NUR 550 PICOT Research Proposal Paper

NUR 550 PICOT Research Proposal Paper

Refer to the PICOT you developed for your evidence-based practice project proposal. If your PICOT required revision, include those revisions in this assignment. You will use your PICOT paper for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal. NUR 550 PICOT Research Proposal Paper

NUR 550 PICOT Research Proposal Paper

Write a 750-1,000-word paper that describes your PICOT.

Describe the population\’s demographics and health concerns.
Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
Compare your intervention to previous practice or research.
Explain what the expected outcome is for the intervention.
Describe the time for implementing the intervention and evaluating the outcome.
Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly. NUR 550 PICOT Research Proposal Paper

Complete the \”APA Writing Checklist\” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your NUR 550 PICOT Research Proposal Paper.
Refer to the \”Evidence-Based Practice Project Proposal – Assignment Overview\” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this NUR 550 PICOT Research Proposal Paper assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. NUR 550 PICOT Research Proposal Paper

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

PICOT Research Proposal Sample Paper

Population Description

The intensive care unit (ICU) is a specialized clinical area concerned with offering care to critically ill patients while monitoring the progress of the patient. Patients admitted in ICU have a critical illness that is possibly reversible. Life-threatening conditions that require ICU support include sepsis, stroke, traumatic brain injury, heart failure, and ruptured brain aneurysm (Anesi et al., 2017 NUR 550 PICOT Research Proposal Paper), among others. Services including blood pressure monitoring, medication administration, ventilation, and close monitoring are offered to patients by trained critical nurses. The main purpose of admission of the patient to ICU is the stabilization of the patient.

The presence of an unfavorable ICU environment, reduced immunity of ICU patients, and the lifesaving procedures including central line insertion and ventilation support predispose patients in ICU to life-threatening infections. The common infections include ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), surgical site infection, and catheter-associated urinary tract infections (CAUTI). The presence of such infections increases hospital stay, cost of care, morbidity, and risk of death. Additionally, research shows that elderly persons are more likely to be admitted to ICU. The presence of comorbidities in this population and advanced age increases the risk of infection hence resulting in poor prognosis. NUR 550 PICOT Research Proposal Paper

Description of Intervention

The chlorohexidine solution is an antimicrobial with bactericidal properties. It is the most effective gram-positive bacteria intervention. It is widely used against microbial as a mouth wash and also reduces skin colonization by antimicrobials. It has a fast onset of action and a prolonged duration hence widely used to reduce colonization. Reduced skin colonization around the catheter leads to the reduced introduction of microbial into the bloodstream hence prevention of CLABSI (Arunga et al., 2021). ICU patients without CLABSI are likely to recover quickly hence reducing the cost of care with improved patient outcomes. As such, it is imperative that nurses offer equitable care to all patients in the ICU using chlorohexidine to prevent the condition. NUR 550 PICOT Research Proposal Paper

Comparison of Intervention to Previous Research

Bathing of areas around the central line with chlorohexidine to prevent CLABSI has been widely leveraged and is acceptable by most healthcare providers. Several kinds of research support the use of chlorohexidine in ICU patients including that of Frost et al. (2018 NUR 550 PICOT Research Proposal Paper). I have used chlorohexidine in the management of my patients in the ICU and the results are immense. Daily bathing and appropriate procedure are useful in reducing the risk of infection.

 In a study by Frost et al. (2018) that sought to study the effectiveness of chlorhexidine in elderly ICU patients, a systemic literature search was done that aimed at identifying the effectiveness of chlorhexidine in reducing CLABSI, CAUTI, multi-drug resistant organism (MDRO), and VAP. The study found out that the use of chlorohexidine lead to a reduction of CLABSI by 29%, reduction of MDRO by 18% while no change in the rate of VAP (Frost et al., 2018). However, the study also found out that daily bathing using chlorohexidine was not achieved.

In another randomized control trial study by Zamir et al. (2020), on the effectiveness of chlorohexidine lock devices in ICU patients, a total of 100 patients were used. 50 were exposed to normal care of the central line while the other 50 used the device. The study revealed a reduced rate of CLABSI from 6.6 to 4.8 in patients who used the chlorohexidine lock device. The study further revealed that immobilizing the catheter helps in reducing the rate of CLABSI.

More evidence from a study by Urbancic et al. (2018) confirmed a reduced rate of CLABSI attributable to chlorhexidine use. The observational study was done in 12 months and pre and post-intervention results were compared. The infection rate reduced from 1.69 per 1000 catheter days to 1.33. The evidence from all these researches conquers my PICOT question. NUR 550 PICOT Research Proposal Paper

Expected Outcome

The expected outcome from this study should not differ from the previous studies regarding CLABSI prevention. I expect to find a reduced rate of CLABSI in patients using chlorhexidine to bath central lines. Reduced CLABSI will lead to a reduced hospital stay, cost of care, and risk of death. Hence patients will be discharged from ICU early enough to enable them to recover. Compared to the use of normal saline in flushing central lines, chlorohexidine offers an additional advantage.

Implementation of Intervention and Evaluating Outcome

Chlorohexidine will be used in bathing patients with the central line. Daily bathing will be done using the right procedure. Continuous assessment of the site and the patient will be done daily and routinely. Monitoring of patients for any signs of infection such as fever, malaise, swelling, and pus accumulation will be done. Blood cultures will be carried out routinely to identify causative organisms in case of infection. Period of hospital stay, general condition of the patient, and incidences of new infections will be used in evaluating the effectiveness of the intervention.

Application of Nursing Science, Social Determinants of Health, Genome, and Genetics in ICU Patients

Nursing science is used by critical care nurses to offer quality care to ICU patients. Nursing expertise and advanced knowledge are required by any nurse who offers care to patients. Additionally, nurses assess the risks and benefits of a particular intervention of patients. Ideally, patients in ICU require support from their relatives as well. Support can be emotionally or financially to enable them to receive care. All social determinants of health are applicable in ICU patients to help in recovery and to reduce readmissions to ICU (Maslove et al., 2017 NUR 550 PICOT Research Proposal Paper).

Genetics is related to heredity while genomes deal with the interaction of genes within an individual. Genome knowledge is required in the monitoring of patients. Monitoring includes infection identification, evaluating prognosis, and tracking response to intervention. Additionally, practitioners often use novel physiology markers in monitoring, identifying endotypes of infection, and response tracking. Finally, understanding the genetic history of a patient in the ICU is important in tracing the origin of certain conditions and therefore will guide the course of treatment to be offered.

NUR 550 PICOT Research Proposal Paper References

  • Anesi, G. L., Wagner, J., & Halpern, S. D. (2017). Intensive Care Medicine in 2050: toward an intensive care unit without waste. Intensive Care Medicine, 43(4), 554–556.
  • Arunga, S., Mbarak, T., Ebong, A., Mwesigye, J., Kuguminkiriza, D., Mohamed-Ahmed, A. H. A., Hoffman, J. J., Leck, A., Hu, V., & Burton, M. (2021). Chlorhexidine gluconate 0.2% as a treatment for recalcitrant fungal keratitis in Uganda: a pilot study. BMJ Open Ophthalmology, 6(1), e000698.
  • Frost, S. A., Hou, Y. C., Lombardo, L., Metcalfe, L., Lynch, J. M., Hunt, L., Alexandrou, E., Brennan, K., Sanchez, D., Aneman, A., & Christensen, M. (2018). Evidence for the effectiveness of chlorhexidine bathing and healthcare-associated infections among adult intensive care patients: a trial sequential meta-analysis. BMC Infectious Diseases, 18(1), 679.
  • Maslove, D. M., Lamontagne, F., Marshall, J. C., & Heyland, D. K. (2017). A path to precision in the ICU. Critical Care (London, England), 21(1).
  • Urbancic, K. F., Mårtensson, J., Glassford, N., Eyeington, C., Robbins, R., Ward, P. B., Williams, D., Johnson, P. D., & Bellomo, R. (2018). Impact of unit-wide chlorhexidine bathing in intensive care on bloodstream infection and drug-resistant organism acquisition. Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine, 20(2), 109–116.
  • Zamir, N., Pook, M., McDonald, E., & Fox-Robichaud, A. E. (2020). Chlorhexidine locking device for central line infection prevention in ICU patients: protocol for an open-label pilot and feasibility randomized controlled trial. Pilot and Feasibility Studies, 6(1), 26.
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