Research Critique

Moses Williams NURS 450 Professor Peggy Melloh Introduction Catheter-associated urinary pathway infection (CAUTI) is a fairly common complication in hospitalized patient roles. Nosocomial infection ginmill and patient gumshoe promotion has been issued and umpteen look fores allow been covered to improve patients quality of life. In this article, exaltation et al. (2005) hypothesize that using a paper-based urinary catheter monitor can sign the incidence of urinary catheterization, and accordingly this volition enhance the patients safety. Critique Part 1 Research Questions or HypothesesThe background and consequence of this study ar properly presented in the introduction. The search motility is presented at the end of the introduction of this article. fear et al. (2005) obtain the research interrogative based on the scientific backgrounds they selected and reviewed Is a urinary catheter reminder effective in reducing the incidence of internal urethral catheteriz ation in the hospitalized patients? (p. 456). The Independent multivariate is a urinary catheter reminder and the dependent variable is the incidence of congenital urethral catheterization. The research irresolution appropriately states the blood betwixt a urinary catheter reminder and the incidence of internal urethral catheterization, thus the research question is specific to one relationship. The research question is gene footstepd from PICO information which means population, intercession, comparison, and outcome (LoBiondo-Wood & Haber, 2010, p. 63). In this study, population is the hospitalized patients in the University of loot Medical Center and a total of 5,678 patients participate in the study. preventive is using a catheter reminder and comparison is non using a catheter reminder.Outcome is the military capability of a use of the reminder. Although hypothesis is not directly pen in the article, angel et al. (2005) imply that a paper-based reminder of indwelli ng urinary catheter expertness help reduce improper catheterization. The research question is not placed in a hypothetical cloth however, the conceptual framework is enclosed in the literature review of the article. Two conceptual frameworks atomic number 18 employ to develop the research question one is patient safety promotion and the other one is infection prevention.The govern of catheter-associated urinary tract infection (CAUTI) is relatively high among the nosocomial infections. Although indwelling urinary catheters are common and essential for some hospitalized patients, somemagazine these are unnecessarily utilize. In this paper, a simple written reminder aptitude cut flock the use of indwelling urinary catheters and consequently this can reduce the rate of CAUTI and improve patient safety. The purpose of this study is not directly stated, save it can be inferred from the research question.The purpose of this study is to test the forte of a indwelling catheter r eminder in decreasing the use of indwelling urinary catheter. The level of evidence of the research does not explain the significance of the study completely, but this is one of the skills that can assist the readers to evaluate the strengths and weaknesses of a research (LoBiondo-Wood & Haber, 2010). This research is Level III because of its quasi-experimental design which tests cause-and-effect relationships. Saint et al. (2005) investigate the relationship between the use of a urinary catheter reminder and the incidence of indwelling urethral catheterization.In prescribe to apply evidence in practice, the nurses should judge the potential for applicability first. Saint et al. (2005) bring up the puzzle that indwelling urinary catheter-associated infection accounts for up to 40% of nosocomial infections. Another problem they find is that many medicos are often un certain of urinary catheterization in their patients. Unfortunately, these overlooked catheters are unnecessarily applied in some patients, and historic the rate of CAUTI can be increased. Based on these findings, Saint et al. 2005) hypothesize that a written reminder can help the physicians remember that their patients have indwelling urinary catheter, so this awareness of urinary catheterization can reduce the incidence of indwelling urinary catheter. Review of the Literature This article does not provide the search strategy including a number of databases and other resources which give away key make and unpublished research. In this article, both(prenominal) the basal sources and the theoretical literatures are self-collected and appraised in order to generate the research question and to conduct knowledge-based research.In the section of the literature review, nineteen professional articles are appraised in order to provide the significance and background of the study. Saint develops the research question based on these analyses. Catheter-associated urinary tract infections in surgi cal patients A breakled study on the excess morbidity and costs is one of the primary sources written by Givens and Wenzel who conduct and analyze this study. In addition, Clinical and stinting consequences of nosocomial catheter-related bacteriuria is a review of a literature article which is the lower-ranking source.Although many studies state that patient safety is a top antecedence and CAUTI can be controlled by the caution of health cover providers, the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and colleagues uncovered is unawareness and negligence by health care providers. In appraising the literatures, Saint finds over one-third of attending physicians were unaware that their accept hospitalized patients had indwelling urinary catheter (2005, p. 456). This article was published in 2005.Among thirty cardinal resources, eighteen articles were published before 2000 and twelve articles were published within past five years . In this paper, the oldest article Saint et al. (2005) reviewed is Factors predisposing to bacteriuria during indwelling urethral catheterization which was published in 1974. This implies that indwelling urinary catheter-associated infection has been issued for more than forty years, and many researchers still work on this topic. The literature review is coherently nonionized so that the readers can understand straightforwardly why this study is planned. Saint et al. 2005) state prevalent and essential use of indwelling urinary catheter in hospitalized patients, and then they question its safety. They point out some problems caused by indwelling urinary catheter, including indwelling urinary catheter-associated infection, the patient discomfort, and increased health care cost.In some patients, the indwelling urinary catheters are not necessarily applied due to a lack of awareness of physicians. Therefore, Saint et al. (2005) come up with the idea that a simple and written reminder assists physicians to be aware of the indwelling catheterization in their atients, so the chances of catheterization will be reduced and the rate of the indwelling urinary catheter-associated infection will be decreased simultaneously. Saint et al. summarize the literature review by stating, an innovative system-wide administrative hinderance designed to remind physicians that their patient has an indwelling catheter in place might help reduce inappropriate catheterization (2005, p. 456). In addition, this logical summary makes them develop the research question appropriately. Internal and External ValidityThis study barely has a potential threat to external validity. On the contrary, the external validity of the findings might be increased because Saint et al. (2005) apply the intervention in a real hospital setting, then the findings can be generalized and applied to other hospital setting. In order to reduce the threats to internal validity, the item-by-item variable is only m anipulated in the intervention group. In other words, the intervention group only gets a urinary catheter reminder to test potential of it.The baseline of differences in age, sex, length of hospital stay, and catheterization is adjusted. The intervention fidelity is maintain throughout the study. Everyday, one nurse gathers information on catheter status, reason for catheterization, and recatheterization (Saint et al. , 2005, p. 457). Also, the time and method of collecting data is constantly maintained. The enhancement strategy such as email, use of tap flag, and paging is used in order to minimize physicians ignorance with a reminder and to increase physicians response. Research DesignThe study uses a pretest-posttest design with a unequal control group, which is one of the quasi-experimental designs. Four hospital wards are selected and divided in two groups. Two wards are assigned to the intervention group to which the reminders are offered, and the other two wards are assig ned to the control group. Data is collected for sixteen months, and sixteen months is divided into two eight-month periods which is pre- and post-intervention (Saint et al. 2005, p. 456). A nonequivalent control group design is adequate for this study because the esearcher can observe the effectiveness or ineffectiveness of a reminder by comparing the outcomes between intervention group and control group. Also, during pre-intervention periods, baseline data can be collected in both intervention and control group which will decrease bias. However, the researcher can simply assume that the condition of both groups is similar at the beginning of the research (LoBiondo-Wood & Haber, 2010). Therefore, the quasi-experimental design is proper to conduct this study in order to answer the research question.References American mental Association. (2002). Publication Manual of the American mental Association. Washington, DC American Psychological Association. LoBiondo-Wood, G. , & Haber, J. (2010). Nursing Research Methods and Critical Appraisal for Evidence-Based Practice (7th ed. ). St. Louis, MO Mosby Elsevier. Saint, S. , Kaufman, S. , Thompson, M. , Rogers, M. , & Chenoweth, C. (2005). A Reminder Reduces Urinary Catheterization in Hospitalized longanimouss. Journal on Quality and Patient Safety. 31(8), 455-462.