My clinical interest topic is looking at Healthcare-Acquired Infections (HAIs) in regard to nurse staffing. HCAIs are infections that patients receive while receiving care in a healthcare facility (Thandar et al., 2021). All settings of healthcare, for example, long-term care facilities, ambulatory clinics, surgical centers, and hospitals, can report HAIs. All hospitalized patients can contract HIAs; however, there are vulnerable populations such as the elderly, young children, and people whose immune system has been weakened. Other factors characterizing HAIs are overuse of antibiotics, failure of healthcare workers to wash their hands, the use of indwelling catheters, and long hospital stays (Thandar et al., 2021).
In the United States, at least 1.7 million HAIs are reported each year, with corresponding 99,000 associated deaths. Of the 1.7 million HAIs, 32 percent are urinary tract infections, 22 percent are surgical site infections, 15 percent are pneumonia, and 14 percent are bloodstream infections (Thandar et al., 2021). HIA are also financially stressing. Thandar et al. (2021) report that the general direct cost of HAIs to hospitals in the United States is approximately $35 billion. Lastly, emotional consequences can also impact healthcare providers, patients, and families.
In research, PICOT questions are important because they add structure to what is being researched. This saves time and effort as more relevant research is retrieved. Healthcare providers are making great strides towards reducing, and in some cases eliminating, HAIs (Cawthorne & Cooke, 2021). The PICOT question for my focus is: For patients that have acquired HAIs, can proper hand hygiene by healthcare staff, compared to adequate nurse staffing, reduce the infection rates withing 12 months? In this PICOT Question, the population is patients that have acquired HIAs, the intervention is proper hand hygiene, the comparison is adequate nurse stuffing, the outcome is the reduction of HAIs rates, and time- 12 months. This question is an intervention question as it specific and relevant to the specified issue comparing two interventions to see which is most effective.
The first database that I used was CINAHL Plus with Full Text. I searched for “staffing and healthcare-associated infections.” This only yielded me with 12 articles. From the resources, I learned that Boolean operators consists of “AND”, “OR”, or “NOT” and can assist with searches by searching combinations of words or phrases. I then added the Boolean operator “OR” and put in “HAIs” and 309 articles came up. I placed limits by clicking on “peer-reviewed” and my search was reduced to 232 articles. Then I set limits on the dates and requested research only from 2015-2020. This took my articles to 118. The second database I used was MEDLINE with Full Text. This time I searched one key phrase at a time. Searching for “healthcare-associated infections” gave me 5,764 articles. Once I added “AND staffing”, 44 articles appeared. Then I added “OR HAIs” and was given 143 articles. I set the same limits with dates and “peer-reviewed” as the previous database.
Using Boolean operators, adding limits, and searching multiple databases are a few ways to add rigor and effectiveness to researching PICO(T) questions. Dias et al. (2021) discuss the spirit of inquiry having an ongoing curiosity about why things are done the way they are. They state that interventions should pique curiosity about evidence supporting their use. Evidence-based practice leads to the highest quality of care, better patient outcomes, and lower costs (Dias et al., 2021).
