Qualitative Research Critique and Ethical Considerations
Qualitative Research Critique and Ethical Considerations
Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses.
Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.
In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
SAMPLE ANSWER
Qualitative Research Critique and Ethical Considerations
Article 1
Johnson, J., Suwantarat, N., Colantuoni, E., Ross, T. L., Aucott, S. W., Carroll, K. C., & Milstone, A. M. (2019). The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. Journal of Perinatology, 39(1), 63. https://www.nature.com/articles/s41372-018-0231-7
Study Problem
Skin bacterial burden on the patients in the Neonatal Intensive Care Unit is a significant issue in the present world. The condition leads to high morbidity and mortality rates of patients in the ICU. Besides, the bacterial skin burden leads to extended stays in the hospital, which leads to increased healthcare costs for the patients. In the United States, more than 300 000 patients in the ICU are reported to have a bacterial skin burden (Johnson et al. 2019). Therefore, research needs to be done to solve the issues of Central-Line-Associated Stream Infection in the Neonatal Intensive Care Unit.
Qualitative Research Critique and Ethical Considerations
Significance of the study to the nursing practice
Antiseptic chlorhexidine gluconate is one of the primary measures that can be used to reduce bacterial infections in the central nervous and central line catheters. Chlorhexidine helps to prevent secondary and primary infections in patients because it has antibacterial activities which reduce pathogens in patient’s skin (Johnson et al. 2019). Therefore, nurses should consider the use of antiseptic chlorhexidine gluconate in the ICU since it is effective in preventing bacterial infections in patients as compared to regular soap and water bathing.
The objective of the study
The primary purpose of the study is to examine the effect of bathing with chlorhexidine gluconate on bacterial skin burden on patients admitted in the Neonatal Intensive Care Unit.
Research Question
Does bathing with chlorhexidine gluconate reduce bacterial skin burden in neonates admitted in the Neonatal Intensive Care Unit?
How does the article answer the PICOT question?
The PICOT question researches the comparison of the effects of bathing with Chlorhexidine and bathing with soap and water daily in decreasing the rate of central line-associated bloodstream infections in patients admitted in the Intensive Care Unit for one year. Therefore, the article helps answer the question by assessing the effectiveness of daily Chlorhexidine baths in reducing central line-associated bloodstream infections. The utilization of antiseptic chlorhexidine gluconate can be used as the primary intervention to fight bacterial load both in the central lines and central venous catheters. Therefore, chlorhexidine gluconate daily baths are imperative compared to regular baths using soap and water in the ICU unit.
How the intervention and comparison groups in the article compare with that one identified in the PICOT question
The PICOT question compares the effects of daily chlorhexidine baths and soap and water baths on the reduction of central line-associated bloodstream infections in patients admitted in the Intensive Care Unit. On the other hand, the article examines the effect of Chlorhexidine daily baths on central-line associated bloodstream infections by comparing the reduction level of central line-associated bloodstream infections between patients in the neonatal Intensive Care Unit who are exposed to Chlorhexidine and those who are not exposed.
Article 2
Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Sustained reduction and prevention of neonatal and pediatric central line-associated bloodstream infection following a nurse-driven quality improvement initiative in a pediatric facility. Journal of the Association for Vascular Access, 23(1), 30-41. Doi: 10.1016/j.java.2017.11.002
Study Problem
Central Line-Associated Blood Stream Infection (CLABSI) is a bloodstream infection that primarily leads to increased mortality and morbidity rates of patients in hospital. About 260,000 central line-associated bloodstream infections are reported in hospitals in the United States. Also, approximately 29,000 death cases related to the central line-associated bloodstream infections are reported every year. Nearly 29,000 US dollars are spent on treating each patient, which creates a burden of about 2.4 billion dollars on the US healthcare system every year.
Significance of the study to nursing
The suffering experienced by families and patients due to the central line-associated bloodstream infections acquired in the hospitals is immeasurable. Therefore, there is a need for nurses to focus on the prevention strategies for bloodstream infections in hospitals, especially in the Intensive Care Unit.
The objective of the study
Hospitals commit developing strategies to minimize the cases of central line-associated bloodstream infections which are the primary source of high costs of care by both patients and health institutions. Also, bloodstream infections are the leading causes of high mortality rates of patients admitted to hospitals. Therefore, the main objective of the study is to characterize the effectiveness and development of centralized Central Line-associated bloodstream infections prevention bundle in pediatric hospitals.
Qualitative Research Critique and Ethical Considerations
Research question
What is the effectiveness of centralized Central Line-Associated Bloodstream Infections prevention bundle in preventing CLABSI for patients in pediatric intensive care unit?
How does the article answer the PICOT question?
The PICOT question researches the comparison between the effects of daily baths with Chlorhexidine and with soap and water in reducing the rate of central line-associated bloodstream infections in patients in the Intensive Care Unit. The article answers the PICOT question by examining the effects of central line-associated bloodstream infections prevention bundle in reducing CLABSI in patients in the neonatal and Pediatric Intensive Care Unit. Therefore, the utilization of antiseptic chlorhexidine gluconate can be used as the primary intervention to fight bacterial load both in the central lines and central venous catheters. Chlorhexidine gluconate daily baths are imperative compared to regular baths using soap and water in the ICU unit.
How the intervention and comparison group in the article compare to those identified in the PICOT question
The PICOT question compares the effectiveness of two interventions, that is, daily baths with Chlorhexidine and regular baths with soap and water in reducing the rate of Central Line-Associated Bloodstream Infections for patients in the Intensive Care Unit. On the other hand, the article compares different interventions, that is, central CLABSI prevention bundles in reducing the rate of Central Line-Associated Bloodstream Infections in patients in the neonatal and pediatric intensive care unit.
Study methods used in each of the two articles and how different they are
The article by Johnson et al. (2019) used an observational study to determine the relationship between Chlorhexidine baths and Central Line-Associated Bloodstream infection prevention. The groin and arm skin bacterial growth were observed in non exposed patients, and 40 Chlorhexidine exposed patients in the Neonatal Intensive Care Unit. The exposed patients were given 2 % Chlorhexidine baths for Central Line-Associated Bloodstream infection prevention.
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On the other hand, the study By Savage, et al. (2018) used a research method where the researchers applied a retrospective time series to examine the effectiveness of various prevention bundles that were developed by nurses in infection control in neonatal and pediatric intensive care unit in 2006-2014. The research was subdivided in to post, peri, pre, and second peri-intervention periods depending on each bundles implementation status.
Results of the studies and their implications to nursing
The study by Johnson et al. (2019) indicated that the bacterial burden reduced after the patients took the first bath. However, the bacterial load returned to baseline after 72 hours. The concentration of residual CHG on the skin reduced with time as the bacterial burden increased.
Bathing with Chlorhexidine decreases the bacterial burden on the skin. However, the burden’s baseline returns after 72 hours. Nurses should be aware that CHG bathing twice a week may not be adequate in reducing the growth of bacterial skin burden in patients admitted in the neonatal Intensive care unit. Targeted interventions in the ICU such chlorhexidine gluconate daily baths can reduce the risk of CLABSI associated with using central lines and central nervous catheters. Thus, the study has shown the efficacy of chlorhexidine gluconate in intensive care patients and support is increasing in caring for non-ICU patients.
On the other hand, the study by Savage et al. (2018) showed that there was a significant reduction in unit Central Line-Associated Bloodstream Infection rates where all units were less than the corresponding National Healthcare Safety Network Central Line-Associated Bloodstream Infection rates after the study.
Prevention bundle for centralized Central Line-Associated Bloodstream Infection can be useful in universalizing central line care, improve and control the quality of care to help maintain low CLABSI rates in the hospital. Thus, the study has shown the efficacy of chlorhexidine gluconate daily baths in reducing the risk of CLABSI associated with the use of central lines and central nervous catheters in intensive care patients.
Ethical Considerations
When conducting research, it is vital to maintain the confidentiality of patient information. Secondly, the study should be supported and approved by the Institutional Review Board. The Institutional Review Board approved the two articles. Besides, participants of the studies were chosen voluntarily, and their health information was confidentially maintained.
References
Johnson, J., Suwantarat, N., Colantuoni, E., Ross, T. L., Aucott, S. W., Carroll, K. C., & Milstone, A. M. (2019). The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. Journal of Perinatology, 39(1), 63. https://www.nature.com/articles/s41372-018-0231-7
Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Sustained reduction and prevention of neonatal and pediatric central line-associated bloodstream infection following a nurse-driven quality improvement initiative in a pediatric facility. Journal of the Association for Vascular Access, 23(1), 30-41. Doi: 10.1016/j.java.2017.11.002
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