Critical Appraisal on Health Care-Free-Samples-Myassignmenthelp

Question: You are Required to Choose A Nursing Issue that is Related to one of the Key Safety And Quality in Health Care Areas From the List Below*a then Research the Issue. Answer: Introduction Medical advances have given life saving care to the patients, yet one of the main risks associated to health care safety is the risk of infections. The unanticipated risks of infections may develop during the course of a surgical treatment a may deteriorate the condition of the patient. According to the consensus a large number of deaths are caused daily due to the HAI (Moore et al.2012). HAI may bring about unwanted mortality and may increase the time of the hospital stay. The HAI necessitates additional costs and can increase the overall cost of the hospital stay. Preventing HAIs is critical to patient. The risk of infection lies with any patient. Risk of infection depends upon the immune capacity of a particular person, presence of invasive medical devices such as catheter tubes and use of antibiotics. Proper preventive measures can help in mitigating the chance of the HAI (Weber et al.2013) Patients admitted in the health settings are subjected to risks of infections. From exposure to microorganisms that are transmitted between the clinical staffs and the patients. Overuse of antibiotics has increased the problems of HAI by giving rise to the antibiotic resistant microorganisms. This paper aims to critically analyze three papers; a qualitative study, a quantitative study and literature review related to the health care associated infections and their nursing interventions (Polin et al.2012). The NSQSH standard 3, refers to the prevention of the health care associated infections, and has presented with guidelines to prevent the nosocomial infections in the inpatients (Moore et al.2013). According to the guideline, prevention strategies like proper surveillance, application of proper disinfection and sterilization techniques, antimicrobial steward ship and proper communication between the patients and the carers can mitigate the possibilities of the health care associated infections. Critical appraisal The CASP tool has been chosen for the critical appraisal of the three papers. CASP tools are appropriate to help the individuals to make sense of research evidence and help them apply to evidence based practice. CASP tools are normally used to appraise a paper critically and thus help to solve the vagueness of any article. A critical research makes sure that all the ethical considerations of the study have been met or whether the research has any beneficial implications over mankind. The Paper by Jackson et al (2012) is an interpretative qualitative study that will discuss about the hospital acquired infections and the insufficient compliance of the guidelines by the health care workers. This study uses vignettes to enquire the nurses about their initiative to prevent the Health care associated infections. In this study twenty semi structured interviews were being undertaken using vignettes and a topic guide. One of the limitations of this paper is that it is a self practiced study, as most of the participants were keen to develop a good impression and present themselves as responsible registered nurses. Therefore it can be acknowledged that the practice of self report is biased. This strength of this study is due to the use of the vignettes which can lessen the socially desirable responses. By allowing the nurses to talk about their practice and the vignette character, some of the disparities between the subjective and the objective data can be removed. For this study the formulation of the research questions, data collection methods were appropriate. All the ethical issues have been granted by the King's college London. The research had been valuable as it actually proved how the irresponsible behavior of the health care workers is related to nosocomial infections. The literature review by Weber et al. (2013) reviews the role of the contaminated hospital surfaces in the spread of the communicable diseases. The paper also demonstrated the how scientific interventions can decrease the risks of microbial contamination and the HAIs. MEDLINE, CINAHL databases have been brain stormed to search the literatures associated with this issue. All the literature used in this study is pertinent to the topic of HAIs. The results obtained from all the studies form all the studies were quite similar. Al most all the studies concluded that enhanced education, checklists and procedures to evaluate the effectiveness of room cleaning along with the immediate feedback to the in charge can lead to the mitigation of the HAIs. The quantitative study by Anderson et al (2012), aims to identify and prioritize the risks and hazards in the surgical wards and the possible recommendations to prevent the sentinel events. Seventy hours of observations have been done and the severity and the frequencies of the severity of the surgical infections have been identified and documented. The strength of this paper is that this was the first systematic proactive analysis of the surgical wards. In this paper the exposures were subjected to minimum bias. All the confounding factors have been addressed properly. Ethical clearance has been received. The time period for the follow up was enough for the assessment. Critical analysis The qualitative study by Jackson et al. (2012) indicated that the behavior of the nurses and other clinical workers to the prevention of the HAIs were quite harmful. although the clinical staffs present themselves that they desire to protect the safety of the patient, but the underlying facts supports that one of the driving factor for the spread of the infections are due to lack of compliance with the guidelines. According to the study, spread of infection is associated with the lack of understanding among the health care staffs. Studies have shown that in most of the cases the health care staffs does not have any guidelines regarding the hand washing procedures and practice. As per the study by Weber et al. (2013) it is necessary to maintain cleanliness in the hospital surfaces as infections can also spread through them. According to Moore et al (2013) Inadequate hand and hygiene, improper disposition of the used apron and gloves and any equipment that can be moved from bed to bed bear high risks of infection. Polin et al. (2012) have emphasized on the following that it is important to disinfect the surgical instrument and clean the site of the surgery to prevent infection to the next patient. According to Otter et al.(2013) the operating theatres should be cleaned with wet vacuum and clean air should be supplied with the help of the high efficiency particulate air filters (HEPA). According to Wunderink et al. (2012) infections can also spread while the meeting of the staffs in hand during the changeover of shifts. Huttner et al. (2013) have emphasized on the "No-touch" methods of surface disinfection. Hospital rooms can be disinfected by using Ultraviolet lights or hydrogen peroxides, both of them have bactericidal effects (Otter et al. 2013). According to Carling (2013) self disinfecting surface can be created by coating the surfaces with metals such as silver or copper, both of which have microbicidal properties. It has been seen that coated surfaces in hospital settings have reduced the risk of the HAIs that spread through contaminated surfaces. Reports suggest that despite of the education and training among the workers, there lacks self motivation among the staffs (Wunderink et al. 2012). It has been argued that self protection in the staffs can be called upon as a motivating factor for the prevention of infection among the patients and the workers. It has been found that in most of the cases the nurses rationalize their own behavior by finding flaws in other's practice. This study reveals that the patients often fail to change their gloves while attending different patients. Hence it can be concluded that Education in the clinical staffs, use of effective antimicrobial substances in hospital surfaces and the surgical sites, effective disposition of the used substances, maintenance of hand and hygiene and self education in patients can reduce the rates of mortality and morbidity due to HAI. Summary table Author/s, (year) Country Aims Sample/ Setting Designs/ methods Main Findings Strengths and limitation of study 1 Jackson et al. 2014 United Kingdom To understand the relation between the health care associated infections and problems in the clinical staffs regarding the lack of compliance with the guidelines. The registered nurses working in the hospital settings. Qualitative study. 20 interviews were conducted using a vignette and a topic guide The findings shows the clinical staffs did not comply by the guidelines of hygiene. Strengths: Use of the vignettes which can lessen the socially desirable responses. Limitations: practice of self report is biased 2 Weber et al. 2013 United States Role of the contamination of the hospital surfaces in the transmission of the pathogens and the possible interventions to reduce the chance. Literature review on publications searched from MEDLINE and CINAHL Literature review on a recent literature that is related to the topic. Vancomycin-resistant Enterococcus spp (VRE),Staphylococcus aureus (MRSA), , Clostridium difficile, norovirus and Acinetobacter spp, can spread through contaminated surface. Improved disinfection and surface cleaning can reduce the transmission of the harmful pathogens. Strengths: Minimum bias, wide spread literature search, Ethical approval received. Implications in the environment. Limitations: The number of articles taken has not been mentioned. 3 Anderson et al.2012 United Kingdom To determine and prioritize the hazards due to infections in the surgical wards and the interventions. Seventy hours of observation has been conducted in the surgical wards. The mode of the health care failure and effect analysis was performed . Quantitative study. A risk assessment survey was performed between fifty nine patients and staffs. Among the hazardous events, the 5 most hazardous event was related to hand hygiene, isolation of infections and disposal of surgical wastes. Strengths: It was the first study to conduct a systematic risk assessment of the surgical wards. The results are supported by other's reports. Ethical approval received. Limitations: All the sentinel events were not recorded and the sample size was not adequate. References Anderson, O., Brodie, A., Vincent, C.A. and Hanna, G.B., 2012. A systematic proactive risk assessment of hazards in surgical wards: a quantitative study.Annals of surgery,255(6), pp.1086-1092. Carling, P., 2013. Methods for assessing the adequacy of practice and improving room disinfection.American journal of infection control,41(5), pp.S20-S25. Huttner, A., Harbarth, S., Carlet, J., Cosgrove, S., Goossens, H., Holmes, A., Jarlier, V., Voss, A. and Pittet, D., 2013. Antimicrobial resistance: a global view from the 2013 World Healthcare-Associated Infections Forum.Antimicrobial resistance and infection control,2(1), p.31. Jackson, C., Lowton, K. and Griffiths, P., 2014. Infection prevention as a show: a qualitative study of nurses infection prevention behaviours.International journal of nursing studies,51(3), pp.400-408. Moore, G., Muzslay, M. and Wilson, A.P.R., 2013. The type, level, and distribution of microorganisms within the ward environment: a zonal analysis of an intensive care unit and a gastrointestinal surgical ward.Infection Control Hospital Epidemiology,34(5), pp.500-506. Otter, J.A., Yezli, S., Perl, T.M., Barbut, F. and French, G.L., 2013. The role of no-touchautomated room disinfection systems in infection prevention and control.Journal of Hospital Infection,83(1), pp.1-13. Otter, J.A., Yezli, S., Salkeld, J.A. and French, G.L., 2013. Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces in hospital settings.American journal of infection control,41(5), pp.S6-S11. Polin, R.A., Denson, S. and Brady, M.T., 2012. Strategies for prevention of health careassociated infections in the NICU.Pediatrics,129(4), pp.e1085-e1093. Weber, D.J., Anderson, D. and Rutala, W.A., 2013. The role of the surface environment in healthcare-associated infections.Current opinion in infectious diseases,26(4), pp.338-344. Wunderink, R.G., Niederman, M.S., Kollef, M.H., Shorr, A.F., Kunkel, M.J., Baruch, A., McGee, W.T., Reisman, A. and Chastre, J., 2012. Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study.Clinical Infectious Diseases,54(5), pp.621-629.