Identifying A Clinical Question
Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least five (5) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Identify a clinical question related to your work environment, write the question in PICOT format and perform a literature search on the identified topic.
Purpose
To enable the student to identify a clinical question related to a specified area of practice and use medical and nursing databases to find research articles that will provide evidence to validate nursing interventions regarding a specific area of nursing practice.
Review the Application Case Study for Chapter 3: Finding Relevant Evidence to Answer Clinical Questions as a guide for your literature search.
Guidelines
1. Identify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.
2. Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).
3. Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.
Sample Answer
Clinical Question
One of the most significant challenges to the delivery of quality healthcare services is hospital-acquired infections (HAIs). HAIs also referred to as nosocomial infections, are the infections that a patient will acquire while they are receiving treatment for surgical or medical conditions (Haque et al., 2018). Hospital-acquired infections occur in various healthcare settings, including ambulatory clinics, surgical centers, hospitals, long-term care facilities, rehabilitation facilities, and nursing homes (Haque et al., 2018). Over the years, scholars have suggested different practices that healthcare facilities can utilize to reduce the prevalence of hospital-acquired infections, including the implementation of hand hygiene protocols. Hand hygiene protocols include the following hand-washing guidelines or the use of alcohol-based rubs among healthcare practitioners in a healthcare facility (Haque et al., 2018).
In a healthcare facility, the adoption of hand hygiene guidelines among healthcare practitioners can therefore go a long way in helping to reduce the rates of hospital-acquired infections. The population of focus would therefore be healthcare practitioners, while the chosen intervention would be the implementation of hand hygiene guidelines compared to not implementing hand hygiene guidelines. The desired outcome would be a reduction in the rate of hospital-acquired infections. The PICOT question would therefore be; among healthcare practitioners in a healthcare facility (P), would the implementation of a hand hygiene (HH) protocol (I) compared to not introducing a hand hygiene protocol (C) help reduce the rate of hospital-acquired infections (O) for a period of six months (T).
Why This Is a Clinical Problem
The issue of nosocomial infections is a significant clinical problem because hospital-acquired infections significantly undermine the delivery of quality health care services to patients in different populations. Nosocomial infections can therefore occur in different healthcare settings, including surgical centers, hospitals, long-term care facilities, ambulatory clinic rehabilitation facilities, and nursing homes, among others (Haque et al., 2018). In a healthcare facility, all hospitalized patients will be significantly susceptible to contracting hospital-acquired infections. However, some patients will be more susceptible to nosocomial infections than others. Elderly people, individuals with compromised immune systems, and young children are therefore more likely to get a hospital-acquired infection compared to other patients (Haque et al., 2018). On the other hand, other risk factors of nosocomial infections include utilizing indwelling catheters, longer hospital stays, and overuse of antibiotics among healthcare practitioners, and failure of healthcare workers to wash their hands. HAIs are a significant challenge in the delivery of health care services in various healthcare facilities across the U.S (Haque et al., 2018). According to the CDC, nosocomial infections account for an estimated 99000 deaths every year and at least 1.7 million infections. The prevalence of hospital-acquired infections includes at least 14% bloodstream infections annually, at least 15% pneumonia infections annually, 22% surgical site infections, and 32% of urinary tract infections annually (Haque et al., 2018).
Literature Search
For the literature search, various scholarly databases were considered, including; CINAHL, MEDLINE®, Joanna Briggs Institute, PsycINFO, Trip, Google, Google Scholar. Only articles written in the past six years from the scholarly databases and from peer-reviewed journals were considered. The key statements considered in the literature search included ‘strategies to reduce hospital-acquired infections, ‘ ‘evaluation of the effectiveness of hand hygiene protocols in a healthcare facility, and ‘strategies to reduce nosocomial infections in a healthcare facility.
Augustine et al. (2019) conducted a qualitative case study that sought to explore the hand hygiene standards that are implemented in the ICU. The purpose of the study was to determine that non-compliance to hand hygiene protocols and standards provided by the CDC played a significant role in affecting the rate of hospital-acquired infections in the ICU. Augustine et al., (2019) study also explored the best practices and the various behavioral factors that can be adopted to improve the adoption of hand hygiene protocols in the ICU. Augustine et al. (2019) explored the various leadership approaches the executive management of healthcare facilities can adopt to motivate various health care workers to comply with hand hygiene protocols in the ICU. Adopting a qualitative study approach, Augustine et al. (2019) therefore concluded that the direct observation method was an effective method that health care workers could utilize to monitor the compliance to hand hygiene protocols in the busy intensive care unit environment. However, direct observation was responsible for unacceptable hand hygiene compliance rates in the ICU, which contributed significantly to a higher rate of hospital-acquired infections. According to Augustine et al. (2019), healthcare facilities need to utilize better methods of ensuring and monitoring the compliance of healthcare workers to hand hygiene protocols in various healthcare settings.
