NURS 8000 Assignment 1: Locating and Critically Analyzing Primary Research Articles
A Sample Answer For the Assignment: NURS 8000 Assignment 1: Locating and Critically Analyzing Primary Research Articles
One of the major activities that a DNP nurse participates in is research, usually evidence-based research. As indicated earlier, my interest is in researching reducing catheter-associated urinary tract infection (CAUTI). This condition is a clinical issue that needs to be mitigated to ensure that the patients have better health outcomes. This write-entails a summary and synthesis of two peer-reviewed articles obtained through the Walden Library search pertaining to reducing catheter-associated urinary tract infections.
Summary of The Articles
One of the articles with the title “Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomized controlled trial” reported by Fasugba et al. (2019) entails reducing CAUTI. The report compares the efficacy of the use of normal saline and 0.1% chlorhexidine solution in cleaning the meatal area prior to inserting urinary catheters in lowering the incidences of CAUTI.
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The study used a cross-sectional randomized control trial in the hospitals for a period of three weeks, with a total of 1642 research subjects recruited in three hospitals (Fasugba et al., 2019). While 58% of them were in the intervention period, the remaining 42% were in the control phase. Among the findings is that among the control group, 13 cases of CAUTI were recorded as compared to only 4 cases among the intervention group; hence the intervention was connected to a 94% reduction of the rates of catheter-associated urinary tract infections.
More recently, a study has been reported by Nassikas et al. (2020) with the title “Intensive care unit rounding checklists to reduce catheter-associated urinary tract infections” This study purposed to determine whether the use of rounding checklist in an intensive care unit lowers the incidences of catheter-associated urinary tract infections. These researchers used a retrospective before-and-after study design.
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Done in an academic community hospital with a 16 bed ICU unit, the intervention used was an ICU rounding checklist which ensured that the caregivers addressed the use of the indwelling catheters. Analysis was then done to compare the pre-intervention duration with the post-intervention after implementing the checklist.
Pre and post-intervention strategy is one of the best ways of determining the efficacy of an intervention in the management of a condition or disease (Spurlock, 2018). Among the findings obtained from the research is that before the intervention, the unit recorded nineteen CAUTI cases per one thousand catheter days. The rate was found to reduce to 2.12 after the intervention from 4.62 before the implementation of the checklist.
Synthesis of The Sources
The findings of Fasugba et al. (2019) implies that by taking care of the meatal area through thorough cleaning, the rates of CAUTI incidences can greatly be reduced. By employing the normal intervention of using the 0.9% saline solution, whose efficacy has also been shown in previous studies (Khahakaew et al., 2019), this current research was able to demonstrate that the use of 0.1% chlorhexidine solution is more efficacious hence introducing better evidence to practice.
Indeed, the findings are in agreement with other studies (Mitchell et al., 2019). However, the findings also differ from other reports where the use of chlorhexidine did not lead to lower incidences of CAUTI, even though that study was a single-site randomized control site.
Several interventions exist for controlling CAUTI. Patients at the ICU particularly need to be free from the infections to give them a better chance of healing; therefore, the study by Nassikas et al. (2020) is significant. They were able to demonstrate that using the checklist in the ICU setting can be vital. These findings can be generalizable in an ICU setting in other locations since the intervention focuses on just using a checklist.
It is important to note that this intervention is relatively cost effective, even though at first it may lead to increased use of indwelling catheters, eventually it allows for lower usage rates. The findings are also supported by other studies. For instance, a study done to combine checklist and education intervention effectively reduced the rates of CAUTI (Menegueti et al., 2019).
References
Fasugba, O., Cheng, A. C., Gregory, V., Graves, N., Koerner, J., Collignon, P., … & Mitchell, B. G. (2019). Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. The Lancet Infectious Diseases, 19(6), 611-619. Doi: 10.1016/S1473-3099(18)30736-9.
Khahakaew, S., Suwanpimolkul, G., Wongkeskij, T., Punakabutra, N., & Suankratay, C. (2019, October). 1151. A Comparison of Periurethral Cleaning Between Normal Saline and Savlon Solutions Before Indwelling Urinary Catheterization in Reducing Catheter-Associated Bacteriuria: A Randomized Controlled Study. In Open Forum Infectious Diseases (Vol. 6, No. Supplement_2, pp. S411-S411). US: Oxford University Press. https://doi.org/10.1093/ofid/ofz360.1015
Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., da Silva Canini, S. R. M., … & Laus, A. M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patients through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheters: a quasi-experimental study. Medicine, 98(8). Doi 10.1097/MD.0000000000014417.
Mitchell, B. G., Fasugba, O., Cheng, A. C., Gregory, V., Koerner, J., Collignon, P., … & Graves, N. (2019). Chlorhexidine versus saline in reducing the risk of catheter associated urinary tract infection: a cost-effectiveness analysis. International journal of nursing studies, 97, 1-6. https://doi.org/10.1016/j.ijnurstu.2019.04.003.
Nassikas, N. J., Monteiro, J. F. G., Pashnik, B., Lynch, J., Carino, G., & Levinson, A. T. (2020). Intensive Care Unit Rounding Checklists to Reduce Catheter-Associated Urinary Tract Infections. Infection control and hospital epidemiology, 41(6), 680-683. Doi: 10.1017/ice.2020.43
Spurlock Jr, D. R. (2018). The single-group, pre-and posttest design in nursing education research: It’s time to move on. Journal of Nursing Education, 57(2), 69-71. Doi: https://doi.org/10.3928/01484834-20180123-02.
As a student pursuing further education in the field of nursing, it is imperative to develop skills that promote proficiency in research, that is, being able to locate sites with scholarly articles, read and carry out a critical analysis and evaluation. This is what will promote success in the field of nursing research and advancement in career as a credible scientist who can actively participate in the generation of new knowledge and skills that promote safer and efficient nursing practices.
The databases available with scholarly work on nursing include; CINAHL Plus and PubMed (Medline) (Hopia & Heikkilä, 2019). The purpose of this paper is to identify two articles from the online nursing resources, write a summary of each article, synthesize the articles from a scholarly standpoint and discuss the difference between summarizing and synthesizing research articles.
The first article reviewed was on evidence-based practice, focusing on the knowledge, attitudes, implementation, facilitators, and barriers among community nurses (Li et al., 2019). This article focuses on the perception of the community nurses about the EBP projects and the barriers they face in carrying out such projects.
The CNs have noted that the EBP projects have not been effective in their healthcare service delivery as they believe it is strongly associated with the advanced practice registered nurses (APRNs) and they find their it difficult to relate it to their own practice. Additionally, it points out to the barriers the CNs face in successfully implementing their EBP projects. The barriers are majorly associated to limited time, resources, knowledge and training and poor motivation that does not encourage them to undertake such projects.
In my second article review, I read through the article on Evidence -based practice education for healthcare professionals: an expert review by Lehane et al., 2018.Accoording to the authors of the article, they do acknowledge the fact that even though EBP-projects are crucial to promoting patient’s safety and quality care, its implementation still remains a big challenge to most healthcare practitioners.
There is need to constantly communicate to the evidences from research to the relevant stakeholders and more specifically healthcare educators which are better placed in articulating the EBP research process and importance. It is the role of nursing academicians and clinical educators to promote the expansion and successful implementation of EBP research findings into practice. This will ultimately result to quality care and updated methods of that are backed by research evidence and data (Lehane et al., 2018).
Article 1
The first article is by Bokhour et al. (2018) and focuses on strategies that healthcare organizations can implement to offer patient-centered care. According to the authors, a core part of implementing patient-centered care (PCC) is transforming the organization’s culture of care. Using the Department of Veterans Affairs, the authors conducted qualitative semi-structured interviews with employees to identify various factors that help entities to offer patient-centered care like effective leadership, patient and family engagement, engaging the staff, and focusing on innovation among other aspects. In their conclusion, the authors are categorical that an effective organizational culture is key to offering patient-centered care.
Article 2
The article by Hower et al. (2019) explores the organizational determinants from decision makers’ point-of-view on implementing patient-centered care. Using a qualitative approach across different health and social care organizations (HSCOs), the authors found that various aspects were important and determined the level of patient-centered care (PCC) that each facility can offer. Among these include effective communication among staff, addressing staff welfare to motivate them, and overcoming resource constraints, especially financial and human resource issues. The authors conclude by imploring HSCOs to tailor their interventions based on their situations to meet these needs.
Article 3
The third article by Rammohan et al. (2023) discusses the implementation of care transition teams to reduce hospital readmission and enhance patient outcomes. Using a two-phase study approach to investigate readmission rates and associated risk factors in a community hospital for about five years, and a care transition team after discharge and patient support to evaluate the social determinants of health (SDOHs). As such, the authors emphasize the critical role that care transition teams play in lowering the rates of hospital readmissions rates and mitigating the financial strain on healthcare organizations. The researchers assert that hospitals through care transition teams can lower the overall readmission rates by identifying and addressing individual risk factors that include evaluation of social determinants of health (SDOHs).
Synthesis of the Articles
The three articles emphasize the need for healthcare organizations to develop and implement effective strategies aimed at providing patient-centered care that can reduce hospital readmissions. According to the Agency for Healthcare Research and Quality (AHRQ) (2020), patient-tailored interventions lead to increased participation of patients in their care plans and management of their condition. Tailoring these interventions ensures that patients get quality care based on care transition teams to reduce possible readmissions. Through these articles, one can identify the relationship between patient-centered care and reduced rates of readmissions, especially within the first thirty days after discharge. The articles are categorical that providing patient-centered care leads to improved care quality and reduces the possibility of readmissions.
Differences Between Summary and Synthesis of Articles
Article summary and synthesis are different based on the goals and focus. At the core of the article’s summary is detailing the topic of the study, methods, and approaches used, the results of the research, and the conclusion. The summary also outlines the main themes of the article. Conversely, synthesizing an article means identifying and critically analyzing the themes and areas of study covered by the authors. Article synthesis entails giving a more in-depth interpretation of the sources and their relevance to the practice issue being researched.
Conclusion
Locating and critically analyzing research articles is a core part of nurturing advanced nursing students’ research skills and attributes. Through this approach, nursing students enhance their ability to attain research evidence and implement it in practice settings to solve patient issues. The implication is that critical analysis entails synthesizing the articles to determine the common themes and their connection to the research goals and interests of the research.
References
Agency for Healthcare Research and Quality (AHRQ) (2020). Rethinking the Role of Primary
Care in Reducing Hospital Readmissions. https://www.ahrq.gov/news/blog/ahrqviews/rethinking-role-of-primary-care.html
Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., Hill, J. N., … & Lukas,
C. V. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC health services research, 18(1), 1-11. DOI: https://doi.org/10.1186/s12913-018-2949-5
Charosaei, F., Rostami, S., Esmaeili, M., Molavynejad, S., & Vanaki, Z. (2021). Effective
strategies for implementing patient-centered care in cardiac care unit: An opportunity for change. Journal of education and health promotion, 10. DOI: 10.1007/s11606-019-05428-2
Hower, K. I., Vennedey, V., Hillen, H. A., Kuntz, L., Stock, S., Pfaff, H., & Ansmann, L. (2019).
Implementation of patient-centered care: which organizational determinants matter from the decision maker’s perspective? Results from a qualitative interview study across various health and social care organizations. BMJ open, 9(4), e027591. DOI: 10.1136/bmjopen-2018-027591
Rammohan R, Joy M, Magam S, et al. (May 15, 2023) The Path to Sustainable Healthcare:
Implementing Care Transition Teams to Mitigate Hospital Readmissions and Improve Patient Outcomes. Cureus, 15(5): e39022. DOI:10.7759/cureus.39022