Part 3A: Critical Appraisal of Research

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.See previous order 122834

Part 3B: Critical Appraisal of Research

Student’s Name

Institutional Affiliations

Part B: Critical Appraisal of Research

Interventions that healthcare professionals choose to address patient care issues and improve healthcare quality must be supported by evidence-based practice. Three of the reviewed articles sufficiently support the use of chlorhexidine wipes or cloth to reduce rates of CLABSIs (Feriani et al., 2021; Musuuza et al., 2019; Sheier et al., 2021). Since the researchers conducted their studies in ICUs using adult and elderly patients as study participants, it will be appropriate for the project team to implement the evidence with older adults at risk of developing CLABSIs.

Feriani et al. (2021) revealed that daily bathing with 2% chlorhexidine wipes was effective in reducing rates of CLABSIs, mortality rates, and costs of guided antimicrobials. In another study, Musuuza et al. (2019) discovered that bathing patients with chlorhexidine gluconate significantly reduced healthcare-associated bloodstream infections (HABSIs) incidences in both non-ICU and ICU settings. Results that are documented in these two sources are further supported by Scheier et al. (2021) who found that the introduction of chlorhexidine bathing to patients hospitalized in the ICU reduced the CLABSI risks. However, in a study conducted by Denkel et al. (2022), the researchers discovered that Chlorhexidine cloths or wipes are effective in keeping incidence densities of CLABSIs per 1,000 central line days low. However, there is no significant reduction in CLABSI rates caused when the intervention is compared with octenidine wash mitts and routine care. Despite this difference, the best practice that has emerged from reviewed literature is the use of chlorhexidine wipes to reduce rates of CLABSIs among the elderly. As recommended by Scheier et al. (2021), investigators should monitor patients for any microbial resistance against chlorhexidine.

 

 

 

 

References

Denkel, L. A., Schwab, F., Clausmeyer, J., Behnke, M., Golembus, J., Wolke, S., Gastmeier, P., & Geffers, C. (2022). Effect of antiseptic bathing with chlorhexidine or octenidine on central line-associated bloodstream infections in intensive care patients: a cluster-randomized controlled trial. Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 28(6), 825–831. https://doi.org/10.1016/j.cmi.2021.12.023

Feriani, D., Souza, E. E., Carvalho, L., Ibanes, A. S., Vasconcelos, E., Barbosa, V. L., Kondo, S. K., & Abboud, C. S. (2021). Is it cost effective to use a 2% chlorhexidine wipes bath to reduce central-line associated blood stream infection? A quasi-experimental study. The Brazilian Journal of Infectious Diseases: An Official Publication of the Brazilian Society of Infectious Diseases, 25(1), 101538. https://doi.org/10.1016/j.bjid.2021.101538

Musuuza, J. S., Guru, P. K., O’Horo, J. C., Bongiorno, C. M., Korobkin, M. A., Gangnon, R. E., & Safdar, N. (2019). The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis. BMC Infectious Diseases, 19(1), 416. https://doi.org/10.1186/s12879-019-4002-7

Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M. R., Schüpbach, R., Falk, C., Sax, H., Kuster, S. P., & Schreiber, P. W. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. The Journal of hospital infection, 110, 26–32. https://doi.org/10.1016/j.jhin.2021.01.007