CCB BIO 205 Handling Specimens of Bacteria Summary Analysis

CCB BIO 205 Handling Specimens of Bacteria Summary Analysis ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON CCB BIO 205 Handling Specimens of Bacteria Summary Analysis I’m working on a writing question and need an explanation to help me understand better. CCB BIO 205 Handling Specimens of Bacteria Summary Analysis Please write a 1 page summary and opinion on the attached paper, attachment_1 Research JOURNAL OF MICROBIOLOGY & BIOLOGY EDUCATION DOI: https://doi.org/10.1128/jmbe.v18i2.1224 Microbiology Education in Nursing Practice † Robert J. Durrant*, Alexa K. Doig, Rebecca L. Buxton, and JoAnn P. Fenn University of Utah, Salt Lake City, UT 84132 Nurses must have sufficient education and training in microbiology to perform many roles within clinical nursing practice (e.g., administering antibiotics, collecting specimens, preparing specimens for transport and delivery, educating patients and families, communicating results to the healthcare team, and developing care plans based on results of microbiology studies and patient immunological status). It is unclear whether the current microbiology courses required of nursing students in the United States focus on the topics that are most relevant to nursing practice. To gauge the relevance of current microbiology education to nursing practice, we created a confidential, web-based survey that asked nurses about their past microbiology education, the types of microbiology specimens they collect, their duties that require knowledge of microbiology, and how frequently they encounter infectious diseases in practice. We used the survey responses to develop data-driven recommendations for educators who teach microbiology to pre-nursing and nursing students. Two hundred ninety-six Registered Nurses (RNs) completed the survey. The topics they deemed most relevant to current practice were infection control, hospital-acquired infections, disease transmission, and collection and handling of patient specimens. Topics deemed least relevant were the Gram stain procedure and microscope use. In addition, RNs expressed little interest in molecular testing methods. This may reflect a gap in their understanding of the uses of these tests, which could be bridged in a microbiology course. We now have data in support of anecdotal evidence that nurses are most engaged when learning about microbiology topics that have the greatest impact on patient care. Information from this survey will be used to shift the focus of microbiology courses at our university to topics more relevant to nursing practice. Further, these findings may also support an effort to evolve national recommendations for microbiology education in pre-nursing and nursing curricula. INTRODUCTION The role of biosciences in pre-nursing and nursing curricula is a well-described, international concern, as educational institutions respond to changes in the clinical environment (1). Key themes among studies include a shift from biosciences to humanistic sciences (sociology, psychology, etc.) in order to provide a more comprehensive, holistic care model (2); inadequate science content in nursing curricula (3–5); poor alignment between curricula and nursing practice (6–8); nurses’ lack of confidence in educating patients and other healthcare professionals (9); and a need for curricula *Corresponding author. Mailing address: University of Utah School of Medicine, Department of Pathology,CCB BIO 205 Handling Specimens of Bacteria Summary Analysis Medical Laboratory Science Division, 30 N 1900 E RM 5R472A, Salt Lake City, UT 84132. Phone: 801-585-6989. E-mail: [email protected]. Received: 16 August 2016, Accepted: 22 June 2017, Published: 1 September 2017. †Supplemental materials available at http://asmscience.org/jmbe that are responsive to a changing clinical landscape (10). Less time devoted to curricula for bioscience, including microbiology, has also led to concerns about possible gaps in foundational knowledge related to patient care (11). Several studies have attempted to identify learning deficits and assess their potential impacts on patient care (6, 12–15). These studies suggest that a particular concern among nurses and nurse educators is the nurses’ lack of comfort in correlating patient symptoms with the underlying pathophysiology and making appropriate care interventions based on that information. Such discomfort can lead to inaction or incorrect actions, either of which may be detrimental to patient care. At least some of the nurses’ discomfort may result from inadequate coverage of certain topics or knowledge applications in a foundational microbiology course (or from nurses not taking such a course in the first place). Without a solid foundation in microbiology, nurses may have knowledge shortfalls in related areas such as infection control, pathophysiology, antimicrobial resistance, critical values, and patient management. ©2017 Author(s). Published by the American Society for Microbiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-NoDerivatives 4.0 International license (https://creativecommons.org/licenses/by-nc-nd/4.0/ and https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode), which grants the public the nonexclusive right to copy, distribute, or display the published work. Volume 18, Number 2 Journal of Microbiology & Biology Education Downloaded from www.asmscience.org by IP: 160.2.163.244 On: Thu, 02 Jul 2020 22:26:29 1 DURRANT et al.: MICROBIOLOGY EDUCATION IN NURSING In 2012, an American Society for Microbiology (ASM) Task Force published curriculum guidelines specific to undergraduate education in microbiology (16), based on survey feedback from microbiology educators. These guidelines recommended six concept areas as focal points in undergraduate microbiology courses—evolution, cell structure and function, metabolic pathways, information flow and genetics, microbial systems, and the impact of microorganisms. The guidelines were intentionally not specific to any one professional program; rather, they sought to outline a well-rounded, foundational microbiology education for a range of undergraduate students. Nursing programs presently devote limited time to microbiology, and many are considering further reducing or even eliminating microbiology instruction. Therefore, it is vital that any microbiology topics they cover be salient to nursing practice. Relevance is key to student success and engagement, and to the proper application of knowledge in the healthcare workplace (4, 10, 17). Although researchers have assessed the microbiology curricula at various institutions and gathered faculty views on the standards for undergraduate microbiology courses (16, 18), no survey, to our knowledge, has asked currently employed nurses for their input on the content and quality of pre-nursing or nursing microbiology courses. CCB BIO 205 Handling Specimens of Bacteria Summary Analysis Our objective was to assess nurses’ perceptions of the relevance of various topics in microbiology and infectious disease to nursing practice, in order to develop data-driven recommendations for educators who teach microbiology to pre-nursing and nursing students. METHODS To identify the relevance of current microbiology education to nursing practice, we developed an Internet-based survey in which we asked nurses about their educational background in microbiology and related topics, about their use of microbiology knowledge in their current work, and about the relevance of specific microbiology course topics in the workplace. The nurses also answered questions about their demographic and place of employment. The microbiology topics included in the survey were from our university’s pre-nursing microbiology course syllabus. This syllabus is loosely based on the American Society for Clinical Laboratory Science Entry Level Curriculum (19) recommendations for Medical Laboratory Science students; it has been modified based on input from nursing and physician educators. The study was submitted to the Institutional Review Board and designated as exempt. The link to the survey was distributed through the University of Utah College of Nursing alumni network in May 2015. Responses from this convenience sample were collected through November 2015. Targeted participants were Registered Nurses (RNs) practicing in the United States or Canada who had completed their undergraduate nursing 2 education in the United States or Canada. RNs practicing in any healthcare setting were eligible to participate. Nurses licensed as Advanced Practice Registered Nurses (i.e., nurse practitioners or clinical nurse specialists) were directed to another, similar survey. Data were collected and managed using REDCap (Research Electronic Data Capture) tools hosted at the University of Utah (20) with the support of the CTSC grant (1 UL1 RR024989 from NCRR/NIH). REDCap is a secure, web-based application designed to support data capture for research studies, providing 1) an intuitive interface for validated data entry; 2) audit trails for tracking data manipulation and export procedures; 3) automated export procedures for seamless data downloads to common statistical packages; and 4) procedures for importing data from external sources. Data were analyzed using IBM SPSS Statistics for Macintosh, Version 22.0. The primary analysis focused on descriptive statistics (frequencies, means, and measures of variance). Independent t-tests were used to examine differences between hospital and community-based nurses, and other demographic groups. RESULTS Two hundred ninety-six RNs completed the survey. As expected due to dissemination of the survey through a university alumni network, most respondents had baccalaureate or graduate degrees (Table 1). Representation was very good across all years of work experience. The majority of respondents work in hospital settings (81.9%); the rest are in community settings (18.1%). Most respondents had a formal microbiology course either prior to or during their program (77.3%), and over half (55.1%) had a microbiology lab. TABLE 1. Survey respondent demographics (N = 296).CCB BIO 205 Handling Specimens of Bacteria Summary Analysis Demographic Characteristics n (%) Highest degree in nursing Associate Baccalaureate Master Other 19 (6.4) 210 (70.7) 54 (18.2) 13 (4.4) Years of experience as a RN <1 1–5 6–10 11–15 16–20 21–25 26–30 31–40 >40 15 (5.1) 87 (29.3) 71 (23.9) 24 (8.1) 14 (4.7) 16 (5.4) 20 (6.7) 35 (11.8) 14 (4.7) RN = registered nurse. Journal of Microbiology & Biology Education Downloaded from www.asmscience.org by IP: 160.2.163.244 On: Thu, 02 Jul 2020 22:26:29 Volume 18, Number 2 DURRANT et al.: MICROBIOLOGY EDUCATION IN NURSING Nurses were surveyed about duties they routinely performed that related to microbiological topics, about the specimens they most frequently collected for microbiological testing, and about the types of infections they most frequently encountered. Among the more frequently performed duties were administration of intravenous/oral antibiotics, patient education regarding specimen collection, and patient education regarding the nature of their infections (Table 2). Specimens most frequently collected by nurses included urine, stool, blood, and sputum (Table 3). Wound and urinary tract infections were the most frequent infection types encountered by respondents (Table 4). Almost half of survey respondents (43.6%) indicated that they routinely encountered fungal infections, which was almost the same percentage as for upper respiratory tract infections (43.9%). TABLE 2. Duties routinely performed (N = 296). Duties % Administer intravenous (IV) antibiotics 64.5 Educate patients about collection of sputum, urine, or stool specimens 59.8 Administer oral (PO) antibiotics 60.8 Educate patients about the nature of their infections 61.1 Routinely interpret results from bacteriology laboratory tests and communicate significant results to healthcare team members 38.5 Deliver specimens from hospital unit or clinic to laboratory 33.8 Read throat cultures inoculated to agar plates and identify Group A Streptococcus 3.4 Perform Gram stains 1.7 Inoculate specimens to culture media and streak the agar plates for isolation of bacteria 0.7 TABLE 3. Specimens routinely collected for microbiology tests (N = 296). Specimen Type % To assign relevance to different microbiological topics, respondents were asked to rate each topic from 1 (no relevance) to 5 (extremely relevant). The highest-rated topics were infection control, hospital-acquired infections, and disease transmission; the lowest-rated were microscope use and the Gram stain procedure (Fig. 1). While there was slight variation in the mean relevance that different age groups assigned to topics, these differences were not statistically significant. Nurses working in hospital settings identified several microbiology course topics as having greater relevance to their practice than nurses working in community settings did. These topics included the collection and handling of specimens (t = 2.9, p = 0.005), knowledge of medically important microorganisms (t = 2.4, p = 0.016), and infection in the immunocompromised host (t = 2.0, p = 0.045). As expected, hospital-based nurses gave the topic of hospital-acquired infections a significantly higher relevance rating than did the community-based nurses (t = 4.4, p < 0.001). Among hospital-based nurses, those working in the emergency department rated the topic of bioterrorism as having higher relevance than did those on acute care units (t = 2.1, p = 0.043). We used a similar five-point rating scale (1 = no interest, 5 = extremely interested) to evaluate the nurses’ interest in continuing education (CE) in the same microbiology course topics that were listed under relevance. These data generally follow the same pattern as the relevance data, with the highest- and lowest-rated topics remaining the same (Fig. 2). The TABLE 4. Infection types routinely encountered (N = 296). Infection Type % Wound Urinary tract 68.9 68.6 Lower respiratory tract 57.CCB BIO 205 Handling Specimens of Bacteria Summary Analysis 4 Gastrointestinal 55.1 Sepsis 54.7 Skin 53.0 Viral 52.0 43.9 Urine culture Stool culture 67.2 53.0 Upper respiratory tract Fungal 43.6 Blood culture from central venous catheter 42.2 Central venous catheter/central line 41.9 Sputum culture 40.2 Bone 26.7 Blood culture from peripheral vein 39.9 Joint 26.4 Wound culture 35.1 Eye 25.0 Anaerobic culture 24.3 Central nervous system 23.0 Ova and parasites 19.6 Sexually transmitted 20.3 Cervical/vaginal culture for sexually transmitted infections 10.8 Ear 19.9 Skin scraping 7.8 Parasitic 17.2 None 22.0 Obstetric/perinatal 12.2 Volume 18, Number 2 Journal of Microbiology & Biology Education Downloaded from www.asmscience.org by IP: 160.2.163.244 On: Thu, 02 Jul 2020 22:26:29 3 DURRANT et al.: MICROBIOLOGY EDUCATION IN NURSING Using a microscope Gram stain procedure Molecular testing methods (e.g. PCR) Microbial genetics Bioterrorism Microbiology cell biology Microbiology course topic Interpretation of susceptibility reports Epidemics and pandemics Differentiation of normal flora vs. pathogens Epidemiology of infectious disease Interpretation of culture results Infection in the immunocompromised host Host defense mechanisms and immune reactions Common medically important microbe groups Vaccines Principles of antimicrobial therapy Collection and handling of specimens Disease transmission Hospital acquired infections Infection control 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 Relevance mean FIGURE 1. Relevance of microbiology course topics (mean; 1 lowest to 5 highest). Error bars represent the standard error of the mean. FIGURE 1. Relevance of microbiology course topics (mean; 1 lowest to 5 highest). Error bars represent the standard error of the mean. Using a microscope Gram stain procedure Molecular testing methods Microbial genetics 24 Microbiology cell biology Bioterrorism Microbiology course topic Collection and handling of specimens Interpretation of susceptibility reports Differentiation of normal flora vs. pathogens Epidemics and pandemics Interpretation of culture results Vaccines Host defense mechanisms and immune reactions Infection in the immunocompromised host Principles of antimicrobial therapy Epidemiology of infectious disease Disease transmission Common medically important microbe groups Hospital acquired infections Infection control 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 Interest mean FIGURE 2. Interest in continuing education (means; 1 lowest to 5 highest). Error bars represent the standard error of the mean. Volume 18,ofNumber 2 4 Journal of Microbiology & Biology Education FIGURE 2. Interest in continuing education (means; 1 lowest to 5 highest). Error bars represent the standard error the mean. Downloaded from www.asmscience.org by IP: 160.2.163.244 On: Thu, 02 Jul 2020 22:26:29 DURRANT et al.: MICROBIOLOGY EDUCATION IN NURSING lone exception was collection and handling of specimens, which had a mean CE interest value (3.1) that was modestly lower than its mean relevance value (4.1). DISCUSSION The high relevance assigned to infection control, hospital-acquired infections, and disease transmission reflects the importance of these topics in patient care. CCB BIO 205 Handling Specimens of Bacteria Summary Analysis These topics should be strongly emphasized throughout the nursing pre-requisite microbiology course. We find it concerning that approximately one in four surveyed nurses did not have a microbiology course as part of their nursing education, given that these topics are unlikely to be covered with a microbiology focus in other nursing curriculum courses. The literature has established that nurses need to understand microbiology topics in order to effectively prevent and recognize healthcare-acquired infections (6, 12–15, 21, 22). Foundational knowledge of disease transmission and prevention is critical. A large number of nurses are routinely encountering fungal infections. When we examine the data more closely, we find that the nurses who encounter fungal infections are concentrated in hospital settings, with the majority (74.4%) in acute care, critical/intensive care, and oncology units— areas where these types of infections are most common. Given the frequency of nurses’ encountering fungal infections, nursing microbiology courses should emphasize the unique characteristics of fungi (e.g., growth rates, reservoirs, antibiotic targets) compared with other microorganisms and the nature of fungal infections in human hosts. The covered information should be practical. For example, a microbiology curriculum could discuss why certain antibiotics work against bacteria but not fungi, as well as the association between the turnaround time of fungal culture results and the growth rates of common fungal pathogens. As the vast majority of nurses (98.3%) do not perform and read Gram stains, it is unsurprising that the nurses assigned the lowest relevance to Gram stain procedures and microscope use. However, the Gram stain result is critical to diagnosis, and how to interpret a Gram stain result should still be covered in a nursing prerequisite microbiology course (albeit with less emphasis on how to operate a microscope). This background knowledge will allow the nurse to understand when a Gram stain result might require an intervention in a patient’s care. The ability to match organism morphology to the suspected pathogen(s) and the subsequent review of the care plan (e.g., antimicrobial therapy) can make a difference in patient outcome, although this responsibility is more aligned with the scope of practice of nurse practitioners, who were not included in this survey. The relatively low mean relevance rating for molecular testing methods may highlight an opportunity to educate nursing students about how these methods apply to patient care. For example, nurses working in community clinics may not know that a Group B Streptococcus polymerase chain Volume 18, Number 2 reaction test is far more sensitive and rapid than a traditional culture. Although molecular test results are generally the responsibility of the physician or nurse practitioner, nurses should know that rapidly identifying a pathogen from a positive blood culture bottle and initiating a proper care intervention can significantly improve patient morbidity and mortal … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10