The Critical Appraisal (CA) Process is to compare and contrast in detail the types of studies you found related to your topic
There are three parts to this MB: Take your time to develop your response as this is about the research article you found that answers your clinical question – PICOT. This section is a major section of the presentation you will give at the end of this course. HINT: Review the presentation guidelines.
I. Discuss your research studies that you have collected that answered your PICOT question.
1.First answer the questions below
2.Summarize your findings.
3.Do not discuss the studies one at a time; compare and contrast the findings as a whole. (This MB is to assist you in understanding the CA process that you will go through to put the findings on your poster. May want to take a look at the poster criteria at this time).
Answer the following questions for each study and then summarize your findings:
1. What type of study was conducted?
2. Is the purpose of the study clearly and concisely stated?
3. Is the literature review well organized and synthesized?
4. Is the method for selection of sample appropriate?
5. Is the presentation of data clear?
6. Are the results based on the data presented?
7. Is the evidence sufficient to draw conclusions?
8. Are the strengths and limitations of the study clearly delineated?
II. Discuss recommendation(s) for evidence-based practice changes – what is the best practice from the conclusion of the summary of findings (above) – What practice change is warranted?
III. Discuss what indicators/outcomes based on the evidence should be tracked on an on-going basis and why for practice change? (They should be based on the evidence you collected – check out the results section and what you pulled out from the CA of each article).
Critical Appraisal Process and Outcomes
Student’s Name
Institutional Affiliations
Critical Appraisal Process and Outcomes
Critical appraisal entails comparing the similarities and differences in various studies that have been searched related to a given study topic. The aim of conducting critical appraisal is to establish the relevance of the identified studies in answering a specific research question (Polit & Beck, 2020). The purpose of this assignment is to critically appraise studies related to the chosen topic and to summarize findings. The author will also recommend the best practice based on the documented evidence and identify outcomes or indicators that the organization can use to assess the effectiveness of the best practice intervention.
Part I
Research has generated a number of studies that have been conducted to support the effectiveness of handwashing in reducing rates of hospital-acquired infections. Three articles have been selected for the critical appraisal. One of them is a systematic review (Mouajou et al., 2021), the other one is a hospital-based survey (Haverstick et al., 2017), whereas another one is a retrospective study (Manasij et al., 2021). Although framed differently, the purposes of the three studies were to examine the effect of handwashing or hand hygiene on the rates of hospital-acquired infections. The authors of the three studies have organized their findings clearly. Haverstick et al. (2017) discovered that hand hygiene or handwashing significantly reduced rates of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. Mouajou et al. (2021) reported similar findings despite the fact that the authors did not specify the types of healthcare-associated infections that reduced in rates following hand hygiene compliance. According to the authors, hand hygiene compliance that comprised mainly of handwashing resulted in lower incidences in the rates of healthcare-associated infections. While Manasij et al. (2021) have reported almost similar findings, the types of infections studied by the authors were different from those evaluated by Haverstick et al. (2017) and Mouajou et al. (2021). Manasij et al. (2021) discovered that handwashing reduced rates of catheter-associated urinary tract infections (CAUTIS) by 28.01%, rates of central line-associated bloodstream infections (CLABSIs) by 37.61%, rates of surgical site infections (SSIs) by 62.39%, and rates of ventilator-associated pneumonia (VAP). The evidence presented in these articles is sufficient to draw conclusions.
Part II
PICOT questions are meant to direct researchers to conduct research with the aim of collecting evidence that can be applied to improve a clinical practice problem. Based on the collected evidence, recommendations are usually provided to improve practice. The essence of evidence-based practice is to collect, process, and implement research findings to improve clinical practice and patient outcomes (Polit & Beck, 2020). Nurses embrace evidence-based practice by implementing only those interventions whose effectiveness is supported by research evidence. The best practice from the conclusions in the summary of findings above is to implement a handwashing strategy in the facility. Doing so will reduce rates of healthcare-associated infections as supported by the documented evidence. The proposed practice change should occur as soon as possible to prevent patients from suffering from even more severe health consequences due to the high rates of healthcare-associated infections. The recommended practice change has been informed by research. Haverstick et al. (2017) concluded that frequent handwashing has a direct influence on the rates of healthcare-associated infections. Similarly, conclusions presented by Mouajou et al. (2021) indicate that hand hygiene compliance reduces rates of healthcare-associated infections. Again, Manasij et al. (2021) concluded that hand hygiene, specifically handwashing, helps to reduce incidences of hospital-acquired infections, especially during the COVID-19 pandemic. Therefore, it is clear that implementing a handwashing strategy will be an evidence-based practice change.
Part III
An organization must set clear indicators outcomes to assess the effectiveness of an evidence-based practice change. According to the Agency for Healthcare Research and Quality (2021), outcome measures or indicators reflect the effects of evidence-based interventions on the health status of patients. The specific outcome measure appropriate for the current scenario is the rate of healthcare-associated infections. The evidence-based intervention whose effect is being evaluated here is handwashing. Handwashing will be considered effective when its implementation in the facility results in a reduction in the rates of healthcare-associated infections over a period of three months. It is important to note that there are several types of healthcare-associated infections. These can be used as indicators or outcomes. Based on the evidence documented in the reviewed articles, the specific indicators that should be tracked on an ongoing basis include; rates of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, surgical site infections, ventilator-associated pneumonia, CLABSIs, and CAUTIs. These indicators have been chosen because they are the outcomes that have clearly been evaluated following the implementation of handwashing intervention in the reviewed studies. For instance, Haverstick et al. (2017) discovered that hand hygiene or handwashing significantly reduced rates of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. Furthermore, Manasij et al. (2021) found that handwashing reduced rates of catheter-associated urinary tract infections (CAUTIS) by 28.01%, rates of central line-associated bloodstream infections (CLABSIs) by 37.61%, rates of surgical site infections (SSIs) by 62.39%, and rates of ventilator-associated pneumonia (VAP).
References
Agency for Healthcare Research and Quality. (2021). Types of quality measures. https://www.ahrq.gov/talkingquality/measures/types.html
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ handwashing and reducing hospital-acquired infection. Critical Care Nurse, 37(3), e1-e8. doi: 10.4037/ccn2017694. PMID: 28572111.
Manasij, M., Amrita, G., Ranabir, P. & Maitraye, B. (2021). Prevention of hospital-acquired infections. Journal of Family Medicine and Primary Care, 10(9), 3354 doi: 10.4103/jfmpc.jfmpc_742_21.
Mouajou, V., Adams, K., DeLisle, G., & Quach, C. (2021). Hand hygiene compliance in the prevention of hospital acquired infections: a systematic review. The Journal of Hospital Infection, S0195-6701(21)00341-8. doi: 10.1016/j.jhin.2021.09.016. Epub ahead of print. PMID: 34582962.
Polit, D. F., & Beck, C. T. (2020). Nursing research: generating and assessing evidence for nursing practice. Wolters Kluwer Health.