In this literature analysis, we shall reflect on a peer-reviewed quantitative research article that has connections to the subject of our research. Our research is meant to explain how does the use of isolation precautions compare to the application of PPE (personal protective equipment) affect the levels of hospital-acquired infections within elderly patients. The reviewed article is titled “Hospital acquired infections (HAI) in the elderly: Comparison with the younger patients.”
The reviewed research was conducted by Meltem Avci, Onur Ozgenc, Seher Ayten Coskuner, and Ali Ilgın Olut, in 2012. Izmir Bozyaka Training and Research Hospital were used as a setting for the research, as it provided plenty of patients to observe and enough medical data to compile and analyze (Meltem, Onur, Ayten, & Ilgin, 2012). The authors identify the problem of elderly patients being more susceptible to HAI in a generic hospital setting. This is a very important subject that can be applied to most hospital settings – elderly patients have weaker immune systems and HAI present greater dangers towards their life and wellbeing. The background of the research supports the importance of the problem, as it indicates that HAI causes deaths among elderly patients every year.
As this article is essentially an experimental research report, it does not have a dedicated literature review, since it is based on statistics and analysis of factual cases rather than dissemination of literature. Despite this, the authors base their research on a limited number of peer-reviewed journals and articles, 13 in total (Meltem et al., 2012). The introduction section mentions several authors and their researches. These are Strausbaugh, 2006, Paillaud et al., 2005, Brusaferro et al., 2006, and Eriksen et al., 2007 (Meltem et al., 2012). These studies are dedicated to the prevalence, incidence, type and microbiological characteristics of hospital-acquired infections (HAIs) in the elderly patients in developed countries. Thus, the article has a solid evidence base to back up its claims and conclusions (Meltem et al., 2012).
The study was conducted using the retroactive analysis method. Data of over 60585 patients was used during research (Meltem et al., 2012). Standard form for each patient included patient’s name–age–gender, hospital location, date of hospitalization, cause of admission, date of infection onset, site of infection, presence of risk factors such as trauma, malignancy, chronic airway disease, diabetes mellitus, cardiovascular disease, immunosuppressive drug use, previous antibiotic therapy, presence of indwelling devices, isolated micro-organisms and susceptibility patterns, treatment and outcomes (Meltem et al., 2012). To protect sensitive and personal information, no names were used in this research. Although no approvals from any ethical committees were mentioned in the body of the article, it can be assumed that the researchers were given such to publish it in a peer-reviewed medical journal.
The results of this research concluded that elderly patients are more susceptible to HAI than younger patients. In all age groups, 825 HAI episodes were detected in 607 patients (Meltem et al., 2012). The authors report that the HAIs rate per 100 admissions was 1.96 in the elderly and 1.05 in the non-elderly (Meltem et al., 2012). The incidence of HAIs per 1000 patient days was 2.49 in the elderly and 1.64 in the younger patients’ group, and the difference for rate and incidence density was statistically significant (p < 0.001) (Meltem et al., 2012). These results support the hypothesis that elderly patients are more vulnerable and susceptible to HAI.
In the discussion section, the authors stated that most of the elderly patients became infected with HAI due to medical services, while most of younger patients – from surgical units. This means that largely elderly patients succumb to nosocomial infections such as MRSA and other diseases, while stronger and younger organisms have a higher chance of withstanding it. One major point brought up in the article is the absence of a separate geriatric ward. The researchers strongly suggest applying one to every hospital setting to reduce the number of HAI. The evidence presented is enough to draw expected conclusions. Limitations of the research are addressed – it does not reflect on the situation in hospitals outfitted with geriatric wards, nor can the results of research be applied universally, as the setting was a hospital in Turkey, meaning that the results reflect on the situation in that country, rather than universally.
Still, this research provides plenty of support and information that can be used in our research. The conclusion regarding the absence of a separate geriatric ward speaks strongly in favor of applying patient isolation precautions in elderly patients, which is the topic of our research. Statements about elderly patients being more susceptible to HAI will serve as excellent justification and background for the ongoing study. Lastly, the research provides a number of HAI most common in a hospital setting, including those of nosocomial and surgical nature. This data will allow for a more narrow study, using these keywords in search engines. It is possible that more dedicated studies exist, fixated largely on studies of these diseases.
References
Meltem, A., Onur, O., Ayten, S., & Ilgin, A. (2012). Hospital acquired infections (HAI) in the elderly: Comparison with the younger patients. Archives of Gerontology and Geriatrics, 54(1), 247-250. Web.