The purpose of this literature review is to analyze a peer-reviewed quantitative article dedicated to effectiveness of isolation precautions techniques and the use of personal protective equipment to determine how these measures can be used, both together, and individually, to drop hospital-acquired infections among male and female patients between 70 and 90 years of age. In this paper, we will analyze an article titled “Preemptive Isolation Precautions of Patients at High Risk for Methicillin-Resistant Staphylococcus aureus in Combination with Ultrarapid Polymerase Chain Reaction Screening as an Effective Tool for Infection Control.”
The article was compiled by a board of researchers, and published in Infection Control and Hospital Epidemiology journal in December 2016. The article is very recent and offers up-to-date results backed by experimental research. It is a quantitative research article, as it deals with statistics regarding spread of MRSA (methicillin-resistant Staphylococcus aureus) in a hospital setting. The authors state that this disease is associated with adverse effects and increased healthcare costs, and is fairly common in most hospitals, which receive patients with this suspected disease. Proposed solution to this problem is preemptive isolation and rapid screening tests (Hallac et al., 2016). The authors identify the problem, the background, and the proposed measures clearly and succinctly, which makes the information easy to assess and understand. The relevance of the article is rated high.
The article does not possess any literature review to speak of, as it is only four pages long. Its reference list mentions ten independent sources published between 2004 and 2016. These sources are all directly related to the subject, and their number allows exploring the issue from all angles. All sources are peer-reviewed and published in various medical journals. Several randomized control trials are cited in this paper, which further enhances its credibility. Thus, the article has a solid evidence base to back up its claims and conclusions.
Methods of research involved systematic sampling of anterior nares, inguinal and perineal regions, as well as studies of catheter insertion sites, urine, and skin lesions (Hallac et al., 2016). For PCR tests, the samples were taken from both nostrils. The samples were then tested to identify various microbiological cultures presented in the patient. Over 10,000 patient-days were analyzed, making the sample base wide and representative. No personal data was available for research. Statistical analysis was performed using specialized digital software, to eliminate possible errors in calculations. The study was approved by the ethics committee of the Charité-University Medicine, Berlin (Hallac et al., 2016). Thus, methods of research are deemed ethical, valid and reliable.
The results of this research showed a significant drop in the mean number of admissions and meant a number of patient-days per month. The number of patients diagnosed with MRSA per 10,000 patient-days dropped from nine to below three (Hallac et al., 2016). The authors attribute this remarkable success with preemptive isolation, which allowed preventing the spread of bacteria during the first three hospital days, which are considered critical for the spread of the bacteria (Hallac et al., 2016). The data presented and evaluated in this article supports this conclusion. The authors did not report any biases or potential deviations from the outcome of this research.
Limitations of this study are very few. The ones reported by the researchers state that the length of phase 1 is relatively short when compared to phase 2 (Hallac et al., 2016). Another factor that may have had an impact on the results of the evaluation is the fact that Europe suffered a MRSA outbreak during the pre-study period, which could have solicited a higher number of recorded MRSA admissions. Limitations and implications of the article are clearly stated, and the evidence presented in it is enough to draw accurate and plausible conclusions. Generalizations were avoided, and conclusions are stated concisely and clearly.
This article has many implications for our research. While the study did not target age groups between 70-90 years specifically, elderly patients are the ones that are going to profit the most from reducing the number of hospital-acquired infections, especially such as MRSA. At their age, any common disease is a bigger threat, as their immune systems tend to be weaker than most. This research shows that preemptive isolation is an effective tool in reducing hospital-acquired infections, even if the time of isolation is no longer than 2-3 days. This means that using this method within 30 days given to achieve a positive outcome is achievable.
It must be noted, however, that the researchers did not attribute the success of their intervention to preemptive isolation alone – rapid MRSA screenings played a big role it. It seems that rapid screenings are of paramount importance for the intervention to be effective. The article has no information on any forms of PPE used during the experiment, so it is safe to assume that they did not have any significant impact on the outcome. Since it is unlikely to find a research dedicated to the comparative analysis of PPE effectiveness versus isolation precautions, the information will have to be extracted from articles focused either on PPE or on Isolation precautions.
Reference
Hallac, G., Neuner, B., Schefold, J.C., Gorzelniak, K., Rapsch, B., Pfuller, R., et al. (2016). Preemptive isolation precautions of patients at high risk for methicillin-resistant Staphylococcus Aureus in combination with ultrarapid polymerase chain reaction screening as an effective tool for infection control. Infection Control & Hospital Epidemiology, 37(12).