Hospital Acquired Infections

Hospital Acquired Infections

Introduction

Hospital-Acquired Infections (HAIs) are infections that people get when receiving treatment at a healthcare facility. Patients can get HAIs through different ways, including penetration through the bloodstream, urinary tract, skin, lungs, and digestive track. Hospital Acquired Infections can become deadly and are often difficult to treat. This work is a critical appraisal of two qualitative research studies about Hospital Acquired Infections.

One of the qualitative research articles for an appraisal is Beyond The Hospital Infection Control Guidelines: A Qualitative Study Using Positive Deviance To Characterize Gray Areas And To Achieve Efficacy And Clarity In The Prevention Of Healthcare-Associated Infections by Anat Gesser-Edelsburg et al., (2018). The second journal article to be appraised is Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: A multicentre, prospective, intervention study by Elisabetta Casselli et al., (2018).

Article 1: Caselli, E., Brusaferro, S., Coccagna, M., Arnoldo, L., Berloco, F., Antonioli, P., Tarricone, R., Pelissero, G., Nola, S., La Fauci, V., Conte, A., Tognon, L., Villone, G., Trua, N., Mazzacane, S. & Conly, J. (2018). Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: A multicentre, prospective, intervention study. PLOS ONE, 13(7), e0199616.

Background Information

The article has a well-laid structure beginning with a well-detailed abstract that captures the summary of the research. At the introduction level, the researchers give well-detailed background information about hospital-acquired infections. This section also has statistics about the problem which helps readers to quickly understand how big a problem HAIs is globally. From the onset, the researchers state that the cleanliness of the hospital surfaces dictates how effective healthcare facilities can prevent HAIs.

The researchers also clearly state the solution to dealing with cleaning hospital surfaces to reduce hospital infections. One of the solutions offered in the study is Probiotic Cleaning Hygiene System (PCHS). According to the study, PCHS has been proven safe for hospitalized patients as it can safely decrease surface pathogens by up to 90%, a figure that is more than what conventional disinfectants can achieve (Caselli et al., 2018). Furthermore, research indicates that PCHS does not select for resistant strains, rather reducing them without increasing sanitation costs.

Thesis Statement and Purpose of Study

After an 18-month trial of a multicentre intervention study on the impact of HAI incidence, the authors clearly state their thesis statement. In this case, the researchers assert that “innovative eco-sustainable microbial-based cleaning procedure can influence HAI occurrence,” (Caselli et al., 2018). To this end, the researchers propose a Probiotic Cleaning Hygiene System as the best containment measure for surface cleanliness in healthcare centres. Concerning, purpose of the study, from the onset, the researchers make clear the aim and objective of their study which is to reduce healthcare-associated infections incidence by using a probiotic-based sanitation system.

Methods

The methodology used for the research was a prospective, pre-post interventional approach. Each HAI occurring during the observation periods in the patients admitted to the enrolled hospital wards in the two observed periods was identified according to the criteria defined by the European Centre for Disease Prevention and Control. Dedicated healthcare professionals collected continuum data from patients’ clinical records in a standardized spreadsheet, per each hospital.

Professionals collecting clinical data were only aware of an incidence study to be conducted during all the study period (18 months) and were blinded to the intervention time and hospital’s groups. A first electronic clinical record was filled out for each admitted patient and contained general data, including gender, age, origin, admission date, admission diagnosis, presence of specific risk factors, antibiotic therapy in the two weeks preceding admission, and presence of colonization by alert.

Results, Findings, and Conclusions

After a survey of 11,842 patients globally to study the impact of sanitation on HAI incidence, the authors indicate their findings. The findings of the research are given by analyzing the main characteristics of the studied populations. With the aid of tables and charts, the authors tabulate their findings concerning hospital-acquired infections. For example, from table 2, readers can see the results of the findings of common hospital infections and their prevalence.

Based on the results of their study, the researchers clearly pin down the conclusion of their research. From the results and findings, the researchers were able to show an association between HAI incidence and environmental microbiota in such a large sample. Overall, collected results may contribute to emphasizing the role of environmental microbiota modulation for cleaning in healthcare settings, introducing the possibility of an ecological approach in the area of environmental cleaning, which might be included among the effective tools available for infection prevention and control (IPC).

Article 2: Gesser-Edelsburg, A., Cohen, R., Halavi, A. M., Zemach, M., van Heerden, P. V., Sviri, S., Benenson, S., Trahtemberg, U., Orenbuch-Harroch, E., Lowenstein, L., Shteinberg, D., Salmon, A. & Moses, A. (2018). Beyond the hospital infection control guidelines: a qualitative study using positive deviance to characterize gray areas and to achieve efficacy and clarity in the prevention of healthcare-associated infections. Antimicrobial Resistance & Infection Control, 7(1), 124–.

This journal article examines the gray areas that hinder the effective handling of HAIs. The significance of the study is that it introduces a new approach of reducing HAIs called Infection Prevention and control (IPC) which is a clinical practice based on evidence-based guidelines.

The heading of the research is appropriate and easily understandable to the readers. Specifically, the authors have used an article heading for the research that is direct and easily understandable. From the heading, a reader can gather the fact that the authors are trying to look beyond the existing hospital infection control guidelines into grey areas that make it difficult for healthcare facilities to effectively curb the problem of HAIs.

To prove the validity of their study, the researchers employ a plethora of peer-reviewed journals as well as a qualitative constructivist research methodology that include personal interviews, observations, and video recordings of identified PD practices to enhance infection control (Gesser-Edelsburg et al., 2018). The plethora of peer-reviewed journals were used to gain background information on the topic of study as well as to compare findings with existing studies on the topic.

Thesis Statement, Results, and Purpose of Study

The article has a clearly stated thesis statement. In the introduction section, the authors start by giving a background to the phenomenon being studied and then proceed to provide a clear thesis statement that shows readers what the study is about. Concerning the purpose of the study, the authors make it clear to the readers what their intentions are as far as conducting the study is concerned.

Findings and Conclusion

The authors have proposed solutions that can be used to reduce hospital infections. The article has adequate information about the nursing practice issue, practical qualitative research, findings, and solutions to deal with the nursing practice issue at hand. The method of study that was used in the research is a qualitative constructivist research methodology, a type of research where researchers aim to understand a phenomenon from the perspective of those who have experienced that phenomenon.

The study has a well-detailed methodology section that gives in-depth details of how the research was conducted. For example, the article lists the methods of data collection that were used such as video recordings, interviews, and observations. The researchers also clearly state where the study was conducted. The study was conducted between January and March 2018, in two Intensive Care Units (ICU) units at Hadassah Hospital, Jerusalem, Israel. Personal interviews were conducted with 82 staff members from the General ICU (GICU) and Medical ICU (MICU).

References

Caselli, E., Brusaferro, S., Coccagna, M., Arnoldo, L., Berloco, F., Antonioli, P., Tarricone, R., Pelissero, G., Nola, S., La Fauci, V., Conte, A., Tognon, L., Villone, G., Trua, N., Mazzacane, S. & Conly, J. (2018). Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: A multicentre, prospective, intervention study. PLOS ONE, 13(7), e0199616–. doi:10.1371/journal.pone.0199616.

Gesser-Edelsburg, A., Cohen, R., Halavi, A. M., Zemach, M., van Heerden, P. V., Sviri, S., Benenson, S., Trahtemberg, U., Orenbuch-Harroch, E., Lowenstein, L., Shteinberg, D., Salmon, A. & Moses, A. (2018). Beyond the hospital infection control guidelines: a qualitative study using positive deviance to characterize gray areas and to achieve efficacy and clarity in the prevention of healthcare-associated infections. Antimicrobial Resistance & Infection Control, 7(1), 124–. doi:10.1186/s13756-018-0418-x