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A Qualitative Study on Preventing Hospital-Acquired Urinary Tract Infection in United Sates Medical Facilities

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Research Critique Part 1: A Qualitative Study on Preventing Hospital-acquired Urinary Tract Infection in United Sates Medical Facilities
Donna Frazier
Grand Canyon University
Introduction to Nursing Research
Chris Thompson-Sanxter
February 01, 2013

Research Critique Part 1: A Qualitative Study on Preventing Hospital-acquired Urinary Tract Infection in United Sates Medical Facilities
Problem Statement The clinical problem in this research article identified as hospital-acquired urinary tract infections in US hospitals and the research problem focused on how to prevent hospital-acquired urinary tract infections. Though urinary tract infections are the most common hospital-acquired infection, accounting for 40% of all nosocomial infections, there is very little information as to why hospitals do or do not use the available preventative methods. (Sanjay, et al., 2008)
Purpose and Research Questions A list of questions were designed using the qualitative method, then used in 38 semi-regulated phone interviews with crucial staff at 14 expressly chosen hospitals and 39 face-to-face interviews at five of those fourteen medical facilities, to identify persistent and integrated ideas that describe in what way healthcare facilities tackled the dilemma of hospital-acquired urinary tract infections. (Sanjay, et al., 2008) The personnel interviewed were able to speak their thoughts freely since the data collection was so accommodating by using open-ended questions since qualitative studies encompass a method of discovery. Through comprehensive examination of the ensuing data, the concerns that face complex healthcare environments can be made known and in turn help clinicians and the policy makers decide on methods to help decrease hospital-acquired urinary tract infections; for this purpose qualitative studies are appropriate.
The questions used in the interviews are listed below; not all questions were asked of each individual, this was dependent on the fact of whether it was done by phone or face to face. 1. Explain the method this healthcare facility went through in deciding to accept or not accept this proactive route. 2. What method did the hospital use to identify the need for the policy? 3. Who facilitated the decision for this healthcare facility to use this practice? 4. In focusing on the challenge of hospital-acquired urinary tract infections, what factors did committee members consider? 5. What obstacles were met when this hospital attempted to get this policy accepted? 6. Is this healthcare facility suffering any problems carrying out the practice, if so what? 7. What are the main stumbling blocks that have prevented your facility from executing practices for reducing healthcare-associated infections? What are the methods? 8. If I were able to solve one main problem that makes it more difficult for your facility to put into action key systems to avert healthcare-associated infections what would it be. 9. If a person wishes to implement a new infection control, policy what committees need to be contacted? 10. How does being an element of a sizable health care system affect the choice and application of infection control policies? What are some of the pros and cons? 11. Who are the primary individuals who need to be on board for changes to occur? 12. Does a group of organized people have a part in the revision or execution of infection control policies at this hospital? 13. What length of time have nurses been included in the field of infection control? 14. What is your opinion of how administration is involved in the approval and execution of infection control policies? (Sanjay, et al., 2008)
In going over the questions asked in the study I confirmed both the purpose and the research questions were related to the dilemma of hospital-acquired infections though neither addressed the urinary tract infections directly. It is thought the qualitative methods were appropriate to answer the research questions. The research is essentially part of a bigger study utilizing both quantitative and qualitative methods with the qualitative method used in this situation.
Literature Review In doing the literature review, I found both quantitative and qualitative studies pertinent to the focus were cited by the author as well as reference material on approaches to quantitative and qualitative research methods, safety issues regarding patients with catheters, studies on silver-coated catheters and antimicrobial catheters use on hospitalized patients. (Saint et al., 2008) Many of the cited articles were older than 2008; 1970s-2007 and there was nothing indicative to show these studies had been evaluated for any weaknesses. It is believed there is adequate information to form a sound argument. Four persistent topics developed from this study data. First, even though preventing hospital-acquired urinary tract infections was of minimal import for most facilities, there was significant acknowledgement of the merit of early removal of a urinary catheter for patients. Second, those facilities that made urinary tract infection prevention a high priority also focused on non-infectious difficulties and had committed advocates, or “champions,” who expedited prevention activities. Third, hospital-specific test studies were essential in deciding whether to use devices such as antimicrobial-impregnated catheters. Last, outside influences, such as public reporting, influenced urinary tract infection investigation and infection deterrence activities.
Clinicians and policy makers can use these findings to develop initiatives that use a champion to promote the removal of unnecessary urinary catheters or utilize outside influences, such public reporting, to enhance patient safety.

Saint, S., Kowalski, C., Forman, J., Damschroder, L., Hofer, T., Kaufman, S., ... Krein, S. (2008, April). A multicenter qualitative study on preventing hospital-acquired urinary tract infections in the US Hospitals. Infection Control and Hospital Epidemiology, 29, 333-341.

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