NRS 433 Rough Draft Quantitative Research Critique and Ethical Considerations

NRS 433 Rough Draft Quantitative Research Critique and Ethical Considerations

NRS 433 Rough Draft Quantitative Research Critique and Ethical Considerations

Quantitative research plays an important role in the research process, providing crucial data and insights that can help support or refute a hypothesis. By measuring variables and controlling for confounders, quantitative studies can provide a great deal of information about cause and effect relationships. This is essential in understanding how the world works and can lead to new breakthroughs in fields such as medicine and nursing. The two quantitative studies considered in topic 1 include Article I: “Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates” by Schuetz et al., (2021), and Article II: “Decreased incidence of methicillin-resistant Staphylococcus aureus bacteremia in intensive care units: a 10-year clinical, microbiological, and genotypic analysis in a tertiary hospital” by Kim et al., (2020). The purpose of this assignment is to analyze article I and II and to determine how they will be used to answer the PICOT question.

Quantitative Studies

Background

According to quantitative article I, the following are factors that are associated with a higher risk of progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) colonization in critically ill neonates: presence of lococcus aureus on admission, gestational age <32 weeks, birth weight <1500 grams, mechanical ventilation for >7 days, total parenteral nutrition for >14 days, and broad-spectrum (Schuetz et al., 2021). The main problem in this article is the progression of methicillin-resistant Staphylococcus aureus-colonized among the critically ill neonates. Methicillin-resistant Staphylococcus aureus (MRSA) is a major problem in healthcare settings worldwide. Study I investigated factors associated with progression to MRSA infection in patients who were colonized with the bacterium. The risk factors for progression to infection among MRSA-colonized patients include being older than 65 years, having certain chronic diseases (e.g., diabetes, COPD, HIV/AIDS), having a history of IV drug use, and being admitted to the ICU.

The purpose of the study was to identify factors associated with progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) carriers. The study population was composed of adults admitted to a long-term care facility who were either colonized or infected with MRSA. Another objective was to find out what causes symptomatic contamination in newborns with methicillin-resistant Staphylococcus aureus (MRSA) colonization in the neonatal intensive care unit (NICU) (Schuetz et al., 2021). The study found that patients who were younger, male, non-white, and had higher numbers of comorbidities were more likely to progress from colonization to infection. These findings are significant for nurses who care for patients with MRSA colonization. Overall, the study’s findings are significant to the nursing profession particularly when it come to the management of hospital acquired infections. The main research question from the article is: What are some of the factors that cause symptomatic contamination in newborns with methicillin-resistant Staphylococcus aureus (MRSA) colonization in the neonatal intensive care unit?

Quantitative study II looked at the decreased incidence of methicillin-resistant Staphylococcus aureus bacteremia in intensive care units. The purpose of this study was to investigate the effect of an intensive care unit (ICU) infection control program on the incidence of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. The main research question for the study was: What are the effects of an intensive care unit (ICU) infection control program on the incidence of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia?

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The results of the study showed that the incidence of MRSA bacteremia decreased significantly following implementation of the ICU infection control program. The rate of decrease was greatest in the ICUs with the most comprehensive program. These findings suggest that implementation of an effective ICU infection control program can reduce the incidence of MRSA bacteremia. The main problem in the study was the increasing incidence of MRSA bacteremia in the intensive care units. The main objective of the study was to determine the impacts of intensive care unit (ICU) infection control program on the incidence of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. The article is significant to nursing because it provide strategies for the management of healthcare acquired infections in the intensive care units.

How the Two Articles Support the Nurse Practice Issue on Hospital Acquired Infection

The two articles analyze factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized among critically ill neonates and the application of Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus. The findings on the above issues are critical in supporting the nurse practice issue on hospital acquired infections. The information provided in these two articles are critical in answering different aspects of the PICOT question. In other words, the two articles are essential in answering the PICOT question because they analyze the intervention that have been defined in the PICOT.

NRS 433 Rough Draft Quantitative Research Critique and Ethical Considerations
NRS 433 Rough Draft Quantitative Research Critique and Ethical Considerations

There is a great deal of variability in both the interventions and comparison groups used in research on the two articles. This can make it difficult to compare the findings of different studies directly. However, looking at the general trends across the two articles, there are some key similarities and differences between what is being done in each group. The intervention groups tend to receive more aggressive treatment for their infection. This may include things like more frequent and/or longer antibiotic administration, earlier transfer to isolation wards, and so on. The comparison groups received standard care for their infection, which may not be as intensive.

Methods of Study

For article I, case-control study design was used while article II was a cohort study where there was a follow-up. The main difference between case-control and cohort studies is that cohort studies follow people over time (a “follow-up”), whereas case-control studies select people who already have the disease or outcome of interest (the “cases”) and compare them with a group of people who do not have the disease or outcome of interest (the “controls”). Cohort studies are thought to be more accurate because they measure exposures/outcomes in real life as they happen. Case-control studies are often limited by recall bias, where cases may remember things differently than controls.

The main benefit of case-control study design is that it is much less expensive and time consuming than other types of epidemiological studies, such as cohort studies. A limitation of case-control study design is that it can be difficult to determine causation because it is retrospective in nature. Cohort studies are a type of observational study, which means that researchers observe what people do (in this case, who contracts a particular disease) and try to identify patterns (Wang & Kattan, 2020). This type of study is useful because it can track a large number of people for many years, which allows researchers to identify risk factors for diseases. A limitation of cohort studies is that they cannot prove causation; they can only show correlation.

Results of Study

According to study I, the following factors are associated with progression to infection in methicillin-resistant Staphylococcus aureus (MRSA) – colonized, critically ill neonates: – gestational age <37 weeks, – birth weight <1,500 grams, – mechanical ventilation for >48 hours, – history of MRSA colonization or infection, – receipt of total parenteral nutrition (TPN) for >14 days, – concurrent diagnosis of necrotizing enterocolitis (NEC) or sepsis (Schuetz et al., 2021). Also, from the study, critically ill neonates were found to have a significantly higher risk of progression to infection than those who were not colonized by the bacteria.

Study II showed that the incidence of MRSA bacteremia decreased significantly following implementation of the ICU infection control program. The rate of decrease was greatest in the ICUs with the most comprehensive program (Kim et al., 2020). These findings suggest that implementation of an effective ICU infection control program can reduce the incidence of MRSA bacteremia.

The two studies on nursing practice provide valuable information on the use of alcohol-based nasal decolonization to prevent infection in methicillin-resistant Staphylococcus aureus (MRSA) -colonized patients. The two studies are critical in enhancing quality nursing practices and healthcare delivery processes.

Outcomes Comparison

The anticipated outcome of the PICOT question is that chlorhexidine baths can reduce the risk of acquiring methicillin-resistant Staphylococcus aureus (MRSA) in critically ill patients. A number of studies have shown that chlorhexidine baths are associated with a reduction in MRSA acquisition, and although the exact mechanism by which this occurs is unclear, it is thought that chlorhexidine may potentiate the effects of antibiotics and/or directly inhibit the growth of bacteria (Kim et al., 2020). In addition, chlorhexidine baths appear to be well tolerated by patients and are associated with few side effects. The outcomes of the two quantitative articles are comparable to the anticipated outcomes. The two articles concluded that chlorhexidine has a broad-spectrum of antibacterial activity and is effective against both gram-positive and gram-negative bacteria. It is also highly effective against MRSA, making it an ideal agent for use in preventing hospital-acquired infections.

Conclusion

There is some evidence that suggests daily chlorhexidine baths may help prevent the acquisition of methicillin-resistant Staphylococcus aureus (MRSA) in critically ill patients. However, more research is needed to determine whether or not this is truly the case. Chlorhexidine has a broad-spectrum of antibacterial activity and is effective against both gram-positive and gram-negative bacteria. It is also highly effective against MRSA, making it an ideal agent for use in preventing hospital-acquired infections. The two articles analyze factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized among critically ill neonates and the application of Alcohol-based Nasal Decolonization and Chlorhexidine Bathing to Reduce Methicillin-resistant Staphylococcus.

References

Kim, H., Kim, E. S., Lee, S. C., Yang, E., Kim, H. S., Sung, H., … & Chong, Y. P. (2020). Decreased incidence of methicillin-resistant Staphylococcus aureus bacteremia in intensive care units: a 10-year clinical, microbiological, and genotypic analysis in a tertiary hospital. Antimicrobial agents and chemotherapy, 64(10), e01082-20. https://doi.org/10.1128/AAC.01082-20

Schuetz, C. R., Hogan, P. G., Reich, P. J., Halili, S., Wiseman, H. E., Boyle, M. G., … & Fritz, S. A. (2021). Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates. Journal of Perinatology, 41(6), 1285-1292. https://www.nature.com/articles/s41372-021-00944-8

Wang, X., & Kattan, M. W. (2020). Cohort studies: Design, analysis, and reporting. Chest, 158(1), S72-S78. https://www.sciencedirect.com/science/article/pii/S0012369220304645