NURS 6052 Evidence-Based Project, Part 1 Identifying Research Methodologies

NURS 6052 Evidence-Based Project, Part 1 Identifying Research Methodologies

NURS 6052 Evidence-Based Project, Part 1 Identifying Research Methodologies

Use this document to complete Part 1 of the Module 2 Assessment, Evidence-Based Project, Part 1: Identifying Research Methodologies

A central line bloodstream infection (CLABSI) is a laboratory-confirmed bloodstream infection not connected to an infection at another site that occurs within 48 hours of a central line placement. It is associated with poor health outcomes, high morbidity and mortality rates, and high healthcare costs for patients and the healthcare system. Most CLABSI cases are preventable with appropriate aseptic techniques, surveillance, and management strategies. The purpose of this assignment is to analyze peer-reviewed articles related to CLABSI. 

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Full citation of selected article	Article #1	Article #2	Article #3	Article #4
	Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): a stepped wedge cluster randomized trial. Implementation science : IS, 16(1), 45. https://doi.org/10.1186/s13012-021-01112-4	Acharya, R., Bedanta Mishra, S., Ipsita, S., & Azim, A. (2019). Impact of Nursing Education on CLABSI Rates: An Experience from a Tertiary Care Hospital in Eastern India. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 23(7), 316–319. https://doi.org/10.5005/jp-journals-10071-23205	Mohapatra, S., Kapil, A., Suri, A., Pandia, M. P., Bhatia, R., Borkar, S., Dube, S. K., Jagdevan, A., George, S., Varghese, B., & Dabral, J. (2020). Impact of Continuous Education and Training in Reduction of Central Line-associated Bloodstream Infection in Neurointensive Care Unit. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 24(6), 414–417. https://doi.org/10.5005/jp-journals-10071-23455	Goldman, J., Rotteau, L., Shojania, K. G., Baker, G. R., Rowland, P., Christianson, M. K., Vogus, T. J., Cameron, C., & Coffey, M. (2021). Implementation of a central-line bundle: a qualitative study of three clinical units. Implementation science communications, 2(1), 105. https://doi.org/10.1186/s43058-021-00204-y
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 was selected because it is concerned with identifying approaches that can prevent CLABSI and the adoption of these interventions among nurses.It relates to the clinical issue because it provides evidence-based data on interventions that can be employed to lower CLABSI rates in hospitals.The study was reviewed by the Duke University and WakeMed’s Institutional Review Boards and established to be exempt.	The article was selected because it assesses the effectiveness of educational program for nurses and how educating nurses can reduce CLABSI rates. It relates to the clinical issue because it adds to literature on interventions that can be employed to lower CLABSI rates in hospitals.All participants gave their informed consent.	The article was selected because it identifies education as an important aspect of the hospital infection control that improves infection-control practices.The study supports that continuous education interventions on hand hygiene with and training on the catheter hub care are the two most crucial preventive measures in reducing CLABSI incidence.Ethical permission for the study was not needed since it was part of routine continuing surveillance activity.	I selected this article because it gives insight on the impact of socio-cultural factors in CLABSI bundle implementation.This relates to the clinical issue since socio-cultural factors could be causing high CLABSI rates or hindering the implementation of preventive strategies. The research was approved by the Research Ethics Boards at the hospital where the research was conducted.
Brief description of the aims of the research of each peer-reviewed article	The aim of the study was to examine the effect of a tailored, multifaceted implementation program on nursing staff’s compliance with the chlorhexidine gluconate (CHG) bathing process and EHR documentation in critically ill patients. It also sought to assess the intervention’s impact on nursing staff’s knowledge and perceptions of CHG bathing, and the effect of the intervention on CLABSI rates.	The study carried out an education based program on hand hygiene with a pre- and post evaluation to evaluate the effect of the educational intervention in promoting performance improvement among the nurses.	The aim of the study was to assess the impact of continuous teaching and training on strict adherence of the bundle care, particularly the compliance of hand hygiene and the care of central-line catheter hub for the prevention of CLABSI among patients in neurocritical ICUs.	The aim of the study was to assess how socio-cultural factors influencing bundle implementation and practices in three clinical units in a pediatric hospital were identified and addressed by leaders of the safety program.
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.	The researchers utilized a stepped wedged cluster-randomized design. Quantitative methods were used to evaluate assess the effect of utilizing a tailored implementation strategies program on nursing staff compliance with daily CHG bathing processes.	The study employed a quantitative quasi-experimental study with respect to education of nursing staff to decrease the incidence of CLABSI.A pretest and post test design was employed to measure nurses’ knowledge on the infection prevention and control practices of central catheter care.	The study applied a quantitative prospective observational study in the NICU over two years from January 2017 to December 2018.	The researchers conducted a qualitative study of the implementation of a hospital-wide safety program
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.	The strength of a randomized control trial lies in its excellent internal validity.The study’s methodology is reliable since it produced results consistent with other studies that have established daily CHG bathing as effective in reducing patients’ risk of infections.The methodology is valid since it adequately evaluated the impact of the implementation program on nursing staff compliance and CLABSI rates.	The methodology is reliable since it produced consistent results with previous studies that show that educating nurses on hand hygiene lower the rates of CLABSI. The methodology passed the validity criterion since it measures what it was supposed to, that is, the impact of a nurses’ educational intervention in reducing CLABSI.	The research methodology is reliable since it the results are consistent with other studies that have established that hand hygiene and catheter hub care reduce CLASI rate.The methodology’s validity is apparent since it actually evaluates if a quality improvement initiative on hand hygiene reduces CLABSI rate.	The methodology is reliable since it produced results consistent with previous studies that socio-cultural factors play a major role in CLABSI bundle implementation.Its validity is evident since it sufficiently identified socio-cultural factors related to bundle compliance in CLABSI prevention.
General Notes/Comments	Adoption of evidence-based CHG bathing practices can be used to lower the cases of CLABSI in healthcare facilities.Education programs for nurses and providing feedback on implementation is an effective way of promoting adoption and compliance of this practices.	CLABSI rates can be alleviated by enhancing compliance with the basic steps of hand hygiene. Although educating and implementing hand hygiene is easy, sustaining it over time is a challenge and requires regular training and motivation for healthcare providers.	Adherence of healthcare providers to hand hygiene practices and catheter hub care alongside continuous teaching, training, and supervision is highly effective in reducing the CLABSI rate.	Difficult to change socio-cultural factors can hinder the sustainability of interventions to reduce CLABSI and are a barrier to further improvements.

Conclusion

The above articles examined the impact of interventions aimed at preventing CLABSI like hand hygiene and catheter hub care. The impact of nurses’ education programs on implementing the hand hygiene and catheter hub care was also examined. The study findings show that these interventions are highly effective in lowering CLABSI rates. However, one of the articles demonstrates that socio-cultural factors can hinder their implementation. The articles highlight evidence-based interventions that can be applied in a quality improvement initiative on reducing CLABSI rates in a healthcare facility.

References

Acharya, R., Bedanta Mishra, S., Ipsita, S., & Azim, A. (2019). Impact of Nursing Education on CLABSI Rates: An Experience from a Tertiary Care Hospital in Eastern India. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 23(7), 316–319. https://doi.org/10.5005/jp-journals-10071-23205

Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): a stepped wedge cluster randomized trial. Implementation science : IS, 16(1), 45. https://doi.org/10.1186/s13012-021-01112-4

Goldman, J., Rotteau, L., Shojania, K. G., Baker, G. R., Rowland, P., Christianson, M. K., Vogus, T. J., Cameron, C., & Coffey, M. (2021). Implementation of a central-line bundle: a qualitative study of three clinical units. Implementation science communications, 2(1), 105. https://doi.org/10.1186/s43058-021-00204-y

Mohapatra, S., Kapil, A., Suri, A., Pandia, M. P., Bhatia, R., Borkar, S., Dube, S. K., Jagdevan, A., George, S., Varghese, B., & Dabral, J. (2020). Impact of Continuous Education and Training in Reduction of Central Line-associated Bloodstream Infection in Neurointensive Care Unit. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 24(6), 414–417. https://doi.org/10.5005/jp-journals-10071-23455

Clinical issues have profound impacts on health care providers and patients, given that they pose a significant risk to the quality of care, patient safety, and nursing staff’s wellbeing. Workplace incivility, characterized by discourteous and disrespectful actions, is typical in the nursing practice. It is among the issues that adversely affect nurses’ confidence and interprofessional collaboration. Anxiety is also high in workplaces where nursing incivility is not effectively controlled, fueling burnout and turnover (Shi et al., 2018). Effective control of nursing incivility is vital to optimizing care quality and patient safety. Since interventions should be evidence-based, it is crucial to search for evidence from credible research as summarized in the matrix worksheet.

Full citation of selected article	Article #1	Article #2	Article #3	Article #4
	Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709	Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966	Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106	Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461
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)	It is a comprehensive article exploring the importance of enhanced awareness through educational programs in reducing nurse-to-nurse incivility. The article explains how cognitive rehearsal techniques can help nurses to cope with incivility. Al-Ghabeesh and Qattom (2018) also supported the role of cognitive rehearsal in helping nurses to cope with workplace problems since it prepares them mentally to cope with stressing situations. Regarding ethics, participation was voluntary and participants’ information treated anonymously.	The article depicts workplace incivility as a disturbing phenomenon, detrimental to clinicians’ health and care delivered. Due to incivility’s psychological and somatic effects, the article investigates how it can be managed from a nurse’s perspective. Concerning research ethics, informed consent was observed to ensure that nurses participated willingly. Nurses were also allowed to withdraw willingly without getting penalized in any way.	The article was chosen since it shows the severity of workplace incivility among nurses and proposes evidence-based interventions. According to Armstrong (2018), incivility has a destructive effect as a cause of emotional upset among nurses, to the extent of risking patient care. This observation coincides with Alshehry et al. (2021) finding that workplace incivility increases the occurrence of unsafe medication administration practices. On ethics, Armstrong (2018) avoided search biases by summarizing data from different databases.	The article is an in-depth exploration of the implications of workplace incivility in health practice. It describes how workplace incivility is correlated with anxiety and job burn-out among nurses, necessitating evidence-based interventions. Regarding ethics of research, consent and anonymity are critical. Participants consented to participate in the survey and information provided was treated anonymously.
Brief description of the aims of the research of each peer-reviewed article	The aim of the research was to help nurses to recognize incivility and reduce its impacts by confronting it through cognitive rehearsal techniques. The ability to confront incivility would improve job satisfaction.	Abdollahzadeh et al. (2017) suggested that many articles have investigated the effects of workplace incivility without proposing practical interventions. In response, the article’s primary aim is to determine how workplace incivility can be prevented in health care settings from a nurses’ perspective.	Guided by the premise that workplace incivility should be effectively controlled, the study critiques and summarized evidence that can help nursing staff to manage workplace incivility. It focused on the practical interventions that can be applied universally as nurses overcome this chronic problem.	The article’s primary aim was to investigate the impacts of workplace incivility on new nursing staff. It further examined the role that resilience plays in moderating incivility-job burn-out connection.
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.	Kile et al. (2019) conducted a mixed method, pilot study. Data before and after nurses received cognitive rehearsal training were obtained via surveys for comparative analysis.	Data was collected via interviews. Researchers used the qualitative descriptive study design. Thus, the article is qualitative research.	The study is a systematic review of current and relevant evidence on workplace incivility. Ten studies were reviewed, implying that it is a quantitative study.	The study was a cross-sectional online survey. Participants (903 registered nurses) completed online questionnaires in May of 2016 in China. Hence, it was a quantitative research.
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.	The key strength of a mixed method approach to research is enhancing the understanding of quantitative and qualitative results’ contradictions. Regarding validity and reliability, researchers use various methods to gather information in mixed methods studies (Schoonenboom & Johnson, 2017). These methods supplement each other making the data more valid and reliable.	Generally, qualitative research allows issues to be examined in-depth. Interviews also allow researchers to ask specific questions that can be redirected as situations oblige (Thorsteinson, 2018). Regarding reliability and validity, interviews allowed one-on-one correspondence and the interview questions were designed in a way that all the participants answered the same questions despite difference locations.	A key strength of systematic reviews is getting a quick answer about a particular clinical issue from previous studies. In this case, information is readily available. Systematic reviews are highly reliable and valid too. Their conclusion about a clinical issue is derived from multiple studies that the researcher(s) assess for relevance and quality.	As a common data collection method, questionnaires have various strengths. It is possible to test many people quickly. Data (quantitative) can be generated and analyzed easily. On reliability, questionnaires facilitate the collection of large volume of data (Oden, 2019). It was the same case in the article. The results were also consistent by showing a positive correlation between workplace incivility, anxiety, and burnout.
General Notes/Comments	The article expands the PICOT by explaining how an educational intervention (cognitive rehearsal) can advance workplace civility. It illustrates how a positive workplace can be promoted to ensure that patients receive safe and efficient care.	The article is a reliable resource that expands knowledge on workplace incivility prevention from a nurses’ perspective. It explains how improving nurses’ skills and communication ability and supporting nurses can be integral in reducing workplace incivility in health care organizations.	The article is highly informative on the implications of workplace incivility in health care settings. It further proposes interventions necessary to manage incivility including educational training on incivility to enhance awareness and communication skills. Overall, it is a useful resource to develop the PICOT.	As nurses continue solving clinical issues, application of evidence-based research is vital. The article expands research on the effects of workplace incivility, which shows the need for policy interventions and other practical solutions.

Conclusion

The research articles in the worksheet evaluate workplace incivility among nurses from multiple dimensions. Causes of nursing incivility have been studied besides impacts of the clinical problem and possible prevention measures. Interventions such as resilience training and cognitive rehearsal techniques have been proposed. The articles will be further critiqued to get the best evidence to be used as the basis for change implementation in nursing practice to reduce incivility.

References

Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966

Al-Ghabeesh, S. H., & Qattom, H. (2019). Workplace bullying and its preventive measures and productivity among emergency department nurses. Israel Journal of Health Policy research, 8(1), 1-9. https://doi.org/10.1186/s12913-019-4268-x

Alshehry, A. S., Alquwez, N., Almazan, J., Namis, I. M., & Cruz, J. P. (2019). Influence of workplace incivility on the quality of nursing care. Journal of Clinical Nursing, 28(23-24), 4582-4594. DOI: 10.1111/jocn.15051

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106

Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709

Oden, C. (2019). Validity and reliability of questionnaires: how to check. ProjectTopics. https://www.projecttopics.org/validity-and-reliability-of-questionnaires-how-to-check.html

Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461

Schoonenboom, J., & Johnson, R. B. (2017). How to construct a mixed methods research design. KZfSS Kölner Zeitschrift für Soziologie und Sozialpsychologie, 69(2), 107-131. doi: 10.1007/s11577-017-0454-1

Thorsteinson, T. J. (2018). A meta‐analysis of interview length on reliability and validity. Journal of Occupational and Organizational Psychology, 91(1), 1-32. https://doi.org/10.1111/joop.12186

University of Maryland Medical Center is a notable healthcare organization that places emphasis on the use of EBP and improvement of patient outcomes in their standards of practices.  UMMS states that discovery and innovation is a value for the HCO. UMMS consistently incorporates the use of new and approved medical findings in their medical treatments. For example UMMC is a NCI-designated comprehensive cancer center and was the first facility in the US to use the GammaPod a new radiation treatment with positive outcomes for patients.

EBP involves using “problem-solving approach to clinical decision making based on the most accurate and reliable evidence and clinical expertise to improve conditions and outcomes for systems” and this is what is exhibited at UMMS.  (Melnyk & Fineout-Overholt, 2018) University of Maryland also enacts frequent policy updates for staff based on  the latest healthcare data in the US to  ensure safety  for staff and best practice for patients. 

UMMS, (n.d.) retrieved https://www.umms.org/ummc/-/media/files/umms/about-us/member-hospitals/

Links to an external site.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

According to the Quigley and White (2013), anywhere from 3%-20% of patients admitted in the impatient setting with suffer from a fall at least once throughout their stay. Within the facility that I work in, patient falls have continued to rise throughout the past year alone. Unfortunately, not all falls result in