The Nursing Practice Problem Research Discussion
The Nursing Practice Problem Research Discussion
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem.
Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following: The Nursing Practice Problem Research Discussion
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Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population.
Following the PICOT format, write a PICOT question in your selected area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. Note: This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology.
Articles must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. The PICOT question will also provide a framework for your capstone project.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment The Nursing Practice Problem Research Discussion.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
The nursing practice problem is the growing incidence of catheter-associated urinary tract infections in patients admitted to the acute care settings. Whilst significance advances in infection control and prevention have so far been attained, the high rates of CAUTIs contribute to increased healthcare costs and the heightened risk of morbidity and mortality among patients (Mota & Oliveira, 2019). Similarly, there is the need for substantial evidence for a nurse-led protocol for the usage of urinary catheters in order to enhance patient safety and to reduce or prevent some of the complications associated with the improper insertion and/or removal of urinary catheters (Fasugba et al., 2018). Nurse-led practices of removing UCs within the acute care environment are gaining prominence since they provide a bundled-based approach to prevent urinary tract infections. Similar sentiments are shared by other researchers who argued that the high-burden of healthcare-associated infections calls for the implementation of evidence-based, multimodal interventions to prevent or reduce CAUTIs in hospitals (Ling et al., 2022; Hamilton, 2018). a comprehensive analysis of the facilitators and barriers for nurse-driven protocols for the sake of ensuring significant improvements in urinary catheter utilization and reduction in CAUTI rates is required (Akpom, 2020). These findings also emphasizes the centrality of patient/staff education, promotion of a patient safety culture, engagement of inter-professional teams and adoption of nurse-driven protocols to assist in reducing the additional burden on the healthcare system due to the growing incidences of CAUTI, particularly in acute care settings (Leelakrishna & Karthick 2018)The Nursing Practice Problem Research Discussion.
PICOT Question: In adult patients with spinal cord injury (P), does adoption of nurse-driven bundle or protocol (I) for urinary catheter insertion and removal, in comparison to current standard of care (C), reduce the rate of catheter-associated urinary tract infections (O), over the course of the patient’s hospital stay? (T)
| Criteria | Article 1 | Article 2 | Article 3 |
| APA-formatted article citation with permalink | Akpom, R. (2020). Does a nurse led surveillance program using a verbal reminder intervention impact catheter-associated urinary tract infection rates? Iris Journal of Nursing & Care, 3(2). https://doi.org/10.33552/ijnc.2020.03.000558 | Ling, R., Giles, M., & Searles, A. (2022). Budget impact analysis of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in New South Wales hospitals. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08313-7 | Hamilton, E. (2018).Nurse-Driven Protocol to Reduce Catheter-Associated Urinary Tract Infections. Capstone. Nova Southeastern University. Retrieved from NSUWorks, College of Nursing. (33). https://nsuworks.nova.edu/hpd_con_stuetd/33. |
| How does the article relate to the PICOT question? | The article did an evaluation of the impact of a nurse-led surveillance program utilizing a verbal reminder intervention on Indwelling urinary catheter (IUC) days and CAUTI rates. | The article relates to the PICOT question since it conducts budget impact analysis of a multi-faceted nurse-led intervention to reduce Urinary catheter utilization. | The article sought to provide scientific evidence in support of the use of nurse-led protocols to reduce the rates of catheter-associated urinary tract infections. |
| Is the article qualitative, quantitative, or mixed methods?
Justify your selection. |
The article is quantitative | Mixed methods. Combines both quantitative and qualitative approaches. | The study utilized a quantitative design |
| Purpose statement | To evaluate whether the utilization a nurse-led surveillance program using a verbal reminder intervention system of the IUC in comparison to the standard protocol affects the rates of CAUTI over 3-month duration. | To present a budget impact analysis of a projected five year NO-CAUTI roll-out across New South Wales public hospitals. | To update and enforce an evidence-based CAUTI prevention protocol for the nursing staff of a medical-surgical unit in an adult acute care facility to lower the usage of indwelling urinary catheters and CAUTI rates. |
| Research question(s) | 1. Did CAUTI rates decrease after implementation of a nursing staff education program using an evidence-based nurse-led surveillance verbal reminder system?
2. Did IUC days and CAUTI rates decrease after implementation of a nursing staff education program using an evidence-based nurse-led surveillance verbal reminder system? 3. Did implementation of a nursing staff education on CDC guidelines helped reduce CAUTI rates as evidenced by improved scores on the nursing staff post-test? |
Will the NO-CAUTI roll-out lead to a decline in catheterization and contribute to budget savings over a five-year period? | I. Are there evidence-based guidelines relating to CAUTI prevention from professional organizations/agencies (e.g. AHRQ, ANA, CDC) and peer-reviewed journals?
II. Can staff training and education on evidence-based, nurse-driven protocol for catheterization lead to effective protocol implementation? |
| Outcome(s) | The utilization of a nurse-led surveillance program utilizing a verbal reminder intervention lead to a decline in CAUTI incidents and an increase in IUC discontinuations. The Nursing Practice Problem Research Discussion | The findings indicated that NO-CAUTI campaign, a nurse-led program, contributed to a significant reduction in catheterization cases, leading to budget savings due to the lower CAUTI rates. | Adoption of the evidence-based nurse-driven CAUTI prevention protocol in the hospital setting was associated with enhanced nurses’ knowledge and perceptions of proper catheterization. |
| Setting
(Where did the study take place?) |
A medical-surgical unit in one of the hospitals in Texas. | Public Hospitals in South Wales, Australia. | A 357-bed acute care hospital in South Florida, the United States. |
| Sample | Daily average population of patients was 20 to 28 with eight licensed staff. | Public Hospitals | A convenience sample of 25 registered nurses from the medical-surgical unit of a South Florida hospital took part in the study. |
| Method | Descriptive statistics of IUC days and CAUTI incidents were computed and analyzed. T-test analysis was conducted for Nurses’ knowledge utilizing Minitab 18 Statistical Data Analysis software. | Budget Impact Analysis | Quantitative Design. Pre-intervention questionnaire and survey questionnaires on CAUTIs and catheter days were used in data collection. |
| Key findings of the study and implications for nursing practice | Nurse-led surveillance programs can contribute to significant reduction in CAUTI rates within the medical care setting. | The post-intervention period experienced statistically-significant decline in catheterization and high overall budget savings due to the reduced CAUTI rates in the sampled public hospitals. | Adoption of evidence-based, nurse-driven protocols and interventions can become an effective approach in the effort to reduce the rates of CAUTIs at the hospital and national-levels. |
| Recommendations of the researcher | The source provides useful knowledge on the prevention and management of healthcare-associated infections. | The source is valuable and useful in terms of providing key information and data on the budget impact analysis of nurse-led protocol for catheterization. | The source is helpful in terms of how it examine the centrality of evidence-based, nurse-oriented interventions in in ensuring appropriate utilization of urinary catheters by nurses, and subsequent reduction in CAUTI rates. |
| Criteria | Article 4 | Article 5 | Article 6 |
| APA-formatted article citation with permalink | Leelakrishna, P., & Karthick R.B. (2018).A study of risk factors for catheter associated urinary tract infection. International Journal of Advances in Medicine, 5(2), 334-339.DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180525 The Nursing Practice Problem Research Discussion
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Fasugba, O., Cheng, A. C., Russo, P. L., Northcote, M., Rosebrock, H., & Mitchell, B. G. (2018). Reducing urinary catheter use: A protocol for a mixed methods evaluation of an electronic reminder system in hospitalized patients in Australia. BMJ Open, 8(5), e020469. https://doi.org/10.1136/bmjopen-2017-020469 | Mota, É. C., & Oliveira, A. C. (2019). Prevention of catheter-associated urinary tract infection: What is the gap in clinical practice? Texto & Contexto – Enfermagem, 28. https://doi.org/10.1590/1980-265x-tce-2018-0050 |
| How does the article relate to the PICOT question? | The article discusses some of the key risks associated with the growing incidence of CAUTIs. A better understanding of the common causes of CAUTIs in post-operative cases is needed to support the development and implementation of nurse-driven protocol in the prevention of CAUTI. | The article indicates that CAUTI infections are common and problematic despite the adoption of infection and control interventions. | The study sought to investigate the gap in clinical practice when it comes to the prevention of CAUTIs in the hospital setting. |
| Is the article qualitative, quantitative, or mixed methods?
Justify your selection. |
The article is quantitative. It conducted multivariable logistic regression to predict CAUTI outcome. | Mixed methods. Both qualitative and quantitative data was collected. | Qualitative |
| Purpose statement | To identify the causative agents and risk factors behind the occurrence of urinary tract infection. | To evaluate the effectiveness, reliability, and efficacy of an electronic reminder systems in hospitalized patients. | To identify the existing gaps in the prevention of CAUTIS within the adult intensive care unit setting. |
| Research question(s) | What are the risk factors for catheter-associated urinary tract infection? | What is the efficacy of an electronic reminder system in diminishing urinary catheter usage and improving delivery of patient care? | Are there any gaps in clinical practice when it comes to the prevention of CAUTIs? |
| Outcome(s) | A number of factors including age, catheter size, duration of catheterization, diabetes, sex and a breach in the closed system of catheter training increased the risk of CAUTI. | Although an electronic reminder system can enhance urinary catheter use, more investigation is still required to determine its effectiveness. | Reduced adherence to several CAUTI prevention measures and protocols is a key risk factor behind the high rates of CAUTIs. |
| Setting
(Where did the study take place?) |
India | Australia | An Adult ICU located in the State of Minas Gerais, Brazil. |
| Sample | 210 Patients | 50 patients | The ICU for adult patients contained ten beds in a large hospital. |
| Method | Statistical Analysis | Mixed Methods approach | Observational study |
| Key findings of the study and implications for nursing practice | Improved understanding of the risk factors in the development of CAUTIs is vital to inform evidence-based solutions to this clinical problem. | The use of an electronic reminder system can form an integral part of the nurse-driven protocol for prevention of CAUTIs in acute care hospitals. | Strong focus on strict compliance with CAUTI prevention measures is integral to enhancing clinical practice safety and improvements in patient care outcomes. |
| Recommendations of the researcher | The source is highly useful in outlining some of the measures to be included in the nurse-driven protocol. | The source is helpful in terms of how it examine the efficacy of an electronic reminder system in ensuring appropriate utilization of urinary catheters by nurses. | The source is informative, and well-focused on addressing the PICOT question. |
References
Akpom, R. (2020). Does a nurse led surveillance program using a verbal reminder intervention impact catheter-associated urinary tract infection rates? Iris Journal of Nursing & Care, 3(2). https://doi.org/10.33552/ijnc.2020.03.000558
Fasugba, O., Cheng, A. C., Russo, P. L., Northcote, M., Rosebrock, H., & Mitchell, B. G. (2018). Reducing urinary catheter use: A protocol for a mixed methods evaluation of an electronic reminder system in hospitalised patients in Australia. BMJ Open, 8(5), e020469. https://doi.org/10.1136/bmjopen-2017-020469
Hamilton, E. (2018).Nurse-Driven Protocol to Reduce Catheter-Associated Urinary Tract Infections. Capstone. Nova Southeastern University. Retrieved from NSUWorks, College of Nursing. (33). https://nsuworks.nova.edu/hpd_con_stuetd/33.
Leelakrishna, P., & Karthick R.B. (2018).A study of risk factors for catheter associated urinary tract infection. International Journal of Advances in Medicine, 5(2), 334-339.DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180525 The Nursing Practice Problem Research Discussion
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Ling, R., Giles, M., & Searles, A. (2022). Budget impact analysis of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in New South Wales hospitals. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08313-7
Mota, É. C., & Oliveira, A. C. (2019). Prevention of catheter-associated urinary tract infection: What is the gap in clinical practice? Texto & Contexto – Enfermagem, 28. https://doi.org/10.1590/1980-265x-tce-2018-0050 The Nursing Practice Problem Research Discussion