Part 2 Identifying Research Methodologies

Article #1:  “Thibault, R., Makhlouf, A. M., Kossovsky, M. P., Iavindrasana, J., Chikhi, M., Meyer, R., & Pichard, C. (2015). Healthcare-associated infections are associated with insufficient dietary intake: an observational cross-sectional study. PloS one, 10(4).”

Article #2:   “Hagel, S., Ludewig, K., Pletz, M. W., Frosinski, J., Moeser, A., Wolkewitz, M., ... & Scherag, A. (2019). Effectiveness of a hospital-wide infection control programme on the incidence of healthcare-associated infections and associated severe sepsis and septic shock: A prospective interventional study. Clinical Microbiology and Infection, 25(4), 462-468.”

Article #3:  “Qasem, M. N., & Hweidi, I. M. (2017). Jordanian nurses’ knowledge of preventing surgical site infections (SSIs) in acute care settings. Open Journal of Nursing, 7(5), 561-582.”

Article #4:   “Wolfensberger, A., Meier, M. T., Clack, L., Schreiber, P. W., & Sax, H. (2018). Preventing ventilator-associated pneumonia—a mixed-method study to find behavioral leverage for better protocol adherence. Infection Control & Hospital Epidemiology, 39(10), 1222-1229.”

I choose this article because it discusses the association between HCAIs with insufficient dietary intake, which relates to the issue of clinical inquiry, that is, Healthcare-associated infections.

I choose this article because it discusses the effectiveness control program on the clinical inquiry issue, which is HCAIs. In this case, it is HCAIs with sepsis and septic shock.

I choose this article because it discusses the knowledge base of nurses’ preparedness to deal with the issue of inquiry, which is HCAIs in an acute care setting.

I choose this article because it discusses behavioral leverage for better adherence to prevent one of the common HCAIs, which is ventilated-associated pneumonia.

The aim of this study was to evaluate the link between dietary intake, nutritional risk, and the prevalence of Healthcare-associated infections (HCAI), in a general hospital population.

The aim of this study was to assess whether hospital-wide infection control program (ICP) is effective at decreasing the burden of HCAIs and associated severe sepsis of sepsis shock or death. 

This study aimed at evaluating the level of Jordanian nurses’ understanding of the evidence-based procedures for the prevention of SSI.

The aim of this study identifies the optimal behavior leverage to enhance ventilator-associated pneumonia (VAP) prevention protocol adherence.

This quantitative study utilized   cross-sectional research design to find out the link between “dietary intake, nutritional risk, and the prevalence of HCAI, in a general hospital. Dietary intake was determined by devoted dieticians on a particular day for all patients who were admitted and receiving 3 meal courses daily. Nutritional risk was determined through utilization of “Nutritional Risk Screening (NRS)-2002, and denoted as a NRS score ≥ 3.” Energy needs were evaluated through utilizing 110% “Harris-Benedict formula.” HCAIs were diagnosed based on the Center for Disease Control criteria and their association with nutritional risk and measured energy intake was conducted by utilizing a multivariate logistic regression analysis. The study used a sample size of 1689 hospitalized patients.

This mixed-method study used quasi-experimental research design with two surveillance periods. Besides, the researcher applied segmented mixed-effects Poison regression and multi-state models. This study used a sample size of 25 000 inpatients.

This quantitative study utilized a cross-sectional research design with a sample size of 200 registered nurses at 4 targeted hospitals, who were recruited conveniently. The study used step regression analysis to determine the most significant predictor.

This was mixed-method study that used adherence measurements to evaluate 4 VAP prevention measures and qualitative analysis of semi structured focus group interviews with frontline nurses in 6 ICU 900-bed University Hospital setting in Zurich.

One of the strength measuring nutritional intakes via recording actual dietary intake of all the 3 meal courses. This measurement reinforced the data on energy intake, which in most cases is often grounded on subjective evaluation of the past week dietary intake of the patient. 

Additionally, the diagnosis of HCAI was done using a standardized methodology that has been published and utilized widely. Further, “Nutritional Risk Screening-2002 score” utilized was a validated nutritional screening tool. Besides, the one-day prevalence survey conducted offered a manageable and reliable methodology of assessing the in general nutritional state.

Additionally, the methodology was validated using validated nutritional screening tool which increase internal reliability to identify patients at risk of HCAIs. 

This study provided unique data on the hospital-wide incidence of HCAIS over long observational period. Besides, this study provides data on the severity of various types of HCAIs in both ICU and general ward patients for the first time.  However, the direct observations of hand hygiene compliance represent a valid instrument for assessing hand hygiene behavior, though it is debatable. 

The study successfully implemented the infection control measures, especially the SSI prevention measures as well as a well-structured progressive education programs that would increase the nurses’ knowledge concerning preventive measures against SSI in acute care settings. The validity was achieved through experts asking whether all questions were properly worded and the chances of misinterpreting them were minimal.

Again, Cronbach’s alpha calculated was 0.81 indicating considerable level of internal uniformity reliability.

The BCW framework offers specific interventions to change behavior by linking sources of behavior to intervention functions.

Besides, the [proposal of interviews matched the ones in the BCW. Additionally, the benefit of technical solutions in the study is supported by Cafazzo’s ‘hierarchy of intervention effectiveness.’ However, no validity and reliability measures were conducted in the study.

The finding suggested that insufficient dietary intake could be a risk factor of HCAI, without the exclusion of reverse causality.

The results showed a significant reduction in severe HAIs in ICUs, indicating that the program works better in ICU setting. 

The study gave an explanation of the barriers that hamper the Jordanian nurses’ knowledge of EBP guidelines for preventing SSIs. 

The findings suggested that technical, rather than education-based, solutions should be encouraged to enhance VAP prevention.