Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations

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Introduction

Healthcare institutions have the moral responsibility of providing high-quality patient care to their clients. Therefore, the organizations should entrench measures that ensure patients are safe from physical injuries, professional malpractice, and Hospital-Acquired Infections (HAI). However, healthcare facilities have several challenges that prevent them from achieving the ultimate goal of delivering high-quality patient care devoid of HAI. The significant problems include inadequate nursing human resources. For this reason, it is imperative to critique available literature to establish whether patients will suffer more from HAI when treated in an ICU understaffed by nurses in comparison with a unit that has a 1:1 nurse-to-patient ratio.

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Background

Hospital-Acquired Infections are significant problems facing healthcare establishments and patient populations, contributing to substantial morbidity and mortality. Shang et al. (2019) studied the association between the unit-level staffing data with healthcare-associated infections and nurse staffing. Studies in the past had methodological challenges, necessitating the investigation. The investigation questioned whether unit-level nurse staffing was associated with HAI such as bloodstream infections, catheter-associated urinary tract infections, and vascular catheter-associated infections. Therefore, the study is significant to nursing since nurses form an essential component of mitigating HAI.

An appropriate nurse-to-patient ratio is essential to reduce nurse workload and improve patient outcomes. However, previous studies have had disparities in definitions and determination of HAI and staffing. Mitchell et al. (2018) conducted a systematic review of the literature to synthesize and understand the link between hospital staffing and HAI vulnerability. The review sought to understand whether understaffing contributed to HAI risk inpatient care. Therefore, it is imperative to standardize literature to provide nurses with sufficient evidence for HAI prevention guidance.

Relevance of the Articles on the Chosen Nursing Practice Issues

The intensive care unit (ICU) facilitates the care of patients with a considerable proportion of stress. The PICOT question is whether patients will exhibit more HAI when treated in a nurse understaffed ICU than a unit with a 1:1 nurse-to-patient ratio. Therefore, Mitchell et al. (2018) investigate the relationship between hospital staffing and HAI will provide information on the ability of adequate nurse staffing in mitigating HAI for ICU patients. Additionally, unit-shift nursing staff evidence will answer the question on the link between understaffing and HAI. Therefore, scientific evidence is essential to provide solutions to clinical problems.

Synthesis of research data is necessary for a practical problem-solving process. In the nursing practice issue investigation, the intervention group involves using the recommended 1:1 nurse to patient ratio in the ICU for improved patient outcomes, including reduced HAI incidence. Moreover, the comparison cohort includes patients treated in an ICU with an inadequate number of nurses and measures the proportion of those who develop HAI. Consequently, Shang et al. (2019) study on the relationship between unit-level staffing data with nurse staffing and HAI contrast the outcomes of those patients cared for by inappropriate nurse-patient ratio with those where the adequate nursing staff was present. However, the systematic review has no comparison and intervention group.

Method of Study

Investigators utilize different forms of study designs to answer stated research questions. Hospital staffing and healthcare-associated infections: A systematic review of the literature involved a step-by-step analysis of studies conducted between January 1, 2000, to November 30, 2015. The design is beneficial in answering the PICOT question since it entails a comprehensive review of all available literature. However, the procedure has reliability concerns since it involves the author’s judgment in determining the studies’ quality to be included in the investigation. Conversely, in the article Nurse staffing and healthcare-associated infection, the unit-level analysis analyzed cross-sectional urban hospital data from 2007 to 2012. The method has the advantage of allowing for multiple exposures and outcomes such as urban. However, the study results based on urban setups may not be used to draw a conclusion on the general population.

Results of the Study

Results from scientific research inform clinical decision-making. Mitchell et al. (2018) found that most studies investigated the link between nursing staffing and HAI, which strongly described understaffing to be associated with HAI upsurge. Additionally, the review found that the nursing studies varied in methodologies and operational definition of HAI indicators of staffing. Mitchell et al. (2019) established that the ICU had the most understaffed nursing shifts than other facilities. Consequently, the vulnerability to HAI among those patients in units with Registered Nurse(RN) understaffing was 15% higher than those with a sufficient RN-to-patient ratio. Therefore, the results indicate that understaffing increases HAI’s burden, necessitating nursing management to lobby for the higher or more nursing staff.

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Outcome Comparison

Desired patient healthcare outcomes improve nurse satisfaction in the delivery of quality care. The PICOT question’s expected outcomes include an increased incidence of HAI among patients in nursing understaffed ICUs than those in ICUs with a 1:1 nurse-to-patient ratio. Therefore, the outcomes would be consistent with the articles’ results; Hospital staffing and health care-associated infections: A systematic review of the literature and Nurse staffing and healthcare-associated infection, unit-level analysis.

Conclusion

Hospitals should design and implement interventions that improve patient care outcomes, including the reduced prevalence of HAI, decreased hospital stay duration, and the subsequent low cost of healthcare. Evidence exists that suggests understaffing, particularly nurse understaffing, to the surge of HAI. However, the nursing studies lack consistency in the methods and operational definition of HAI and staffing designation. Nonetheless, hospitals should invest in adequate nursing human resources to mitigate HAI.

References

Mitchell, B. G., Gardner, A., Stone, P. W., Hall, L., & Pogorzelska-Maziarz, M. (2018). Hospital staffing and health care-associated infections: A systematic review of the literature. The Joint Commission Journal on Quality and Patient Safety, 44(10), 613-622. Web.

Shang, J., Needleman, J., Liu, J., Larson, E., & Stone, P. W. (2019). Nurse staffing and healthcare-associated infection, unit-level analysis. The Journal of Nursing Administration, 49(5), 260. Web.

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NursingBird. (2022, July 6). Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations. Retrieved from https://nursingbird.com/hospital-acquired-infections-quantitative-research-critique-and-ethical-considerations/

Reference

NursingBird. (2022, July 6). Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations. https://nursingbird.com/hospital-acquired-infections-quantitative-research-critique-and-ethical-considerations/

Work Cited

"Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations." NursingBird, 6 July 2022, nursingbird.com/hospital-acquired-infections-quantitative-research-critique-and-ethical-considerations/.

References

NursingBird. (2022) 'Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations'. 6 July.

References

NursingBird. 2022. "Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations." July 6, 2022. https://nursingbird.com/hospital-acquired-infections-quantitative-research-critique-and-ethical-considerations/.

1. NursingBird. "Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations." July 6, 2022. https://nursingbird.com/hospital-acquired-infections-quantitative-research-critique-and-ethical-considerations/.


Bibliography


NursingBird. "Hospital-Acquired Infections Quantitative Research Critique and Ethical Considerations." July 6, 2022. https://nursingbird.com/hospital-acquired-infections-quantitative-research-critique-and-ethical-considerations/.