Clinical Nursing Practice Problem
Safety: Healthcare-Associated Infections (HAIs).
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The rationale for choosing the problem
HAIs present one of the most important issues in nursing practice, as these infections incur severe consequences for patients and the healthcare system on the whole. First of all, serious complications can be caused by HAIs. What is more, these complications may result in a patient’s death. For this reason, HAIs are associated with the increase in mortality rates and the rise in healthcare costs in the USA. It is clear that all necessary measures are required in order to prevent these serious consequences.
Clinical Nursing PICOT Question
In emergency clinic nursing care, how does alcohol-based hand sanitizer, contrasted with antimicrobial hand cleanser, influence Hospital Acquired Infection (HAI) rates on neonates in a half year?
P- (patient population/patients of interest): neonates in the emergency clinic nursing care
I- (Intervention): Antimicrobial hand washing
C- (Comparison): Alcohol-based hand sanitizer
O- (Measurable outcome): Reduce HAIs rates with appropriate hand hygiene
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T- (Time frame in months): 6 months.
Evidence Retrieval Process and Summary
The two selected studies analyze the statistics concerning HAI rates and associated risks. Therefore, these two studies are relevant to the issue of HAIs.
The evidence presented in the research papers is selected as it demonstrates the direct correlation between HAIs and subsequent severe complications. The research data is supported by statistics and highlights the importance of the issue in nursing practice and the healthcare system in general.
Implications of the Evidence
The first research by Evans et al. concerns the HAIs risk factors, which include patient characteristics, medical treatments, and the setting where the care is delivered. The statistical analysis demonstrates that multidrug-resistant organisms (MDROs) become the reason for approximately 2 million infections annually. About 1% of these infections result in death in the USA. What is more, the study underlines gaps in the HAIs research, which are to be covered. The identified gaps relate to HAIs and MDROs prevention for patients receiving care outside of acute care. This evidence shows the high significance of the issue and underlines the need for effective measures aimed at HAIs control and prevention.
The second study by Nelson et al. narrows down the topic to the HAIs associated with gram-negative bacteria and MRSA. The statistics show that more than 30% of HAIs are provoked by gram-negative bacteria. The research of the mortality rates attributed to the healthcare-associated infections indicates that HAIs associated with gram-negative bacteria and MRSA provoke significantly increased 30- and 90-day mortality risks. This evidence includes invasive cultures, which are probably true HAIs, as well as noninvasive ones, which are probably colonizations. Thus, the research highlights the elevated mortality risks due to negative bacteria and MRSA HAIs.
I am confident that the nursing practice committee should concentrate the following research on the issue of HAIs, as this problem may directly affect patients’ lives. HAIs have the highest potential of hindering the treatment and cure of a patient. What is more, the complications associated with HAIs lead to increased mortality rates. Therefore, the HAIs issue is of high importance and should be addressed to cover the identified gaps in the existing research.
Evidence Search Terms
The relevant searchable terms that were used for the evidence search include the following:
- Antimicrobial-resistant pathogens
- Methicillin-resistant Staphylococcus aureus (MRSA)
- HAIs mortality rates
- Multidrug-resistant organisms (MDROs)
Evidence Search Strategies
- Selected publication dates within last ten years
- Subject, title, or author search box
- Academic or scholarly (Peer Reviewed) journals
- Quotation marks for keywords
- Selected key terms from
Evans, C. T., Jump, R. L., Krein, S. L., Bradley, S. F., Crnich, C. J., Gupta, K.,… & Morgan, D. J. (2018). Setting a research agenda in prevention of healthcare-associated infections (HAIs) and multidrug-resistant organisms (MDROs) outside of acute care settings. Infection Control and Hospital Epi-demiology, 39(2), 210-213.
Nelson, R. E., Slayton, R. B., Stevens, V. W., Jones, M. M., Khader, K., Rubin, M. A…. & Samore, M. H. (2017). Attributable mortality of healthcare-associated infections due to multidrug-resistant gram-negative bacteria and methicillin-resistant Staphylococcus aureus. Infection Control and Hospital Epidemiology, 38(7), 848-856.