? Evidence Based Clinical Question Search Assignment

?Evidence Based Clinical Question Search Assignment ? ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON ? Evidence Based Clinical Question Search Assignment Purpose: The purpose of this Assignment is to give you a practical application to implement your PICOT idea, supported by the evidence-based research you have obtained in during your systematic review. You will apply evidence-based research findings, discovered from your clinical question, and then integrate those to support your suggested change in nursing practice. ? Evidence Based Clinical Question Search Assignment Directions: Identify your refined PICOT question. See attached Files for PICOT info Using PubMed and the Cochrane collaboration database, do a systematic review of your clinical question. Describe your systematic review and include an errors analysis. Determine an evidence-based quantitative article from the search that contains an evidence-based randomized control trial. Summarize the case study selected. Describe the study approach, sample size, and population studied. Apply the evidence from this review to your practice specifically in your overview. Evaluate the outcomes, identifying the validity and reliability. Discuss if the study contained any bias. Determine the level of evidence identified in the review. The length should be no less than 10 Pages in APA format. ? Evidence Based Clinical Question Search Assignment To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home. Assignment Requirements: Before finalizing your work, you should: be sure to read the Assignment description carefully (as displayed above) consult the Grading Rubric (under the Course Home) to make sure you have included everything necessary; utilize spelling and grammar check to minimize errors; and Your writing Assignment should: follow the conventions of Standard American English (correct grammar, punctuation, etc.); be well ordered , logical, and unified , as well as original and insightful ; display superior content, organization, style, and mechanics; and; use APA 6th edition format SEE ATTACHED GRADING RUBRIC!! mn504_unit_5_assignment_grading_rubric.xlsx picot_assignment_1.docx presentation.pptx PICOT Question Central Line-Associated Infections Courtney Pribonic Kaplan University 3/5/2017 Introduction Patients hospitalized in intensive care units (ICU) sometimes suffer from central line-associated infections (CLAI). These illnesses are mostly caused by microorganisms which act on the central venous catheters. As a way of eliminating this adverse effect, evidence based care has implemented various intervention techniques most of which are grouped as a bundle that comprises of various individual activities. This paper seeks to identify a suitable evidence-based care intervention for preventing CLAI among adult patients hospitalized in ICUs. ? Evidence Based Clinical Question Search Assignment PICOT Question In formulating and developing this research, a systematic review was mainly done on Cochrane database on studies tackling care and maintenance of the CVC published between 2010 and 2017, Scopus, PubMed, and the web of science. This was founded on the PICOT strategy question; “What are the best CLAI-related preventive and intervention measures implemented in adult patients who are hospitalized in an ICU?” The outcomes of the research after analysis presented bundles which included elements such as maximal barrier precautions and hand hygiene. Essentially, these were in the form of multidimensional strategies and programs such as impregnated bandages and catheters as well as the commitment of the staff to keeping facilities infection free (JC et. al., 2011). Treatment of critically ill patients depends on the Central Venous Catheters (CVC) by a significant percentage. For instance, in intensive care units, techniques such as the use of invasive devices and diagnostic procedures are utilized to trigger particular patient complications like the health associated infections (HAI). However, there is a significant challenge in the ICU regarding prevention and control of nosocomial infections as a result of microorganisms (Blot, et.al, 2014). These organisms are usually multiresistant and create the need to use broad spectrum antibiotics. Therefore, the invasive procedures used in ICU to some extent complicate the control of infections. In this regard, the central line-associated infection (CLAI) is the major complication that incurs to the central venous catheters. The current intervention procedures for CLAI are in the form of bundles which are used wholesomely. This means that each package is implemented by carrying all the activities included in it and not just selecting a few. One of the commonly utilized technique is the care package. This bundle contains five elements which include; clean skin preparation with chlorhexidine, hand hygiene, avoidance of femoral sites, elimination of unnecessary catheters, and sterile barrier precautions during CVC. As per JC et al. (2011) methodology, the bundle was implemented along with a strong safety culture, education, and organizational strategies. Moreover, during implementation, information was collected for calculating the rates of infection and monitoring the level of adherence to hygiene. The results obtained a 2.d level of evidence. Another intervention is the quality technique which comprises of two different bundles. This particular response also has a strong focus on hand hygiene, and the two bundles included are the CVC insertion and CVC maintenance (Blot, et.al, 2014). CVC insertion has these elements; femoral vein avoidance, skin preparation with chlorhexidine, and maximal sterile barrier. On the other hand, the CVC maintenance bundle comprises of daily checks to ascertain the needs of CVC insertion, connection checking and assessment without the use of needles, and suitable bandage replacement techniques. Blot, et.al (2014) while implementing these interventions, he coupled the elements with educational programs which were disseminated via teaching videos, conferences, and surveillance processes. The evidence level attained was 2.d. The study by the Institute for Healthcare Improvement (IHI) as stated by Perin et.al (2016) focused on the significance of implementing all significant elements that are included in all bundles. In this regard, the study proposed that a list is used to monitor and evaluate the applicability of the elements in caring for ICU adult patients. From the study’s finding, it was found that when compliance and adherence to efficient implementation of all items of a bundle is high, the rates of infection within adult patients in ICU reduces significantly. The EBP level of evidence of this research was 3e. This technique is similar to the use of multidimensional approach in preventing CLAI in ICU patients. This includes combining elements from various bundles and applying them at once (Berenholtz, et.al, 2014). In practice, the elements considered most includes combining a bundle of intervention, outcome surveillance, education, infection and feedback rates, performance feedback, and process surveillance. Their level of evidence is often 2.c. This study shows that different types of care bundles can be used as EPB Interventions for Prevention of central line-associated infections in ICU/CCU. However, both of them revolve around having high levels of hygiene. This means that microorganisms responsible for causing various central line-associated infections in ICU such as complications of the central venous catheters are propagated via unhygienic practice (Latif, et.al, 2015). However, it is evidence that the care bundle comprises of elements which are vital for preventing these infections. However, the elements on their own are not highly efficient, and they need to be coupled with strong safety culture, education, enabling organizational strategies, strong staff engagement, and surveillance processes. ? Evidence Based Clinical Question Search Assignment Conclusion The three studies made offer ways to prevent central line-associated infections among patients hospitalized in ICUs. Two of the studies showed that implementation of good care practice leads to a reduction in rates of central line-associated infections in ICU/CCU. In this regard, the best care measures come from the bundle which includes CVC maintenance and insertion and vital strategies such as engagement and education of the staff, surveillance process, and safety culture. These are features associated with the care bundle. Therefore, it is evidence that the care bundle which comprises insertion cleaning with chlorhexidine, femoral site avoidance, strict hand hygiene, and catheter removal as soon as it becomes unnecessary is the best intervention for preventing CLAI among adult patients hospitalized in intensive care units. ? Evidence Based Clinical Question Search Assignment References Berenholtz, S. M., Lubomski, L. H., Weeks, K., Goeschel, C. A., Marsteller, J. A., Pham, J. C., … & Yang, T. (2014). Eliminating central line–associated bloodstream infections: a national patient safety imperative. Infection Control & Hospital Epidemiology , 35 (01), 56-62. Blot, K., Bergs, J., Vogelaers, D., Blot, S., & Vandijck, D. (2014). Prevention of central line–associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis. Clinical Infectious Diseases , ciu239. JC, O., GL, S., N, S., O’Horo, J., Silva, G., & Safdar, N. (2011, January 1). Anti?infective locks for the treatment of central line?associated bloodstream infection: A systematic review and meta?analysis (Provisional abstract). Retrieved March 6, 2017, from http://onlinelibrary.wiley.com/o/cochrane/cldare/articles/DARE-12011007506/frame.html Latif, A., Kelly, B., Edrees, H., Kent, P. S., Weaver, S. J., Jovanovic, B., … & Berenholtz, S. M. (2015). Implementing a Multifaceted Intervention to Decrease Central Line–Associated Bloodstream Infections in SEHA (Abu Dhabi Health Services Company) Intensive Care Units: The Abu Dhabi Experience. infection control & hospital epidemiology , 36 (07), 816-822. Perin, D. C., Erdmann, A. L., Higashi, G. D. C., & Sasso, G. T. M. D. (2016). Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review. Revista Latino-Americana de Enfermagem , 24 . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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