Assignment Evidence-Base Project, Part 1: Identifying Research Methodologies

Assignment: Evidence-Based Project, Part 1: Identifying Research Methodologies
Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course.
Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.
Part 1: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

The full citation of each peer-reviewed article in APA format.
A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
A brief (1- to 2-paragraph) 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.

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Solution

Matrix Worksheet Template

 

Use this document to complete Part 2 of the Module 2 Assessment, Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies

 

 

Full citation of selected article Article #1 Article #2 Article #3 Article #4
Loftus, R. W., Dexter, F., & Robinson, A. D. (2018). High-risk Staphylococcus Aureus transmission in the operating room: a call for widespread improvements in perioperative hand hygiene and patient decolonization practices. American journal of infection control, 46(10), 1134-1141.

 

 

 

 Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs vs Handwashing. American Journal of Critical Care, 27(4), 334-337.

 

 Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … & National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. The Lancet Infectious Diseases, 18(11), 1269-1277. Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. British Journal of Nursing, 27(7), 382-388.
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 encompasses the epidemiology of transmission of pathogen and its awareness. It also discusses how compliance against these pathogens can be achieved through intraoperative infection measures. The study was focused on staphylococcus Aureus which is associated with virulence and resistance to antibiotics. Staphylococcus Aureus was also claimed to be the cause of high pathogen transmission within an acute care setting thus resulting to infection to the community.

 

 

 

 The authors base their research work from the guidelines of WHO and the CDC concerning hand hygiene. These guidelines suggest that use of soap and water is the best way of controlling and managing infections after contamination with body fluids or after visiting the toilet suspected to contain harmful pathogens. Alcohol-based hand hygiene and hand rubs are however recommended in every clinical setting. The article addresses the impact of healthcare associated infections to the patients and the community. These impacts include patient safety, increased morbidity and mortality rates, increased medical costs and prolonged hospital stays. The researchers of the article also acknowledge the practice of hand hygiene to maintain the safety of patients from methicillin-resistant staphylococcus Aureus. There are however very few healthcare policies that address health related infections associated with hand hygiene. According to national hand hygiene initiative, healthcare associated infections are significantly reduced by hand washing. The article addresses healthcare-associated infections as a global health issue. Some of the infections identified include urinary tract, respiratory and surgical infections. The article therefore advocate for better ways of controlling infections. These ways include education and reinforcing knowledge to individuals at high risk of contracting these infections.
Brief description of the aims of the research of each peer-reviewed article There was a claim by the researchers that antibiotic resistance are highly associated with healthcare acquired infections. The use of antibiotics is therefore discouraged in healthcare settings by encouraging healthcare providers to be practicing the basic prevention measures. The study focused on reduction of infections acquired in surgical sites through improving hand hygiene measures. The study therefore aimed to look at the type of staphylococcus in the healthcare setting. Frequent hand washing is a major cause of contact dermatitis according to the authors of the article. It is therefore a significant reason why other methods are preferred in clinical setting rather than frequent hand washing method. Alcohol based sanitization are preferred due to bacteria reduction and reduced irritation of skin. The study focused to investigate the effect of ABHRs associated with the use of lotions and creams on health outcomes. It is a study that aimed at assessing and evaluating the outcomes of national hand hygiene initiative (NHHI). It also aimed at evaluating its impact on the incidences of healthcare associated Staphylococcus Aureus and compliance of hand hygiene. The fact that healthcare provider’s compliance to hand hygiene is vital to patients’ safety is what influenced the study to be conducted. The goal was to evaluate effectiveness of alcohol-based gel in infections control in a clinical setting. Renal nursing was the main focus of the article.
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. Quantitative research methods were used in this study. The method involved isolation of staphylococcus Aureus from three different medical centers. The collected species then underwent analytical profile indexing, bio-firm absorbance and genome analysis. A computer generated list was used where it randomly generated 274 case pairs. The isolated 178 species were found to be staphylococcus Aureus. About 173 of the 178 were found to be causing transmissions. A research concerning antibiotic resistance and virulence was also conducted. Poisson regression and X2 tests were incorporated as statistical analysis.

 

 

 

 

 Qualitative method approaches were used in this systematic literature review. MEDLINE and CINAHL databases were utilized where researchers used key words such as hand washing, dermatitis and ABHR to locate the research work. The search had been limited to a maximum of 10 years old articles. Original articles were the only considerations where findings were presented in tables for comparison. The research involved a qualitative longitudinal study. The NHHI’s outcomes in the first eight years of its implementation were assessed by the study. Assessment involved the participation of the hospitals, cost and hand hygiene guidelines compliance with healthcare associated staphylococcus Aureus. The process of evidence based practice was reviewed on effectiveness of alcohol based gel. The findings about the best gel were also published.
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. There was randomization process of study participants that was incorporated by the researchers. The researchers also used large samples in their study thereby increasing the applicability to a large population. Randomization also played a role in portraying the relationship of the effect and cause between the studied variables.

 

 The literature search that was involved was limited to articles written within the last 10years. The limit played a role in ensuring that the findings could applied in the current clinical practice. It also ensured that the guidelines were in line with the current WHO and CDC recommendations. The researchers also used key words such as hand washing and dermatitis in their search thus ensuring studies relevant to the clinical issue. There was incorporation of a wide population data that was used to determine the impact of NHHI. Statistical analysis was also done using t-test, p-value of 0.05 which was concluded to be statistically significant. Assessment of data was also done for consistency and error by use of a standard process for validation and review. Validity and accuracy of data was maximized through taking two samples that included representative hospital sample and a poorly performing site sample. The steps and procedures of quality evidence based practice are utilized. There is also the use of numerous sources which justify the research work.
General Notes/Comments Staphylococcus Aureus is associated with hyper-transmissible and pathogenic intraoperative strains.

 

 

 

 

 

 

 The use of ABHRs in clinical setting should be encouraged since hand-washing after and before the use of ABHRs removes sebum and emollients layers thus increasing the chances of contact dermatitis. Frequent hand washing should be done regularly in any given clinical setting for the safety of healthcare providers and their patients. The NHHI guidelines should therefore be observed to minimize healthcare associated infections. Alcohol based sanitizers are more effective compared to use of detergents which can cause dissemination of pathogens. Alcohol based hand rubs should therefore be placed at every entrance of a ward and bedside of every patient for use before and after performing every activity.