at-risk hospital departments.Infection Control & Hospital Epidemiology,35(2), 122-129. Dasgupta, S., Das, S., Chawan, N. S., & Hazra, A. (2015). Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India.Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine,19(1), 14. Eveillard, M., Kempf, M., Belmonte, O., Pailhoriès, H., &Joly-Guillou, M. L. (2013). Reservoirs of Acinetobacterbaumannii outside the hospital and potential involvement in emerging human community-acquired infections.International Journal of Infectious Diseases,17(10), e802-e805. Khan, H. A., Ahmad, A., &Mehboob, R. (2015). Nosocomial infections and their control strategies.Asian pacific journal of tropical biomedicine,5(7), 509-514. Rosenthal, V. D., Maki, D. G., Mehta, Y., Leblebicioglu, H., Memish, Z. A., Al-Mousa, H. H., ... &Apisarnthanarak, A. (2014). International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device- associated module.American journal of infection control,42(9), 942-956.
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7EVIDENCE BASED NURSING RESEARCH Van Nguyen, K., Do, N. T. T., Chandna, A., Nguyen, T. V., Van Pham, C., Doan, P. M., ... &Olowokure, B. (2013). Antibiotic use and resistance in emerging economies: a situation analysis for Viet Nam.BMC public health,13(1), 1158. Zimlichman, E., Henderson, D., Tamir, O., Franz, C., Song, P., Yamin, C. K., ...& Bates, D. W. (2013). Health care–associated infections: a meta-analysis of costs and financial impact on the US health care system.JAMA internal medicine,173(22), 2039-2046.