Question:

Research Literature Support. Students use the Research Critique Table to identify the relevant elements in each research study article that support the PICOT/PICo questions.

For this section, ten additional references must be included in order to provide a useful overview of the literature that is relevant to the identified PICOT/PICo problem or solution.

This section should be presented as Research Literature Support.2.

Research Method/Design. In this section, students will identify the research strategy and design they are using to get the data to answer the question PICOT/PICo.

This assignment requires that the research approach be either quantitative, or qualitative.

The sub-categories for each research approach are the research design.

The quantitative approach includes the design categories of experimental and quasi-experimental.

The qualitative approach is based on the design categories of phenomenology (ground theory), epidemiological, historical, and epidemiological.

This content must be included:

Identification of the research method as either quantitative or qualitative, or mixed

Identification of research design

Description of the selected design

Rationale of the selected design

Identifies one advantage in the chosen design

Identifies one flaw in the selected design3.

Sampling technique: Here, the student will discuss the sampling procedure to be used in order for the student to find the appropriate participants.

This section also includes a discussion on participants’ rights.

You must include the following:

Describe the target audience

Determine if the project uses probability or nonprobability sample

Include a description about the sampling procedure and the sample size.

Identify two positive aspects of the selected sampling process

Identify one negative aspect of the chosen sampling process

Define the rights of participants (e.g.

Confidentiality, anonymity, protection against harm

Answer to Question: 364JA Nursing

The basic definition of sick patients is those people who are often afflicted by disease and require consistent clinical observation and medical management support from healthcare staff.

Hospitalized patients should consider the use of CVCs (central venous catheters). This is important for administering medications and nutrients.

CVCs can be placed from the bedside and are not difficult to insert.

These CVCs can be used as an integral part of MICUs.

CVCs pose risks to patients due to the possibility of infection as well as thrombotic or mechanical complications.

CVC-related errors and challenges are due to the loss of skin elasticity as a result the insertion of an intravascular catheter. Additionally, infection can occur along these lines due the movement of surface pathogens surrounding the tip and inclusion points of the catheter (Ullman (2016)).

The occurrence of catheter-related disease is associated with severe complications, death, and even death for hospitalized patients. Therefore, it is essential to avoid the use of intravascular gadgets and physician’s facility-associated expenses. (Weeks. Hsu. Yang. Sawyer. Marsteller., 2014).

One example of such regulatory mechanisms is the use of occlusive cats at the CVCs inclusion point.A promising strategy implemented to reduce the extra luminal course of contamination is the use of chlorhexidine gluconate-impregnated dressing set at the time of CVC insertion (Ullman et al., 2017).

Chlorhexidine, a disinfectant-free and germ-free solution, is used to sterilize surgical instruments and for skin sanitization prior to surgery.

It could be used for both the skin care of the patient as well as the cleaning of surgical instruments by staff using the CVC.

It is unclear whether surface disinfectants with chlorhexidine – liquor are required before inserting intravascular device like CVCS.

The arrangement made before CVCs are inserted is effective to counteract and control bacterial colonization around the entry point to the skin and, consequently, prevent intravascular catheter infection. (Bashir Olson, Walters, and Walters 2012. Duzkaya, Sahiner, Uysal, Yakut, and Citak (2016) led an investigation looking at the viability of chlorhexidine-impregnated dressing and the standard dressing in preventing catheter-related circulation system diseases (CRBSIs) on 100 patients (50 for standard and 50 for Chlorhexidine dressing conceded at the pediatric emergency unit).

The results showed that the patients who were given a chlorhexidine-impregnated dressing saw a reduction in catheter-related diseases, contamination, colonization, and local contaminants. Another meta-analysis of nine randomized medical tests presumed that chlorhexidine-impregnated gel poultices diminish the rate of catheter-associated circulation system contamination and the colony formation in few catheter needles.

The use of these products is highly recommended. However, additional strategies for dressing focal catheters are not recommended (Safdar und al., 2014.

Another examination proved that Chlorhexidine gel cataplasm has fast, effective antibiotic movement. They are made up of a simple hydrogel and a polyurethane shell that continuously releases chlorhexidine at 2%.

Evidence-based studies show that cataplasm should not be left on the skin for more than a week.

In another meta-investigation, daily showering with chlorineidine was found to be associated with lower rates of measured healing facility procured circulating system contaminations. It also had no impact on patients who are fundamentally sick.

Chlorhexidine was found to reduce the number of cases of Gram-positive Bacteremia using mupirocin.

Therefore, it is possible that chlorhexidine dressings can be used to prevent CVC lines infections.

Research ApproachA quantitative report, with an exploratory approach, will be used to break down the utilization of chlorhexidine-impregnated gel dressings in fundamentally sick patients in contrast with povidone-iodine dressing in averting CVC inclusions diseases.

The research will be based on a randomized clinical trials study design (Septimus (2016)) and the collection of data from both the test and control groups.

Chlorhexidine dressing will only be used on one set of patients with catheters in MICU.

CVC-additions will be used on the second group of patients. The final set of patients won’t require any of the treatments.

The patient’s treatment will be followed for one year.

Thereafter, data on the number of cases of infection that could be caused by CVC combination will be collected. The severity of the disease will also then be classified.

This research method will enable you to gather data about three groups of participants and provide the necessary information.

This information can then be used to analyze the research data and determine whether chlorhexidine counteracts CVC-line disease.

Exploratory investigation is an excellent way to infer causality regarding medication or interventions.

This is because the focus is on the impact of particular outcomes.

If additional elements are being regulated, the specialist may mention that an independent control variable caused a change within the reliant entity (Tashakkori und Teddlie (2012)).

Analysts are able to weigh and categorize data by using this method of exploration.

An in-depth examination of the relationship between an independent variable and a dependent variable is conducted.

This is useful because it gives the analyst a better idea of the final results.

The ability to measure data can make quantitative exploration useful in testing theories.

The study is repeatable so results can easily be verified and checked.

This research design is best suited to achieving the desired outcomes.

The problem is that you need to choose a sample that is representative for the entire population. Therefore, valid data can be more difficult to obtain.

It can be expensive and time-consuming to conduct research with large sample sizes.

Sampling Method

They must meet the criteria of being hospitalized or sick.

After receiving informed consent, participants will receive information regarding the purpose of the research as well as key procedures.

The research will be carried out in the MICU of a high-quality, sophisticated healing center in the United States of America (Florida Doctor’s Facility Orlando).

Patients over 18 years of age are included in the current study. Nurses administer medications or nutrients to patients through CVCs and use chlorhexidine-soaked cataplasm.

For the purpose of collecting information, non-probability sampling plans will be employed.

The standard example is used to collect quality information throughout the time period.

This testing strategy will eliminate all potential confounding factors to ensure that the research is valid.

The 150 MICU patient sample will be divided into three groups: the povidone/iodine and chlorhexidine groups.

The survey will be conducted with the participants after one week and two weeks respectively.

The variables to be checked are pain, stress levels, white blood count and temperature.

These data will all be recorded until the prescribed time.

A company will make chlorhexidine-soaked Gel poultice for the study.

It will measure approximately 8.5cm X 111.5cm. It will have translucent gel soaked at 2% chlorhexidine in the focal bit. There will also be a 3cm-X4cm territory and glue edges made of polyester texture.

After dressing the catheter, two adhesive taps will be used.

This will also be used for the impregnating dressing with povidone-iodine.

This system is more powerful than convenience testing.

This could provide trustworthy information about the effects of intervention on people.

Due to the large sample size, the technique is susceptible to bias.

Also, it is possible that the large sample size will make investigation monotonous.

Participants will be provided with questionnaires to assess the effects of the drugs on their respective sample groups.

The questionnaire responses will be administered independently, and all data recorded will be kept private.

Their rights will be clarified before any data are collected from them.

Participation will only occur if the participant is confident about their right to confidentiality.

The expert will analyze and categorize data collected based on different outcomes.

ReferencesBashir, M. H., Olson, L. K., & Walters, S. (2012).

The application of chlorhexidine to the skin with chlorhexidine glue dressings suppressed normal skin flora. American Journal of Infection Control, 40(4), 344-348. doi:10.1016/j.ajic.2011.03.030Choi, E. Y., Park, D., Kim, H. J., & Park, J. (2015).

A meta-analysis of the effectiveness and safety of chlorhexidine bathing for healthcare-associated bloodstream infections.

Annals of Intensive Care. 5(1). doi:10.1186/s13613-015-0073-9Duzkaya, D. S., Sahiner, N. C., Uysal, G., Yakut, T., & Citak, A. (2016). Chlorhexidine-Impregnated Dressings and Prevention of Catheter-Associated Bloodstream Infections in a Pediatric Intensive Care Unit. Critical care nurse, 36(6), e1-e7.Gavin, N. C., Webster, J., Chan, R. J., & Rickard, C. M. (2016).

Frequency and severity of catheter-related infections caused by central venous accessibility devices.

The Cochrane Library.Nogueira, L. D., Koike, K. M., Sardinha, D. S., Padilha, K. G., & Sousa, R. M. (2013).

Nursing workload in the public and private intensive care units. Revista Brasileira de Terapia Intensiva, 25(3), 225-232. doi:10.5935/0103-507x.20130039Pfaff, B., Heithaus, T., & Emanuelsen, M. (2012).

One-piece Chlorhexidine Gluconate Transparent Clothes for Critically Ill patients. Critical Care Nurse, 32(4), 35-40. doi:10.4037/ccn2012956Safdar, N., O’Horo, J. C., Ghufran, A., Bearden, A., Didier, M. E., Chateau, D., & Maki, D. G. (2014). Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection. Critical Care Medicine, 42(7), 1703-1713. doi:10.1097/ccm.0000000000000319Septimus, E. J. (2016). Faculty of 1000 evaluation for Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial.

F1000-Post-publication peer review and discussion of biomedical literature. doi:10.3410/f.1166053.793513076Tashakkori, A., & Teddlie, C. (2012).

Integrating Qualitative, Quantitative and Applied Research Approaches. The SAGE Handbook of Applied Social Research Methods, 283-317. doi:10.4135/9781483348858.n9Timsit, J., Mimoz, O., Mourvillier, B., Souweine, B., Garrouste-Orgeas, M., Alfandari, S., … Lucet, J. (2012).

Randomized Controlled Trial of Chlorhexidine Dressing in Adults with Critical Illness: Highly Adhesive and Chlorhexidine Dressing. American Journal of Respiratory and Critical Care Medicine, 186(12), 1272-1278. doi:10.1164/rccm.201206-1038ocUllman, A. J., Kleidon, T., Gibson, V., McBride, C. A., Mihala, G., Cooke, M., & Rickard, C. M. (2017).

Pilot randomized controlled trial of innovative dressing and securement for tunneled central vanous access devices in pediatrics. BMC Cancer, 17, 595. https://doi.org/10.1186/s12885-017-3606-9Ullman, A. J., Cooke, M. L., Mitchell, M., Lin, F., New, K., Long, D. A., … Rickard, C. M. (2016).

Cochrane systematic Review: Dressing and Securement for Central Venous Access Devices (CVADs) International Journal of Nursing Studies, 59, 177-196. doi:10.1016/j.ijnurstu.2016.04.003Weeks, K. R., Hsu, Y., Yang, T., Sawyer, M., & Marsteller, J. A. (2014).

Study of the effects of a multifaceted intervention on central-line days in intensive care units. Results of a nationwide multisite study.

American Journal of Infection Control. 42(10). S197-S202. doi:10.1016/j.ajic.2014.06.003.