Advanced Levels Of Clinical Inquiry And Systematic Reviews Paper
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Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
***Appraisal sheet and 1-2 page paper
Nosocomial infections are infections that are acquired during or after hospital care. Among COVID-19 patients, nosocomial infections can include bacterial infections such as pneumonia, urinary tract infections, and other infections due to antibiotic-resistant bacteria. Other infections that can occur include fungal infections, such as Candida, and viral infections, like the flu or other respiratory viruses. Nosocomial infections are more common in patients receiving intensive care, particularly those requiring mechanical ventilation and those with weakened immune systems. Patients with a compromised immune system are especially vulnerable to nosocomial infections due to their weakened ability to fight them Advanced Levels Of Clinical Inquiry And Systematic Reviews Paper
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The PICOT question aims to investigate the effectiveness of isolation precautions as a Covid-19 prevention measure. Specifically, it seeks to determine if isolation precautions, as compared to standard precautions, reduce the incidence of nosocomial infections among Covid-19 infected patients in a three-month period. This question is important because it can help to provide evidence-based recommendations on the efficacy of isolation precautions in preventing nosocomial infections and other secondary infections in Covid-19 patients.
These databases are essential for evidence-based research as they provide access to high-quality, peer-reviewed literature on various topics. BioMed Central provides access to a wide range of open-access biomedical journals, ScienceDirect provides access to a vast range of journals related to the sciences, The Cochrane Library provides access to evidence-based systematic reviews and meta-analyses, and PubMed Central provides access to an extensive collection of free full-text biomedical and life sciences journal articles. These databases enables me have access to the latest, most reliable evidence on my topic to inform the research.
The article by Abbas et al. (2021) emphasizes the importance of social isolation and other COVID-19 prevention precautions in reducing nosocomial infections among COVID-19 patients. The systematic review provides evidence that social isolation and other precautions such as hand hygiene play a critical role in curbing the spread of the virus. Specifically, the authors found that the implementation of social isolation protocols, including physical distancing, contact tracing, and quarantine, can significantly reduce the transmission of COVID-19 and other nosocomial infections.
The study by Luong-Nguyen et al. (2020) was a retrospective study (Level II) that examined nosocomial infections with SARS-CoV-2 in different departments. The authors identified social isolation as an effective measure to curb the spread of nosocomial infections and Covid-19. This suggests that isolating people who have tested positive for Covid-19 or who have been in contact with a Covid-19 patient is key to reducing the spread of the virus and infections in healthcare settings.
The article by He et al. (2020) was also a retrospective study (Level II) that examined nosocomial infections among Covid-19 patients. The authors noted that nosocomial infections were very common among Covid-19 patients in the ICU. They concluded that using social isolation and hand hygiene can help prevent infections and complications. This indicates that social distancing and proper hand hygiene are important measures to take in order to reduce the spread of nosocomial infections, especially among those with Covid-19 in the ICU. Advanced Levels Of Clinical Inquiry And Systematic Reviews Paper
The Bardi et al. (2021) study was a retrospective study that looked back at nosocomial infections associated with COVID-19 in the intensive care unit. The study found evidence of bacterial and fungal co-infections in patients with COVID-19 in the intensive care unit. This suggests that nosocomial infections can occur in patients with COVID-19. The authors of the study suggested that effective preventive measures, such as social isolation, should be taken to prevent the spread of infections to other patients within the unit. Social isolation is an essential preventative measure because it helps reduce the risk of infection transmission by limiting contact with other people.
Systematic reviews are a powerful tool in evidence-based research, providing a comprehensive and unbiased overview of all available evidence on the study topic. Unlike traditional literature reviews, systematic reviews employ a rigorous and transparent methodology to identify, assess, and synthesize all relevant evidence and can be used to answer a specific research question. For example, in my study context of nosocomial infections in Covid-19 patients, systematic reviews were used to identify the most effective interventions for preventing nosocomial infections, such as social isolation. The review involved carefully searching multiple databases and identifying all relevant studies, critically appraising the quality of evidence, and synthesizing the results to provide an overview of the current evidence. Through this systematic approach, systematic reviews can provide valuable insights into the effectiveness of interventions for preventing nosocomial infections in Covid-19 patients.
Introduction
Hospital acquired infections refer to the various infections that are acquired while one is receiving treatment. Nosocomial infections are also not present during admission thereby indicating that the infections have either been acquired from the environment or from people one interacts with. Nosocomial infections have been found to complicate the treatment process, increase the virulence of the existing disease, or even cause death in some individuals. COVID-19 for instance is one of the nosocomial infections that caused a lot of mortality among patients seeking primary care and subsequently caused fear thus scaring people from seeking healthcare services. This paper seeks to analyze four peer-reviewed articles that I selected related to nosocomial infections and use them to complete the Matrix Worksheet. Advanced Levels Of Clinical Inquiry And Systematic Reviews Paper
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| Full citation of selected article | Article #1 | Article #2 | Article #3 | Article #4 |
| Wang, L., Zhou, K. H., Chen, W., Yu, Y., & Feng, S. F. (2019). Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015. BMC infectious diseases, 19(1), 1-9. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3772-2 Advanced Levels Of Clinical Inquiry And Systematic Reviews Paper | Luong-Nguyen, M., Hermand, H., Abdalla, S., Cabrit, N., Hobeika, C., Brouquet, A., … & Sauvanet, A. (2020). Nosocomial infection with SARS-Cov-2 within departments of digestive surgery. Journal of visceral surgery, 157(3), S13-S18. https://doi.org/10.1016/j.jviscsurg.2020.04.016
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He, Y., Li, W., Wang, Z., Chen, H., Tian, L., & Liu, D. (2020). Nosocomial infection among patients with COVID-19: A retrospective data analysis of 918 cases from a single center in Wuhan, China. Infection Control & Hospital Epidemiology, 41(8), 982-983. https://doi.org/10.1017/ice.2020.126
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Bardi, T., Pintado, V., Gomez-Rojo, M., Escudero-Sanchez, R., Azzam Lopez, A., Diez-Remesal, Y., … & Pestaña, D. (2021). Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. European Journal of Clinical Microbiology & Infectious Diseases, 40, 495-502. https://link.springer.com/article/10.1007/s10096-020-04142-w | |
| Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest) | The article was chosen because it analyzes the risk factors that are associated with nosocomial infections Respiratory Intensive Care Unit, one of the essential departments that handles critically ill patients.an article by Edwardson and Cairns (2019) also reiterates the fact that nosocomial infections increases the length of stay in the intensive care units as well as increased risk of mortality.
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I chose the article because it highlights COVID-19 as a nosocomial infection among hospitalized patients who have undergone surgeries. The article further states that COVID-19 led to a reduction in surgical activities which significantly affected the provision of emergency healthcare services. The ideas presented by this article have been supported by A study by Baviskar et al., (2019) who stated that nosocomial infections increases the length of stay as well as mortality among surgical patients in the ICU. This article is therefore relevant to my study because it focuses on the impact of nosocomial infections in healthcare. | This article was chosen because it helps to depict the impact of nosocomial infections among patients with COVID-19. This article states that the percentage of people with COVID-19 who had nosocomial infections who succumbed was higher than those who recovered. This article is therefore relevant to my topic of interest given that it reinforces the idea that nosocomial infections cause an increase in mortality among hospitalized patients. | The outbreak of COVID-19 pandemic wreaked havoc in the healthcare system globally and paralyzed most of the operations including those in developed countries. Alongside the burden associated with the pandemic, nosocomial infections such as bacterial and fungal co-infection were reported. This article was chosen because it is relevant to my topic of interest which is nosocomial infections and their impact in healthcare. This study is consistent with another one by Du et al., (2021) that demonstrated the burden of nosocomial infections among COVID-19 patients. |
| Brief description of the aims of the research of each peer-reviewed article | The study aimed at determining the risk factors as well as the epidemiological factors associated with nosocomial infections in the Respiratory Intensive Care Unit in a healthcare facility.
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The aim of the study was to report the various instances of nosocomial infections as a result of COVID-19 among patients admitted in hospitals with digestive surgeries.
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The aim of the study was to investigate nosocomial infections among COVID-19 patients as well as assess the risk factors that contribute to the high prevalence of the infections and also identify prevention and control measures. Some of the common preventive measures against nosocomial infections is hand hygiene which has been proposed by several scholars including Sikora, and Zahra, (2022). | The aim of this study was to investigate the clinical symptoms of fungal and bacterial infections that are associated with COVID-19 among patients admitted to the intensive care units. Further, the study aimed at assessing the impact of these infections on critical illnesses. |
| Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific. | The study used an observational prospective surveillance that was conducted in a Respiratory Intensive Care Unit. The infection rate, devise associated infections as well as the distribution of infection sites was equally investigated.
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The study employed a non-interventional retrospective study that was carried out in three digestive surgeries. The patient data of patients that developed nosocomial infections with COVID-19 were retrieved from computer medical records.
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The study used a retrospective study design by analyzing clinical data from 918 patients in an inpatient hospital from December 30, 2019, to February 29, 2020. The study identified 65 patients who had nosocomial infections to be members of the case group while 260 non-nosocomial infection patients as there control group. Clinical data analyzed in the study include basic disease, demographics and the current treatments. | The study employed a retrospective study of all patients that were admitted in the intensive care unit in a tertiary hospital in the city of Madrid who had been confirmed to have COVID-19. The study included all patients that had tested positive for SARS-CoV-2 in nasal or respiratory tract samples.
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| A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected. | One strength of the study is based on the sample size used. The study used a large sample size of 1347 patients which is relatively big enough to generalize to the general population. | A major strength of the study is that it focused on three departments of digestive surgery and this helps to depict the clear picture of the real issues in maters nosocomial infections. | A major strength of the study is that it involved a relatively large sample size of 918 patients which is good enough to be generalized to the general population. Further, the inclusion criteria were reliable to meet the target group. | One of the strengths of the study is based on the inclusion and exclusion criteria used to identify suitable subjects for the study. For instance, those who were included in the study had to be COVID-19 positive patients admitted to the ICU. Further, patients transferred from other facilities were excluded from the study. The inclusion and exclusion criteria therefore help to achieve reliable and valid data. |
| General Notes/Comments |
Some of the risk factors identified as major causes of an increased risk of nosocomial infections include the use of ventilators as well as immunosuppressive therapy. |
The risk of nosocomial infection with COVID-19 among patients hospitalized with digestive surgeries is a significantly high. It is therefore essential to institute necessary measures to help minimize the risks of nosocomial infections to ensure safe surgery.
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Nosocomial infections present a great burden to the healthcare sector and this affects the quality of services as well as patient outcomes. It therefore important to ensure appropriate prevention measures are in place to prevent the prevalence of nosocomial infections among hospitalized individuals. | Despite having no effective drug against COVID-19, the increase in nosocomial infections among these patients admitted to the ICU significantly increased mortality among COVID-19 patients. |
References
Bardi, T., Pintado, V., Gomez-Rojo, M., Escudero-Sanchez, R., Azzam Lopez, A., Diez-Remesal, Y., … & Pestaña, D. (2021). Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. European Journal of Clinical Microbiology & Infectious Diseases, 40, 495-502. https://link.springer.com/article/10.1007/s10096-020-04142-w
Baviskar, A. S., Khatib, K. I., Rajpal, D., & Dongare, H. C. (2019). Nosocomial infections in surgical intensive care unit: A retrospective single-center study. International journal of critical illness and injury science, 9(1), 16.
Du, Q., Zhang, D., Hu, W., Li, X., Xia, Q., Wen, T., & Jia, H. (2021). Nosocomial infection of COVID‑19: A new challenge for healthcare professionals. International journal of molecular medicine, 47(4), 1-1.
Edwardson, S., & Cairns, C. (2019). Nosocomial infections in the ICU. Anaesthesia & Intensive Care Medicine, 20(1), 14-18.
He, Y., Li, W., Wang, Z., Chen, H., Tian, L., & Liu, D. (2020). Nosocomial infection among patients with COVID-19: A retrospective data analysis of 918 cases from a single center in Wuhan, China. Infection Control & Hospital Epidemiology, 41(8), 982-983. https://doi.org/10.1017/ice.2020.126
Luong-Nguyen, M., Hermand, H., Abdalla, S., Cabrit, N., Hobeika, C., Brouquet, A., … & Sauvanet, A. (2020). Nosocomial infection with SARS-Cov-2 within departments of digestive surgery. Journal of visceral surgery, 157(3), S13-S18. https://doi.org/10.1016/j.jviscsurg.2020.04.016
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Sikora, A., & Zahra, F. (2022). Nosocomial infections. In StatPearls [Internet]. StatPearls Publishing.
Wang, L., Zhou, K. H., Chen, W., Yu, Y., & Feng, S. F. (2019). Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015. BMC infectious diseases, 19(1), 1-9. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3772-2 Advanced Levels Of Clinical Inquiry And Systematic Reviews Paper
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