Research Summary Table

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ResearchSummary Table

ResearchSummary Table

Author (year)

Purpose

Sample/Number of Participants (provide descriptive statistics)

Design

Level of Evidence

Findings (provide any inferential statistics)

Limitations

Blanck, W., Donahue, M., Brentlinger, L., Stinger, K. &amp Polito, C. (2014).

To test the application of bundle approach (including bedside checklists) of catheter health care practices to reduce the occurrence of urinary tract infection (UTI).

Convenience sample of 317 pre-intervention and 310 intervention patients with catheter.

A descriptive study of protection of patients with catheter from infection.

III: Evidence obtained from one quasi-experiment study.

The risk of infection reduced by half, following the use of bedside checklists.

Lack of randomization during the group assignment.

Camargo, T. &amp Edmond, B. (2016).

To determine the effectiveness of standard checklist in reducing the risk of infection among patients with catheter.

Convenience sampling of 2,200 patients with catheter.

A descriptive study seeking to explain the reduction in the risk of infection following the implantation of catheter.

III: Evidence obtained from one quasi-experiment study.

The use of standard checklist and procedures minimize the risk of infection and inappropriate application of catheter.

Risk of bias due to reliance on senior nurses only in data collection. The high turnover of nurses resulted in the non participants inserting catheter and monitoring patients.

Jaggi, N. &amp Sissodia, P. (2012).

To determine the ability multimodal UTI supervision that is based on UC checklist to prevent UTI among patients with catheter.

Convenience sampling of 4,286 patients living with catheter implantation.

A descriptive study conducted to assess the effectiveness of patient supervision protocols or checklists to minimize the risk of infection.

IV: Evidence obtained from case control.

Effective adherence to checklists and protocols reduced the risk of UTI by 47.1 %.

Patient categorization complicated the study. Risk of subjectivity due to a failure to apply a random approach in sampling.

Sharma, I., Sembian, N. &amp Kumari, V. (2016).

To determine the effectiveness of catheter health care protocols and checklists in minimizing the risk of UIT.

Convenience sampling of 54 female patients with catheter.

A comparison study comparing effectiveness of standard protocols and conventional treatment in minimizing the risk of UTI in clients with catheter.

IV: Evidence obtained from case control.

There is no statistical difference in application of protocols or checklists and conventional treatment of clients with catheter.

Risk of subjectivity due to a failure to apply a random approach in sampling.

Summary

Urinarytract infection (UTI) is among the most common challenges affectingpatients with kidney disease after catheter implant procedures. Therisk of suffering from opportunistic infections is more common amongthe hospitalized patients than the outpatient clients (Camargo &ampEdmond, 2016). Different strategies have been used in an effort tocontain this challenge. The use of catheter protocol or checklists tomonitor the progress of hospitalized patients is among the newapproaches that are being considered in the modern health carefacilities. Therefore, the PICOT question that this study seeks toanswer is “In patients with kidney problems and implanted with thecatheter (P), how can adherence to monitoring protocols or checklists(I) compared to conventional treatment (C), reduce the risk of UTI(O), within one year (T)?” The key word search is the main strategyused to identify the relevant articles that were required to answerthe question. Some of the key words and phrases used include“effectiveness of checklists in UTI prevention”, “adherence toprotocols in patients with catheter”, and “catheter and UTIprevention”. This search strategy led to the online identificationof four articles that will be analyzed in this paper.

Differentresearch designs were used by authors of the four articles. Two ofthe studies (Blanck, Donahue, Brentlinger, Stinger &amp Polito, 2014and Camargo &amp Edmond, 2016)aredescriptive and they are based on the quasi-experimental design. Onestudy (Jaggi &amp Sissodia, 2012) is also descriptive, but it isbased on the case control design. One research (Sharma, Sembian &ampKumari, 2016) is comparative and it is based on the case studycontrol design. It compares the effectiveness of adherence tochecklists and conventional therapy for clients with the catheter inthe prevention of UTI. Therefore, two of the studies were conductedusing quasi-experimental design while the other two were based on thecase control.

Thelevel of evidence of the findings reported in the articles variesfrom each other. The level of evidence of the first two articles(Blanck etal.,2014 and Camargo &amp Edmond, 2016)isIII. The level of evidence of the last two articles is IV. Level IIIevidence is gathered using controlled trials that are well designed,but without any randomization. Therefore, this category of evidencewas gathered through a quasi-experiment. The level IV evidence thatis reported by Jaggi &amp Sissodia (2012) and Sharma, Sembian &ampKumari (2016) was gathered by conducting case control studies. Theinformation on the level of evidence in each article is importantbecause it indicates the extent to which the findings can beconsidered to be reliable and credible. Therefore, the reader of thearticles can easily choose whether to rely on the results reported ineach article to make decisions or not.

Thefindings indicate that three out of the four articles considered inthis study support the notion that adherence to catheter treatmentprotocol or checklists minimizes the risk of UTI among patientssuffering from kidney diseases. For example, Blanck etal.(2014) reported that the use of checklists to monitor the progress ofclients with catheter minimizes the risk of contracting the UTI by 50%. Although Camargo &amp Edmond (2016) did not provide specificstatistics, the findings of their research showed that standardprocedures and checklists used in monitoring patients who haveundergone catheter implantation minimize the chances of gettinginfections. Similarly, Jaggi &amp Sissodia (2012) reported that aproper observation of checklists leads to the delivery of qualitycare and patient monitoring, which protects them from the risk ofgetting infections after undergoing surgery for the implantation ofthe catheter. However, the findings reported by Sharma, Sembian &ampKumari (2016) indicated that there is no significant differencebetween the application of standard protocols and checklists intaking care of the client with catheter and the use of conventionaltreatment of the same condition. Therefore, the first three studiesgive a positive response to the question by indicating that the useof checklists can minimize the risk of getting infections amongpatients suffering from kidney diseases and have undergone surgeryfor implantation of the catheter. The findings of the last article(Sembian &amp Kumari, 2016) provide a negative response to thequestion by indicating that the use of checklists and standardprotocols cannot protect patients with catheter from infections morethan the conventional therapy.

Sampleswere selected using a convenient approach, which increased the riskof bias in the four studies. The number of participants selected inthe first three studies (Blanck etal.,2014, Camargo &amp Edmond, 2016, and Jaggi &amp Sissodia, 2012) wasadequate because it helped the research collect data that wassufficient to respond to the question. However, the 54 femaleparticipants who were recruited in the fourth article (Sharma,Sembian &amp Kumari, 2016) were inadequate. This is because thestudy was based on case control, which implies that a bigger datawould be required in order to obtain reliable findings.

Eachof the studies has limitations. The lack of randomization was a majorlimitation in Blanck etal.(2014) and Camargo &amp Edmond (2016). This challenge can beminimized by applying a random sampling approach in order to reducebias. The limitation associated with the difficulty of patientcategorization in the third article (Jaggi &amp Sissodia, 2012) canbe minimized by reducing the number of variables considered in thestudy. This will simplify the process of classifying clientsaccording to different variables. Lastly, the risk of bias in thefourth article (Sharma, Sembian &amp Kumari, 2016) can be reduced byapplying a random sampling approach in order to enhance therepresentativeness of the sample.

Inconclusion, there is sufficient evidence to support the idea thatthere should be a change in practice where nurses who take care ofpatients suffering from kidney problems and there are implanted withcatheter to use standard protocols and bedside checklists inmonitoring their progress. This change in practice will reduce therisk of UTI and increase patient outcome. In others, nurses shoulduse the checklists to ensure that all variables that determine thewellbeing of the patient are monitored, thus facilitating a timelydiscovery of any change in the health status. This measure, use ofstandard checklists or procedures, should be considered as anaddition to the conventional therapy.

References

Blanck,W., Donahue, M., Brentlinger, L., Stringer, K., &amp Polito, C.(2014). A quasi-experimental study to test a prevention bundle forcatheter-associated urinary tract infections. Journalof Hospital Administration,3 (4), 101-108 DOI:10.5430/jha.v3n4p101Retrieved March 20, 2017, fromhttp://www.sciedu.ca/journal/index.php/jha/article/viewFile/4232/2598

Camargo,T. &amp Edmond, B. (2016). Sustainability of a program forcontinuous reduction of catheter-associated urinary tract infection.AmericanJournal of Infection Control,11 (2015), 1-6. DOI: 10.1016/j.ajic.2015.11.037 Retrieved March 20,2017,fromhttps://www.researchgate.net/publication/292339392_Sustainability_of_a_program_for_continuous_reduction_of_catheter-associated_urinary_tract_infection

Jaggi,N. &amp Sissodia, P. (2012). Multimodal supervision program toreduce catheter associated urinary tract infection and its analysisto enable focus on labor and cost effective infection controlmeasures in a tertiary care hospital in India. Journalof Clinical and Diagnostic Research,6 (8), 1372-1376. DOI: 10.7860/JCDR/2012/4229.2362 Retrieved March20, 2017, fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3471501/pdf/jcdr-6-1372.pdf

Sharma,I., Sembian, N. &amp Kumari, V. (2016). Effectiveness of thecatheter care protocol vs. conventional catheter care on catheterassociated urinary tract infection. InternationalJournal of Health Science and Research,6 (10), 135-138. Retrieved March 20, 2017, fromhttp://www.ijhsr.org/IJHSR_Vol.6_Issue.10_Oct2016/22.pdf