REVIEW OF LITERATURE1 Review of Literature Introduction Surgical site infections (SSIs) have been linked to mortality, financial costs, and reduced quality in patients that have undergone operations. SSI is the infection that occurs on the side of the body where surgery has taken place. In spite of precautions taken to prevent SSIs, incidents of SSI are still prevalent in the healthcare sector, creating a need for an intervention. The present study takes into consideration post-surgery intervention that can help reduce cases of SSIs. This paper uses the PICOT statement: In perioperative patients (P), how effective are chlorhexidine baths (I) compared to regular soap and water baths (C ), in controlling the number of surgical site infections (O) during the perioperative and recovery period after surgery (T)? This review of literature evaluates the suitability and applicability of six peer-reviewed journals that have been selected to help in exploring the PICOT statement. Comparison of Research Questions In Badia et al. (2017), the researchers evaluated evidence and impact of SSIs on quality of life and associated costs. This is in line with the PICOT statement, as it aims to have a positive impact once the capstone project makes an intervention on the issue. In Grundmeier et al. (2018), the researchers wanted to investigate and validate the rule warranting detection of post ambulatory surgeries. These research questions supports the PICOT statement in the sense that it uses EHR data to provide an intervention into the understanding the detection of ambulatory infections after surgeries. The study by Martin, et al., (2015) thrived on the research question of determining the independent association between diabetes and SSIs in multiple surgical procedures. Compared to Badia et al.’s study, the researchers in this study were concerned with the independent case of diabetes.
REVIEW OF LITERATURE2 In Chakravarthy et al. (2017), the research question was to determine factors commonly associated with SSIs. This research question draws the study close to the PICOT statement by relating directly into the investigation of the factors leading to SSI’s. Once the factors have been identified, the researchers can propose possible intervention. In Mueck and Lillian (2017), the researchers focused on-high risk patients to assess the intervention through counseling and modification of perioperative care to improve outcomes. This research question is in line with the objective of capstone project due to focusing on counseling and post-surgery intervention. The research question in Kunutsor, Whitehouse, Blom, and Beswick (2017) was to determine the progress and validation of high-risk-based models in the management of SSIs. This research question is in line with the PICOT statement in the capstone study as it draws the findings close to determining possible interventions to reduce the cases of SSIs. Comparison of Sample Populations The study sample in Badia et al. (2017) was six countries in Europe. Grundmeier et al. (2018), EHR data for thirty months was analyzed. The researchers observed two models, one with data and the other without. In Martin et al. (2015), the researchers analyzed a total of ninety-four peer-reviewed articles published between 1985 and 2015. The samples in Chakravarthy et al. (2017) twelve patients per year were studies for two years with a control sample of three hundred and thirty cases. In Mueck and Lillian (2017), the researchers did not use any sample. They only reviewed literature on the topic using meta-analysis approach. Kunutsor et al. (2017), nine peer-reviewed scores studying the risk of SSIs were discovered and implemented in the study. Comparison of the Limitations of the Study
REVIEW OF LITERATURE3 In spite of their link to the capstone projects, these studies had limitations. For instance, Kunutsor et al. (2017) used a sample of nine to make a generalizing conclusion. Some studies like Martin et al. (2015) used data from 1985, which is a huge sample to make a reasonable conclusion. Badia et al. (2017) used data from six European countries, which is big for analysis and producing reasonable conclusions. Conclusion and Recommendations for Further Research In conclusion, these studies offer viable information in understanding the causes, impact, and interventions that have been done to tackle SSIs after surgery. Even though researchers have limitations in their studies, they have made significant contributions for the study. All the studies have opened room for future research on their topic. Since analysis and understanding of SSI is an ongoing process, the PICOT statement in the current study will contribute to these study and establish the progress that researchers have made to analyze the treatment and management of SSIs. I would recommend that additional research is done to help minimize risks and chances of SSIs. The present study under the current PICOT statement could render the intervention effective by minimizing the risks associated with SSIs. I would also recommend that studies carried out on SSIs take into consideration the samples for population. A large sample is difficult to analyze. It is better to have a smaller but representative and reliable sample.
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REVIEW OF LITERATURE4 References Badia, J. M., Casey, A. L., Petrosillo, N., Hudson, P. M., Mitchell, S. A., &Crosby, C. (2017). Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries.Journal of Hospital Infection,96(1), 1-15.Retrieved fromhttps://www.ncbi.nlm.nih.gov/pubmed/28410761 ChakravarthyM, Rangaswamy S, George A, Anand T, Senthilkumar P, & Rose S., A., J. (2017). Risk stratification of surgical site infection in a tertiary care hospital: A prospective case- control study.Patient Safe Infect Control, 5,73-77. Retrieved from http://www.jpsiconline.com/text.asp?2017/5/2/73/223694 Grundmeier, R. W., Xiao, R., Ross, R. K., Ramos, M. J., Karavite, D. J., Michel, J. J., ... & Coffin, S. E (2018). Identifying surgical site infections in electronic health data using predictive models.Journal of the American Medical Informatics Association,25(9), 1160-1166. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29982511 Kunutsor, S. K., Whitehouse, M., R., Blom, A., W. & Beswick, A., D. (2017).A systematic review of risk prediction scores for surgical site infection or per prosthetic joint infection following joint arthroplasty.Epidemiology & Infection,145(9), 1738-1749 Retrieved from https://www.cambridge.org/core/journals/epidemiology-and-infection/article/ systematic-review-of-risk-prediction-scores-for-surgical-site-infection-or-periprosthetic- joint-infection-following-joint-arthroplasty/8887D57F7F5C8DC198B075843B7FE628 Martin, T., E, Kaye, K., Knott, C., Nguyen, H., Santarossa, M., Evans, R., Elizabeth B., & Jaber, L. (2015). Diabetes and risk of surgical site infection: A systematic review and meta-analysis.Infection Control & Hospital Epidemiology,37(1), 88-99. Retrieved from
REVIEW OF LITERATURE5 https://www.shea-online.org/index.php/journal-news/press-room/press-release-archives/ 432-diabetes-identified-as-a-risk-factor-for-surgical-site-infections Mueck, K., M., &Lillian S. K (2017). Patients at high-risk for surgical site infection.Surgical Infections,18(4), 440-446. Retrieved from https://www.liebertpub.com/doi/full/10.1089/sur.2017.058