NURS FPX 8030 Assessment 2 Evidenced-Based Literature Search and Organization

Patient Safety Issue, PICO(T) Question, and Evidence

Hospital-acquired infections (HAIs) pose trouble to cases’ safety at the Memorial Regional Hospital, especially in intensive care units (ICUs). The frequency rates of Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infections (CAUTI), and other HAIs have been on the rise, resulting in advanced mortality, morbidities, and increased health care costs. Internal data from Memorial Regional Hospital reveal CLABSI and CAUTI rates of 0.553 and 0.926 per 1,000 device days, singly, in 2023, which exceed public marks (Leapfrog, 2024). 

The HAIs compromise patient safety, stretch recovery, and strain sanatorium resources, requiring immediate intervention to reduce their frequency. Gaps in infection control practices, linked through staff interviews and internal data, contribute to the frequency of HAIs in ICUs. External validation substantiates the necessity for change.

Peters et al. (2022) illuminate the significance of hand hygiene, environmental cleanliness, antimicrobial stewardship, and staff education in preventing HAIs. CDC (2024) reports that one in 31 rehabilitated cases acquires an HAI annually, resulting in over 72,000 deaths. The findings stress the need for multifaceted, validation-predicated strategies to reduce HAIs and ameliorate patient safety at Memorial Regional Hospital. 

The PICOT Question

In ICU cases at Memorial Regional Hospital (P), how does the performance of hand hygiene protocol (I), as compared to current practices (C), affect the rate of HAIs (O) over 12 weeks (T)? 

Best Evidence Search Strategy

Establishing an effective approach to developing the quest terms is vital to the chances of the most applicable validation for the PICOT question about Memorial Regional Hospital and ICU cases and the impact of a comprehensive hand hygiene protocol on the rates of HAIs. In relating the main factors of the PICOT question, ICU cases are the population of interest, and a hand hygiene protocol and antimicrobial stewardship are the interventions of choice compared to the current practice in reducing HAIs and enhancing patient safety (Akkoc et al., 2021).

PubMed, CINAHL, and the Cochrane Library databases were used, since these are rich sources of medical, nursing, and clinical disquisition papers (Kuti et al., 2021). Such an approach guarantees access to the most applicable validation for administering analogous interventions in the ICU. The PRISMA flowchart is presented in the appendix to outline the process of study identification and addition and rejection criteria. 

Databases and Keywords

Opting for applicable databases and keywords is critical for conducting an effective quest to gather the swish validation on the impact of a hand hygiene protocol and antimicrobial stewardship on HAIs in ICU cases. Databases analogous to PubMed, CINAHL, and the Cochrane Library were employed for their extensive collections of high-quality clinical and nursing disquisitions (Kuti et al., 2021). Pivotal quest terms included “hand hygiene,” “healthcare-associated infections (HAIs),” and “infection prevention.” Boolean operators like AND, OR, and NOT optimized the quest by refining and expanding it to identify applicable studies that could guide quality improvement enterprises. 

Inclusion and Exclusion Criteria

The selection criteria involved papers in English published after 2019 that compared the goods of hand hygiene and antimicrobial stewardship on HAIs in ICU case populations. The addition criteria included studies with samples of ICU cases, reported at least one of the PICOT question’s issues, analogous CLABSI and CAUTI rates, and contained validation-predicated interventions. Studies performed outside the ICU were barred, and studies with pediatric cases and those addressing other types of interventions other than hand hygiene were barred (Raoofi et al., 2023). 

According to these criteria and to ensure the quality of the papers named, the authors screened and included 12 papers in the review. Only papers directly applicable to the issue were included in the review, thus proving the effectiveness of targeted interventions in abating HAIs and adding patient safety (Raoofi et al., 2023). A total of 12 studies were retained, as they handed information on the connection of interventions in ICUs, which nearly matched addressing HAIs at Memorial Regional Hospital. 

Appendix

Identification of Studies Via Databases and Registers

Search Strategy

• selecting databases The quest was done by using PubMed, CINAHL, and the Cochrane Library databases. These databases were named based on their capability to give content of biomedical and nursing literature, furnishing the rearmost information on hand hygiene morals and HAI forestallment in the ICU. 
• original hunt results A total of 25 records were linked across the named databases. No fresh records were set up in registers or other sources. 
• Netting Process The first 25 records were barred by reviewing the title and epitome of each record in order to estimate connection to the PICO(T) question. A total of 9 records were barred after the vetting due to impertinence or poor quality. 
• Eligibility Criteria Only papers published after 2019 in English, peer-reviewed, and addressing at least one of the precedents, which included ICU cases, hand hygiene, or antimicrobial stewardship, were considered for addition in the review. Inquiries also had to give quantitative issues such as CLABSI and CAUTI rates. The PICOT question barred studies that passed in settings other than the ICU, children, and interventions that were not within the compass of the question. 

NURS FPX 8030 Assessment 2: Evidence-Based Literature Search and Organization

• barred studies During the eligibility assessment, 2 reports were barred due to deficient data or lack of focus on the intervention. 
• Included Studies The review included 12 studies, offering robust validation directly related to the PICOT question. The studies offered critical perceptivity into the effectiveness of hand hygiene and antimicrobial stewardship in reducing HAIs in ICU cases. 
• PRISMA Flow Diagram A PRISMA flux illustration was developed to visually represent the identification, netting, and addition processes for the studies. The illustration reflects the records linked, screened, barred, and included throughout the review process.

NURS FPX 8030 Assessment 2: Evidence-Based Literature Search and Organization

Leapfrog (2024). Hospital details table. Hospitalsafetygrade.org. https://www.hospitalsafetygrade.org/table-details/memorial-regional-hospital

Peters, A., Schmid, M. N., Parneix, P., Lebowitz, D., de Kraker, M., Sauser, J., Zingg, W., & Pittet, D. (2022). Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: A systematic review. Antimicrobial Resistance & Infection Control, 11(1), 1–9. https://doi.org/10.1186/s13756-022-01075-1 

Raoofi, S., Pashazadeh Kan, F., Rafiei, S., Hosseinipalangi, Z., Noorani Mejareh, Z., Khani, S., Abdollahi, B., Seyghalani Talab, F., Sanaei, M., Zarabi, F., Dolati, Y., Ahmadi, N., Raoofi, N., Sarhadi, Y., Masoumi, M., Sadat Hosseini, B., Vali, N., Gholamali, N., Asadi, S., & Ahmadi, S. (2023). Global frequency of nosocomial infection A methodical review and meta-analysis. Public Library of Science, 18(1), e0274248. https://doi.org/10.1371/journal.pone.0274248