Please respond to the Discussions and also response to the peer discussionsDQ1Submit a summary of six of your articles on the discussion board. (see articles attached). Discuss one strength and one weakness to each of these six articles on
why the article may or may not provide sufficient evidence for your
practice change.DQ2Name two different methods for evaluating evidence. Compare and
contrast these two methods.Peer DQ1Although many evidence-based researches studies have evaluated
different approaches for fall prevention, fall rate continues to be in
higher range in acute care facilities that is, approximately 3.3 to
11.5 per 1000 patients per day in United States during their admission
(Bouldin et al., 2013). Unintentional falls increase the financial
burden to the health care facility by adding additional treatment cost
and increase the length of hospital stay of the patient (Sahota et
al., 2013). To prevent those fall related incidence and financial
burden different types of fall detection devices are invented and used
in health care facilities. However, due to lack of time and resources
evidence-based research has not been conducted.1. In a qualitative study by Chaudhuri, Thompson & Demiris
(2014), authors analyzed the effectiveness of wearable and
non-wearable devices on fall prevention of elderly patients in the
real-world situation. The authors compiled and systematically analyzed
data from previously published papers on fall detection. They found
that only a fraction of the elderly patients was interested in using
such devices; many were reluctant to use such devices
citing the privacy issues.Strength- This article reviewed and examined the extent to which
fall detection devices have been tested in the real world.Weakness- This review was limited to articles written in English and
indexed in PubMed, CINAHL, EMBASE or PsycINFO and as such may have
omitted other relevant published studies.2. In the quantitative article by Shorr et al. (2012), the authors
conducted a paired cluster-randomized trial to investigate whether the
use of bed alarm decreases the number of falls and fall-related
injuries in a hospital setting. Their result showed that overall, the
intervention increased the use of alarm mechanism among the patients;
however, did not have any clinically or statistically significant
effects on fall or fall-related events.Strength- An intervention increased the use of alarm mechanism among
the patients.Weakness- The study was conducted at a single site and was slightly
underpowered compared with the initial design.3. In the article by Sahota et al. (2013), authors conducted a
randomized controlled trial of bed and bedside chair pressure sensors
using radio-pagers and found that it did not reduce the rate of
in-patient bedside falls, time to first bedside fall and are not cost
effective in elderly patients in acute, general medical wards in the UK.Strength- They conducted a randomized controlled trial of bed and
bedside chair pressure sensors using radio-pagers (intervention group)
compared with standard care (control group) in elderly patients
admitted to acute, general medical wards, in a large UK teaching hospital.Weakness- There was several limitations in a study that need to be
recognized. The study was powered to detect a 35% reduction in the
rate of bedside falls, based on the sample size estimates from our
pilot study. It is possible that the intervention may be associated
with a smaller reduction in bedside falls, which may have been missed.4. In the article by Bouldin et al. (2013), fall and injurious fall
prevalence varied by nursing unit type in US hospitals. They used data
from the National Database of Nursing Quality Indicators (NDNQI)
collected between July 1, 2006 and September 30, 2008 to estimate
prevalence and secular trends of falls occurring in adult medical,
medical-surgical and surgical nursing units. Over the 27-month study,
there was a small, but statistically significant, decrease in falls
(p<0.0001) and injurious falls (p<0.0001).Strength- The strengths of this study include the large number of
nursing units reporting data and the national sample of hospitals.Weakness- They did not assess practices among nursing units nor seek
to identify unit characteristics associated with fall rates or changes
in fall rates over time.5.In the study by Quigley (2016), the evidence supports the
importance of determining specific risk factors and initiating
multifactorial fall risk factors tailored to the individual. Yet,
little evidence exists for single interventions, universal fall
prevention strategies, and population-specific fall prevention
strategies. A review of the literature confirms the effectiveness of
many fall prevention practices and interventions remains insufficient.
Of particular concern are rehabilitation units in hospitals that have
higher fall rates compared to other acute units.Strength- The strength of this article is identification of the best
practice interventions to prevent falls on rehabilitation units.Weakness- The views expressed in this article are those of the
author and do not represent the views of rehab nurses.6. Evidence of this review indicates patient-centered interventions
in addition to tailored patient education may have the potential to be
effective in reducing falls and fall rates in acute care hospitals.
There is limited high quality evidence demonstrating the effectiveness
of patient-centered fall prevention interventions so novel solutions
are urgently needed and warrant more rigorous, larger scale randomized
trials for more robust estimates of effect (Avanecean et al., 2017).Strength- This study evaluated the effectiveness of patient-centered
interventions on falls in the acute care setting.Weakness- Due to clinical and methodological heterogeneity among the
included studies, a meta-analysis was not possible. The findings of
this review have been presented in narrative form.References,Avanecean, D., Calliste, D., Contreras, T., Lim, Y., &
Fitzpatrick, A. (2017). Effectiveness of patient-centered
interventions on falls in the acute care setting: A quantitative
systematic review protocol. JBI Database of Systematic Reviews and
Implementation Reports, 15(1), 55-65. Retrieved from https://journals.lww.com/jbisrir/Fulltext/2017/010...Bouldin, E. D., Andresen, E. M., Dunton, N. E., Simon, M., Waters,
T. M., Liu, M., ... Shorr, R. I. (2013). Falls among adult patients
hospitalized in the United States: Prevalence and trends. Journal of
Patient Safety, 9(1), 13. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC35722...Chaudhuri, S., Thompson, H., & Demiris, G. (2014). Fall
detection devices and their use with older adults: A systematic
review. Journal of Geriatric Physical Therapy, 37(4), 178- 196.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC40871...Sahota, O., Drummond, A., Kendrick, D., Grainge, M. J., Vass, C.,
Sach, T., ... Avis, M. (2013). REFINE (Reducing Falls in
In-patient Elderly) using bed and bedside chair pressure sensors
linked to radio-pagers in acute hospital care: A randomised controlled
trial. Age and Ageing, 43(2), 247-253. Retrieved from https://academic.oup.com/ageing/article/43/2/247/1...Shorr, R. I., Chandler, A. M., Mion, L. C., Waters, T. M., Liu, M.,
Daniels, M. J., ... Miller, S. T. (2012). Effects of an intervention
to increase bed alarm use to prevent falls in hospitalized patients: A
cluster randomized trial. Annals of Internal Medicine, 157(10),
692-699. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC35492...Quigley, P. A. (2016). Evidence levels: applied to select fall and
fall injury prevention practices. Rehabilitation nursing, 41(1), 5-15. doi/abs/10.1002/rnj.253Peer DQ2The article by Buckner and Read (2016) discusses that the
old-fashioned observation method for hand hygiene compliance has
proved to be ineffective. Badge-based locating technology using
a real-time locating system provides continuous monitoring of hand
hygiene compliance, and offers valuable feedback that can be
customized by staff group, individual, room, or time. This study
evaluates the impact of implementing an automated badge-based
monitoring system with individual feedback on hand hygiene compliance
rates across numerous hospitals. The dramatic difference was noted
between the compliance assessed through direct observation and
baseline compliance recorded by an automated system further supports
the inaccuracy of direct observation. This study had a
limitation of a small sample size, but provides the necessary support
for the hand hygiene monitoring system in the department.
In a different article by Chang, Reisinger, Jesson, Schweizer, Morgan,
Forrest, and Perencevich (2016), the authors discussed the physical
barriers to low hand hygiene compliance and different ways that it can
be reduced. The gold standard was the direct observation for
hand hygiene compliance upon entering and exiting patient rooms
because of the availability of alcohol hand sanitizers. However,
hand washing cannot be easily observed through direct observation and
this supports the need for hand hygiene monitoring system that will
also alert healthcare providers to wash their hands. This study
is limited to the description of the use of hand sanitizers rather
than hand washing with soap.
Chassin, Nether, Mayer, and Dickerson (2015) worked on the quality
improvement project using a Lean, Six Sigma method to improve hand
hygiene compliance in the organization. This articles provides
valuable information on various causes of the hand hygiene
noncompliance in various facilities and possible interventions at the
causes. The article discusses a special tool that is used to initiate
hand hygiene compliance project in clinical care settings.
Healthcare organizations used the Targeted Solutions Tool to discover
specific causes of hand hygiene noncompliance. This study is
great because it discusses the Targeted Solutions Tool in depth and
will allow me to use it in our healthcare facility.
In the study by McCalla, Reilly, Thomas, and McSpedon-Rai (2017), the
authors described the relationship between hand hygiene compliance and
healthcare associated infections. It is imperative for healthcare
organizations to assess compliance by the hospital infection control
staff. This article discusses the automated hand hygiene
compliance system that was used as an alternative method to human
observations. In this retrospection cohort design study,
researchers concluded that personal observations of the hand hygiene
compliance is not as effective as an electronic monitoring
badge. The rates of healthcare associated infections can be
significantly reduced with the electronic hand hygiene monitoring
system.
In another study, the researchers examined the perceptions and
barriers to nonsurgical scrubbed hand hygiene in the operating room
and endoscopy procedure room using Likert-scale surveys (Pedersen et
al., 2017). The results of the study showed poor role modeling
and inconvenience are the two major reasons for low hand hygiene
compliance rate. There is a need to monitor hand hygiene
compliance and feedback from the monitors can provide reminders and
improve self-awareness of hand hygiene practices.
Szilagyi et al. (2013) researched the hand hygiene compliance using
the World Health Organization five moments to assess hand hygiene
techniques in various healthcare organizations. This article
provides information on the hand hygiene education and assessment
program that was implemented in the hospital setting that included
educational stations to improve hand hygiene quality in healthcare
providers. This study supports the need for ongoing education
and training in improving hand hygiene compliance and technique of
clinical staff. The limitation of this study was the small
sample size and the educational program that was implemented in only
one healthcare facility. DavidBuckner, J. B., & Read, M. (2016). Individual monitoring
increases hand hygiene compliance in multicenter registry utilizing
badge-based locating technology. AJIC: American Journal of
Infection Control, 44(Supplement), S94-S97. https://doi-org.chamberlainuniversity.idm.oclc.org...Chang, N. N., Reisinger, H. S., Jesson, A. R., Schweizer, M. L.,
Morgan, D. J., Forrest, G. N., & Perencevich, E. N. (2016).
Feasibility of monitoring compliance to the My 5 Moments and
Entry/Exit hand hygiene methods in US hospitals. American Journal of
Infection Control, pii: S0196-6553(16)00158-9. doi:10.1016/j.ajic.2016.02.007Chassin, M. R., Nether, K., Mayer, C., & Dickerson, M. F.
(2015). Beyond the collaborative: Spreading effective improvement in
hand hygiene compliance. The Joint Commission Journal on Quality &
Patient Safety, 41(1), 13-25.McCalla, S., Reilly, M., Thomas, R., & McSpedon-Rai, D. (2017).
Major Article: An automated hand hygiene compliance system is
associated with improved monitoring of hand hygiene. AJIC:
American Journal of Infection Control, 45(1),
492–497. https://doi-org.chamberlainuniversity.idm.oclc.org...Pedersen, L., Elgin, K., Peace, B., Masroor, N., Doll, M., Sanogo,
K., ... Bearman, G. (2017). Barriers, perceptions, and adherence: Hand
hygiene in the operating room and endoscopy suite. American Journal Of
Infection Control, 45(6), 695-697. doi:10.1016/j.ajic.2017.01.003Szilagyi, L., Haidegger, T., Lehotsky, A., Nagy, M., Csonka, E.-A.,
Sun, Z., ... Fisher, D. (2013). A large-scale assessment of hand
hygiene quality and the effectiveness of the "WHO 6-steps".
BMC Infectious Diseases, 13(1), 249. doi:10.1186/1471-2334-13-249Peer DQ3Hand
hygiene is recognized by infection prevention and control
experts as the single most important intervention in decreasing
the spread of infection in both healthcare and community
settings. Because the hands are vectors for transmission between
people as well as inanimate objects such as environmental
surfaces (i.e., blood pressure cuffs), it is critical to
practice frequent hand hygiene using the traditional soap and
water or an alcohol-based hand rub as appropriate.
Summary
of six of your articles.....
1. Filho, M. A. O., Marra,
A. R., Magnus, T. P., Rodrigues, R. D., Prado, M., de Souza Santini,
T. R., … Edmond, M. B. (2014). Major article: Comparison of
human and electronic observation for the measurement of compliance
with hand hygiene. AJIC: American Journal of Infection
Control, 42, 1188–1192. https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic....
Strength:
Comparison of human and electronic observation for the measurement
of compliance with hand hygiene for staff members.
Weakness:
They only did a small sample size, there would be enough
evidence on the outcome.
2. Boyce, J. M. (2017). State
of the Science Review: Electronic monitoring in combination with
direct observation as a means to significantly improve hand
hygiene compliance. AJIC: American Journal of Infection
Control, 45, 528–535. https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic....
3. Vaidotas, M., Yokota, P. K.
O., Marra, A. R., Sampaio Camargo, T. Z., Victor, E. da S., Gysi,
D. M., … Edmond, M. B. (2015). Major article: Measuring
hand hygiene compliance rates at hospital entrances. AJIC:
American Journal of Infection Control, 43,
694–696. https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic....
Strength: They
compared electronic handwash counters with the application of
radiofrequency identification (GOJO
SMARTLINK) (electronic observer) that counts each activation
of alcohol gel dispensers to direct observation (human
observer) via remote review of video surveillance.
Weakness:
Even though the GOJO system was useful in capturing real life
hand hygiene complaince at the resception area, this will not
capture everyone who enters the hospital. There
are other entrances into the hosptial such as emergency
room.
4. Knighton, S. C., McDowell, C., Rai,
H., Higgins, P., Burant, C., & Donskey, C. J. (2017).
Major Article: Feasibility: An important but neglected issue
in patient hand hygiene. AJIC: American Journal of
Infection Control, 45, 626–629. https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic....
Strength:
Patient hand hygiene may be a useful strategy to prevent acquisition
of pathogens and to reduce the risk for transmission by colonized
patients. Several studies demonstrate that patients and
long-term-care facility (LTCF) residents may have difficulty using
hand hygiene products that are provided; however, none of them
measure feasibility for patients to use different hand hygiene products.
Weakness:
This study can't expect eveyone to use the hand hygiene
products. Soap and water works just fine if there are some
alergic reactions to the products. This study wont be able to give
good data, there will be outliers.
5. Ibrahim Aliyu, Teslim O Lawal, Wasiu
Olawale, Kehinde Fasasi Monsudi, & Bashir Mariat Zubayr.
(2018). Hand hygiene practices among doctors in health
facility in a semi-urban setting. BLDE University Journal
of Health Sciences, Vol 3, Iss 1, Pp 43-47 (2018), (1),
43. https://doi-org.lopes.idm.oclc.org/10.4103/bjhs.bj...
Strength:
The study was among doctors on proper hand washing and the
importance of good hand hygiene.
Weakness:
The study didn't focus on other staff members in the
department, it only focued on the doctors.
6. Hosein Zakeri, Fatemeh Ahmadi, Ehsan
Rafeemanesh, & Lahya Afshari Saleh. (2017). The knowledge of
hand hygiene among the healthcare workers of two teaching
hospitals in Mashhad. Electronic Physician, Vol 9, Iss 8, Pp
5159-5165 (2017), (8), 5159. https://doi-org.lopes.idm.oclc.org/10.19082/5159
Strength:
Training all health care professionals on hand hygiene.
Weakness:
The did the observation by visual observation only. They found out
that after the training, there were still alot of staff who was
not doing proper hand hygiene. More education should
have been provided to the particpants of the study. Peer DQ4Submit a summary of six of your articles on the discussion
board. Discuss one strength and one weakness to each of these six articles on
why the article may or may not provide sufficient evidence for your practice
change.1)Windle, P. E. (2008).
Addressing the Nurse Staffing Shortage. Journal of PeriAnesthesia Nursing, (3),
209. Retrieved from https://lopes.idm.oclc.org/login?url=http://search...·Strength:The article presents tremendous amounts of
data regarding the nursing shortage as many new RN grad are not graduating
enough ti be able to fill the numerous vacancies at many healthcare facilities.·Weakness: The article
does not address experience or lack of it. Many position require years of
experience but new nurse fresh out of school may lack such experience. Unless
they are hired but a new Grad RN program where they are taught such skill it
becomes difficult to find quality work.·This article does not
provide the rounded information needed to complete the research I need. This is
just one portion of the bigger whole needed to complete the writing.2)Witzel,
P. A., Smith, T. C., & Ingersoll, G. L. (2006). Staffing incentive programs
to meet workforce shortage needs. Nurse Leader, 4, 46,55-48,55. https://doi-org.lopes.idm.oclc.org/10.1016/j.mnl.2...·Strength: Presents ideas and incentives in order
to recruit and retain the nursing workforce.·Weakness: This is limited to facilities that
actually promote incentives – not all facilities do this. This is not state
wide nor country wide programs.·This address only on portion of the problem. I
will need other articles to complete the rest of the information needed. Though
it does addressa mjor issue in the nursing
field.· 3)Alban,
A., Coburn, M., & May, C. (1999). Addressing the emergency nursing staffing
shortage: Implementing an internship using a nursing school instructor model.
Journal of Emergency Nursing, (6), 509. Retrieved from https://lopes.idm.oclc.org/login?url=http://search...·Strength: Aware of specialty positon nurses and
is offering internships programs to prepare new nurses to fill vacant positions·Weakness: Many different specialties were not
covered that many students wanted to go over.·This is a fantastic program to offer hospitals
for the many different specialties.4)Cracking
the books - Training entry-level employees may help to ease staffing shortages
for hospitals. (n.d.). HOSPITALS & HEALTH NETWORKS, 78(7), 28. Retrieved
from https://lopes.idm.oclc.org/login?url=http://search...·Strength: New program designed to help entry
level employees gain the experience and education the facility needs.·Weakness:Problems getting funding, learning space, initial costs.·This is a great program set to have new
employees grow confident in their skills and position and helps decrease
turnover rates.5)Martin,
C. J. (2015). The Effects of Nurse Staffing on Quality of Care. MEDSURG
Nursing, 24(2), 4–6. Retrieved from https://lopes.idm.oclc.org/login?url=http://search...·Strength: Identifies the quality of serviceand patient outcomes is in direct correlation
to staffing numbers·Weakness:Does not discuss how to retain nurses nor how the turnover rate is
regarding this program.·A great article that provides quality
information regarding patient care bases on staffing levels.6)Tate,
C. W. (2006). Saviours or scapegoats? It is time to stop blaming agency staff
for the woes of the NHS and join forces to solve staffing shortages. Nursing
Standard, (40), 34. Retrieved from https://lopes.idm.oclc.org/login?url=http://search...·Strength: The article provides info on quality
experienced nurses to fill much needed open shifts that facilities desperately
need. ·Weakness: does not fully explain quality of
agency staff or provide in-depth info on quality of care.·Provides limited info on agency quality of care.Peer DQ5The two types of evaluation methods of the evidence in research
studies is systematic reviews and meta-analysis. According to
literature, systematic reviews provide explanations and answers to
research questions through collecting and summarizing all the evidence
that fits into a specific eligibility criteria (PubmedHealth,
2018). Systematic reviews identify, assess, and summarize the
research findings of various scholarly studies that are relevant to
the topic of interest to assist researchers and clinicians in
decision-making processes. The negative side of the systematic
review is that is needs enough data to make the necessary conclusion,
in addition to the time it takes to analyze all the prior studies.
Meta-analysis on the other hand, uses statistical analysis to
summarize results of prior studies (Haidich, 2010). When more
than one study shows significant statistical results, then
meta-analysis method would be the ideal method to evaluate the common
theme among them. Meta-analysis is considered an effective
method to evaluate evidence. The negative part of using
meta-analysis is variations in the results of the studies that can
mislead researcher to make improper conclusions on the prior research studies. DavidPubmed Health. (2018). What is a Systematic Review?
Retrieved from https://www.ncbi.nlm.nih.gov/pubmedhealth/what-is-...Haidich, A. B. (2010). Meta-analysis in medical research.
Hippokratia, 14(Supp 1), 29-37. Peer DQ6Qualitative research is often used for exploring.
It helps researchers gain an understanding of underlying reasons,
opinions, and motivations. It provides insights into the problem or
helps to develop ideas or hypotheses for potential quantitative
research. Qualitative
data collection methods vary using unstructured or semi-structured
techniques. Common methods include focus groups, individual
interviews, observation or immersion, and diary studies. The
sample size is typically small, and respondents are selected to
fulfill a given quota.
Quantitative research is used to quantify the
problem by way of generating numerical data that can be transformed
into useable statistics. It is used to quantify attitudes, opinions,
behaviors, and other defined variables, and generalize results from
a larger sample population. Quantitative research uses measurable
data to formulate facts and uncover patterns in research.
Quantitative data collection methods are much more structured; they
include various forms of surveys – online surveys, paper
surveys, mobile surveys and kiosk surveys, face-to-face interviews,
telephone interviews, longitudinal studies, website interceptors,
online polls, and systematic observations
Two
methods of evaluating evidence are: Qualitative research
method and Quantitative research method
Compare between qualitative and
quantitative analysis:
Both
are methods of research
Both
are limited by variables
Both
are applicable in the study of similar
phenomenon
Both
are dependent on the researcher who chooses the type of
information to gather and how to interpret the
data
Contrast
between qualitative and quantitative analysis:
Qualitativeresearch
relies primarily on inductive process in formulating hypotheses.
On the contrary quantitative research depends on deductive
process.
Qualitative
research methods include focus groups, interviews, and reviews of
analysis. Quantitative research include surveys, structured
interviews, and observations.
Qualitative
research is text-based whereas Quantitative research is
number-based.
Qualitative
research has unstructured or semi-structured response options
while the former has fixed response options
Qualitative
research lacks statistical tests whereas
statistical tests are used for
analysis
Qualitative
research less generalizable
while Quantitative
research generalizable
References:Wienclaw,
R.
A.
(2013).
Quantitative
and
Qualitative
Analysis.
Research
Starters:
Sociology
(Online
Edition).
Retrieved
from https://lopes.idm.oclc.org/login?url=http://search...