Health Care Associated Infections Task

The interpretation of research in health care is essential to decision making. By understanding research, health care providers can identify risk factors, trends, outcomes for treatment, health care costs and best practices. To be effective in evaluating and interpreting research, the reader must first understand how to interpret the findings. You will practice article analysis in Topics 2, 3, and 5.

For this assignment:

Search the GCU Library and find three different health care articles that use quantitative research. Do not use articles that appear in the Topic Materials or textbook. Complete an article analysis for each using the “Article Analysis 1” template.

Refer to the “Patient Preference and Satisfaction in Hospital-at-Home and Usual Hospital Care for COPD Exacerbations: Results of a Randomised Controlled Trial,” in conjunction with the “Article Analysis Example 1,” for an example of an article analysis.

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Health Care Associated Infections Task

Topic: Literature Review/ Infection Control in health care organization

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.

Health Care Associated Infections Task

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

Title page

Introduction section

A comparison of research questions

A comparison of sample populations

A comparison of the limitations of the study

A conclusion section, incorporating recommendations for further research

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Health Care Associated Infections Task

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences): Nurses play a key role in preventing Health-Care Associated Infections (HCAI) in healthcare facilities. Analyzing materials and research in the area can help identify challenges, problems and opportunities to increase knowledge on infection control and prevention. The information gained from the materials can then be used to improve how HCAIs are prevented and controlled in healthcare facilities and carry out more research in the area of HCAIs.

Health Care Associated Infections Task

Criteria	Article 1	Article 2	Article 3	Article 4
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	R Accardi, S Castaldi, A Marzullo, S Ronchi, D Laquintana, M Lusignani. Journal: Annali di Igiene : Medicina Preventiva e di Comunita https:// doi.org/10.7416/ai.2017.2137	Habibollah Arefian, Monique Vogel, Anja Kwetkat, Michael Hartmann Journal: PLOS One https://doi.org/10.1371/journal. pone.0146381	Dian Baker, and Barbara Quinn Journal: American Journal of Infection Control https://doi.org/ 10.1016/j.ajic.2017. 08.036	Christine Boer, and Elizabeth Kiss Journal: Critical Care Nursing Clinics of North American https://doi.org/ 10.1016/j.cnc.2016.09.012
Article Title and Year Published	Prevention of healthcare associated infections: a descriptive study Published: 2017	Economic Evaluation of Interventions for Prevention of Hospital Acquired Infections: A Systematic Review Published: 2016	Hospital Acquired Pneumonia Prevention Initiative-2: Incidence of nonventilated hospital-acquired pneumonia in the United States Published: 2017	Hospital-Acquired Infections: Current Trends and Prevention Published: 2016
Research Questions (Qualitative)/Hypothesis (Quantitative)	How can healthcare associated infections be prevented in healthcare facilities?	How much can hospitals save when hospital-acquired infections are controlled or eliminated?	How can hospital acquired pneumonia be prevented in hospitals in the United States?	Examining current trends in the spread and prevention of hospital acquired infections.
Purposes/Aim of Study	The aim of the study was to verify whether there is knowledge and adherence to prevention and control of infections by nursing staff.	To assess the costs and benefits of interventions that prevent hospital-acquired infections and to also evaluate reporting quality.	To increase knowledge in the understudied area of nonventilated hospital-acquired pneumonia (NV-HAP).	To explore how nurses and other care officials can work together to prevent the incidence of preventable diseases.
Design (Type of Quantitative, or Type of Qualitative)	Qualitative: Descriptive study	Qualitative: Systematic Review	Qualitative: Systematic review	Qualitative: Case study
Setting/Sample	The study had 264 nurses as participants from 16 wards.	Searched Journals in Medline via PubMed and the National Health Service Economic Evaluation Database.	The study extracted NV-HAP cases from 2014 with patient data, outcomes and preventive interventions also collected.	Data was collected from Centers for Disease Control and Prevention which monitors infection rates across American hospitals.
Methods: Intervention/Instruments	The study used questionnaires with self-reporting methods, and observation of wards to determine whether best practices were used.	The study used quasi-experimental and randomized trials to analyze the economic impact of four hospital-acquired infections. They include; urinary tract infection, bloodstream infections, surgical wounds infections and pneumonia.	Medical records were collected from 24 hospitals in the United States and reviewed to determine the level of documented pneumonia preventive infections.	Data analyzed from the CDC was from the 1970s. The data was used to determine the rates of infections that have occurred in the United States’ hospitals over the period of time.
Analysis	128 questionnaires were completed and used in the analysis of data. The average score was 15.0 ± 4.1 (mean ± SD) on a maximum achievable of 23 and >75%.	The search found 2067 articles with only 27 meeting the required criteria.	There were 1,300 patients with NV-HAP in 21 hospitals that collected data. A chart review was used to determine the number of infections within the hospitals.	The mortality rates of five Hospital Acquired Infections (HAIs) was acquired and analyzed to determine how infection rates occur in hospitals.
Key Findings	The nurses showed a high level of knowledge when it came to hand hygiene, covering lumens of central venous catheters when not in use, and maintenance of the urinary drainage bag. However, the results were negative as nurses had a knowledge gap on cleaning, disinfecting and sterilizing wards and equipment with a lot of incorrect answers.	The cost savings values were US $7.0 (IQR 4.2-30.9) with a median of US $13,179 per month.	Most infections (70.8%) were acquired outside ICUs while 18.8% required patients to be transferred to the ICU. Most of the affected patients did not have fundamental hospital care that was associated with prevention of pneumonia.	The article found that nurses are central to the prevention of HAIs in American hospitals. HAIs are considered “nurse sensitive” meaning the infections rate can easily be controlled by nurses which also aid in reducing economic impact in hospitals.
Recommendations	The case study should consider a larger pool of participants to better determine disinfection practices in larger areas.	According to the article, the reporting quality was low with only four articles considered to be high quality. Therefore, it is recommended that the study widens its pool of studies to find high quality results.	The study focused on an understudied field which means there was minimal information to go by. Further research is required to develop more knowledge in the area.	More research is required to better understand what has changed since the 1970s and how nurses are central to stopping prevention of HAIs in hospitals.
Explanation of How the Article Supports EBP/Capstone Project	The study highlights issues relating infection control in healthcare facilities. It presents both strengths and weaknesses of nursing staff when it comes to disinfecting equipment and facilities. This will help in understanding some of the gaps that exist in infection control and what can be done to address these gaps.	The study analyzes how hospitals can save costs through infection control. This will be critical to the capstone project by supporting the financial benefits of infection control in hospitals.	The study focuses on an understudied area which will be a great addition to the project. Furthermore, it focuses on a specific type of infection which will be beneficial in showing how infections are acquired in facilities and knowledge regarding the prevention of such infections within a hospital setting.	The study uses historical data collected by the CDC since the 1970s to determine the rate of infections in hospitals. Such data and analysis will be essential to the project by providing insight into the mortality rates of Hospital Acquired Infections (HAIs) and how nurses are central to preventing such diseases.

Criteria	Article 5	Article 6	Article 7	Article 8
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Stefan Erb, Reno Frei, Marc Dangel, Andreas F Widmer Journal: Infection Control & Hospital Epidemiology https://doi.org/ 10.1017/ice.2016.226	Alex W. Friedrich P. et al. Journal: Wiener Medizinische Wochenschrift https://doi.org/ 10.1007/s10354-018-0676-5	Moriceau,G. Gagneux- A. Brunon, J Gagnaire, C Mariat, F Lucht, P Berthelot, E Botelho-Nevers Journal: Médecine et Maladies Infectieuses https://doi.org/ 10.1016/j.medmal .2015.11.001	Elahe Tajeddin, Marjan Rashidan, Maryam Razaghi, Sima S S Javadi, Somayeh J Sherafat, Masoud Alebouyeh, Mohammad R Sarbazi, Nahid Mansouri, Mohammad R Zali Journal: Journal of Infection and Public Health https://doi.org/ 10.1016/j.jiph.2015.05.010
Article Title and Year Published	Multidrug-Resistant Organisms Detected More Than 48 Hours After Hospital Admission Are Not Necessarily Hospital-Acquired Published: 2017	Control of hospital acquired infections and antimicrobial resistance in Europe: the way to go. Published: 2019	Preventing healthcare-associated infections: Residents and attending physicians need better training in advanced isolation precautions Published: 2016	The role of the intensive care unit environment and health-care workers in the transmission of bacteria associated with hospital acquired infections Published: 2016
Research Questions (Qualitative)/Hypothesis (Quantitative)	The research question focused on healthcare-acquired infection rates in Swiss hospitals. The specific areas of concern was multidrug-resistant organisms (MROs) which are major concern when it comes to infections.	Since current funding and remuneration doesn’t support prevention Healthcare-Acquired Infections (HCAI) and anti-microbial resistance, it is time to develop less production economic financing system for clinical microbiology and infection control.	Are physicians knowledgeable on IPs? The study aimed at determining whether the knowledge possesses by physicians is sufficient and whether there is a need to improve training or change it so as to address the high rates of infections in hospitals that are related to IPs.	The study’s research question was to determine how cross contamination works in hospital ICUs. How are healthcare workers involved in the transfer of HAIs into ICU environments?
Purposes/Aim of Study	The study aimed at estimating preventable proportion of healthcare-acquired infections in Switzerland by analyzing patients that were infected by multidrug-resistant organisms (MDROs).	The study aimed at determining prevention and control measures for Healthcare-Acquired infections and anti-microbial resistance (AMR)	To evaluate physicians’ knowledge on Isolation Precautions (IPs)	The study attempted to determine the rates of contamination amongst health-care workers and surfaces in ICU by bacteria associated with healthcare-acquired diseases (HAI).
Design (Type of Quantitative, or Type of Qualitative)	Qualitative: Case Study	Qualitative: Descriptive Study	Qualitative: Case Study	Qualitative: Case Study
Setting/Sample	The study assessed hospitalized patients that had MDROs from the year 2002 to 2011 to see if there was any evidence of nosomical transmission.	The article utilized various articles to try and understand how HCAIs and AMRs can be prevented in hospitals.	111 physicians completed a questionnaire. 60 of them were attending physicians while 51 were resident physicians.	The study was conducted in Shahid Beheshti University of Medical sciences in Tehran from 2010 to 2012.
Methods: Intervention/Instruments	The researchers analyzed 1,190 cases where 274 (23.0%) were classified as CDC-HAMICS. Only 51.8% of the infections in CDC-HAMICS were acquired in hospitals and could have been prevented.	The article uses different sources which range from studies and other materials on the same subject.	The participants were provided a questionnaire that measured their knowledge on Isolation Precautions which are a major contributor to infections in hospitals.	The researchers obtained 602 and 762 swab samples from ICU environments and hands of healthcare workers. They were then measured to understand the cross-contamination within the ICU environment.
Analysis	Most infections acquired in hospitals are preventable. However, may be difficult to prevent as seen in the case study.	The current economic model used in the prevention of infections doesn’t work, hence, the need for a new model that can prove efficient in addressing HCAIs and AMRs.	Most physicians had poor knowledge on IPs which points towards lack of knowledge on how to prevent infections in hospitals. This could explain why there are so many infections happening in hospitals today.	51% of the environment and 34.5% of the workers were contaminated by different species of bacteria that were involved in the study.
Key Findings	The researchers found that the CDC may overestimate the rate of preventable infections by a factor of 50%. This gives inaccurate information on how to prevent such infections since the data is inaccurate.	The study recommends that a new economic model is developed so as to better address the increasing rate of infections in hospitals.	The respondents had a very poor knowledge of the types of IPs. Some of the IPs include droplet precautions (11.7%), and airborne (16.3% correct answers)	The study found that ICU staff and environmental surfaces are sources bacterial agents that are involved in HAIs in the Intensive Care Units.
Recommendations	The researchers found that CDC may overestimate the rate of infections by 50%. Therefore, more studies are needed to verify this so as to develop a new method that accurately measures the rate of infections in hospitals.	More research is required in the field. However, the article presents its findings from other sources efficiently.	Overall, physicians had poor knowledge on Isolation Precautions that could lead to infections in healthcare facilities. This shows a need for education on this area to ensure that healthcare professionals are knowledgeable about IPS and infections in general.	The research shows a correlation between the spread of infections in hospitals in ICU staff and surfaces. More research is recommended to determine how such cross-contamination can be prevented.
Explanation of How the Article Supports EBP/Capstone	The study focuses on rates of infections including preventable infections. Therefore, it will be critical in providing information on how certain infections can be prevented in a hospital setting.	The article supports the project by addressing economic models used in financing prevention of HCAIs and AMRS which will help in developing the project and addressing the effectiveness of such models.	The study identified a deficiency in knowledge regarding safety precautions. Therefore, this article will help in identifying these areas and coming up with ways to increase knowledge regarding infection control among physicians.	The article shows how healthcare workers are involved in the cross-contamination which leads to the spread of infection. Therefore, this supports material in the project that shows correlation between the spread of infections and bacteria with healthcare workers and hospital surfaces.

Health Care Associated Infections Task