Nursing Practice Problem Essay

Nursing Practice Problem Essay

Nursing Practice Problem Essay

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.


General Requirements

Prepare this assignment according to the APA guidelines.

Sample Paper on Cholera

The cholera outbreak is a worldwide health menace associated with poor hygiene, unsafe drinking water, and food. Although the World Health Organization records between three and five million cholera cases annually, most cases come from third-world countries. For instance, Sub-Saharan Africa recorded over 86% and 90% of global cholera cases and deaths, respectively, between 2000 and 2009 (Nguyen et al., 2014 Nursing Practice Problem Essay). As such, Cholera infections are a threat to community health and, therefore, a subject of significance in the nursing field. Therefore, community nursing professions are required to understand cholera spread and control measures as the frontline fighters of the epidemic. The articles evaluate the relationship between consumption of untreated water and cholera outbreaks while reflecting on how regular handwashing and water treatment could impact cholera control. The studies will be substantial in helping prove the importance of water disinfection and handwashing exercise in the control of the spread of cholera. The purpose of the studies is to help measure the risk of cholera among people with access to safe drinking water against those with no access. The objective of the articles is to help prevent cholera spread by providing sustainable and reliable interventions that promote hygiene and reduce the risk of transmission of vibrio cholerae infections. The articles aim to prove that consumption of untreated water, contaminated food, and poor hygiene practices are major causes of cholera transmission. Consequently, interventions targeting improved water treatment and hygiene are significant in reducing cholera transmission.

Relevance of the Articles to Contaminated Hands, Water and Cholera

The PICOT research focuses on unearthing the relationship that exists between Cholera outbreaks and contaminated hands and water. The question seeks answers to whether handwashing and disinfection of drinking water among households and school children helps control the rate of cholera outbreak. Both articles are therefore fully relevant to the PICOT question, and they adequately address the question. In the first study, the researchers interview cholera positive patients and their negative counterparts concerning their access to treated water. The article will provide the answer to the PICOT question by giving the rate of use of safe drinking water among the cholera cases as opposed to the control cases or the uninfected samples. The article demonstrates the high prevalence of cholera among people with little access to disinfected water. The study further appreciates that point-of-use chlorination, adequately maintained water networks, sewage systems, and safe hygiene practices must be adhered to prevent future cholera outbreaks.Nursing Practice Problem Essay

The second article reflects on a combination of hand washing hygiene and water treatment interventions which are both hospital-based. Just as in the PICOT question, two groups are used to illustrate how effective the interventions could be. The study evaluates two groups, intervention contacts, and control contacts, under two varying accesses to stored drinking water and handwashing with soap (George et al., 2016). The article will answer the PICOT question by determining the difference in prevalence rate among the two groups of people.

Method of Study

Both articles used similar research methods. The first article applied the matched case-control study, where cholera cases and controls were sampled from two communities of free towns in Sierra Leone. Cholera patient samples were drawn from a Cholera treatment unit. After that, control samples were drawn randomly from among the patients’ neighbors whose households did not register Cholera symptoms in the recent past. Both were evaluated for accessibility and consumption of safe drinking water. The second article applied randomized controlled trial to evaluate the efficacy of Cholera-Hospital-Based-Intervention for 7-days also abbreviated as CHoBI7. In the study, cholera patients’ intervention contacts and control contacts were randomly selected in Dhaka Hospital, Bangladesh (George et al., 2016). The intervention team received both the oral rehydration solutions (ORS) and CHoBI7, while the control team received the ORS alone. Cholera-Hospital-Based-Intervention provided water storage safety and promoted consistent handwashing with soap. Further randomly selected days of the week were made intervention days, and the other half made control days.

The advantage of the first method is that selecting controls from neighbors of a patient gave accurate results of a common environment eliminating the bias on the basis of geographical advantage. Random Matched case study has its limitations as it can be challenging to evaluate a large population in a short time. The advantage of the method in the second article is that it limited the probability of seasonal variations and selection bias. The limitation of the second method is that it would put the control group at risk of spreading cholera infections amid the experiment.

Results of Study

In their research, Nguyen et al. (2014) concluded that untreated water significantly contributes to the outbreak of cholera. Their statistics indicated that chlorinated or boiled water among Cholera patients was lower than those who did not have Cholera symptoms. The researchers found out that 20% of the Cholera cases used unimproved water sources as opposed to 11% of control cases or those from uninfected samples (Nguyen et al., 2014). Equally, only 89% of cholera cases stored drinking water instead of 95% of the control population in Sierra Leone. Street vended food, drinks, and water were also significantly associated with cholera.

In their study, George et al. (2016) found out that intervention contacts had a 47% lower incidence of symptomatic and asymptomatic vibrio cholerae infection than control contacts during the intervention period. The odds of handwashing in the intervention group in key events were 14 times higher than in the control arm. Equally, a higher proportion of the household visits in the intervention arm had soap present at the latrine area compared to control arm counterparts. The researchers further found out that vibrio cholerae was present in 6% of stored water samples in the control arm and none in the intervention arm households.

The articles are vital in addressing the cholera outbreak in the community. The findings will positively impact the trend on how stakeholders in the community health career will handle cholera in treatment and prevention. The articles will enhance society’s awareness to sufficient measures against cholera. The study enhances understanding of the importance of thorough and frequent hand wash, drinking safe treated water, and general hygiene as the prime factors in the control of cholera. The studies have also efficiently illustrated the effectiveness of the public collective participation and adherence to hygiene as an important measure of success against cholera. Nursing Practice Problem Essay

     Outcomes Comparison

The agenda of the PICOT question is the role of handwashing and drinking safe treated water in the control of cholera. The question also suggests that households and school children who do not carry out regular hand washing and drink disinfected drinking water are likely highly susceptible to cholera and other bacterial diseases. The outcomes of both studies completely match the PICOT question. The two studies anonymously conclude that contaminated water causes cholera and that regular hand washing and drinking treated water are among the major solutions to the spread of cholera. Thus both the articles have illustrated high relevance to the PICOT question, and they have also converged to a common outcome.


Nguyen, V. D., Sreenivasan, N., Lam, E., Ayers, T., Kargbo, D., Dafae, F., & Brunkard, J. M. (2014). Cholera epidemic associated with consumption of unsafe drinking water and street-vended water—Eastern Freetown, Sierra Leone, 2012. The American journal of tropical medicine and hygiene, 90(3), 518-523. Retrieved from April 17th, 2021.

George, C. M., Monira, S., Sack, D. A., Rashid, M. U., Saif-Ur-Rahman, K. M., Mahmud, T., & Alam, M. (2016). Randomized controlled trial of hospital-based hygiene and water treatment intervention (CHoBI7) to reduce Cholera. Emerging infectious diseases, 22(2), 233. Retrieved from April 17th,2021.