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Prepare this assignment as a 1,500-1,750 word paper using the
instructor feedback from the previous course assignments and the
guidelines below.PICOT Question Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.The
final PICOT question will provide a framework for your capstone project
(the project students must complete during their final course in the
RN-BSN program of study).Research CritiquesIn
the Topic 2 and Topic 3 assignments, you completed a qualitative and
quantitative research critique on two articles for each type of study (4
articles total). Use the feedback you received from your instructor on
these assignments to finalize the critical analysis of each study by
making appropriate revisions.The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.Refer
to “Research Critiques and PICOT Guidelines – Final Draft.” Questions
under each heading should be addressed as a narrative in the structure
of a formal paper.Proposed Evidence-Based Practice ChangeDiscuss
the link between the PICOT question, the research articles, and the
nursing practice problem you identified. Include relevant details and
supporting explanation and use that information to propose
evidence-based practice changes.General RequirementsPrepare
this assignment according to the APA guidelines found in the APA Style
Guide, located in the Student Success Center. An abstract is not
required.This assignment uses a rubric. Please review the rubric
prior to beginning the assignment to become familiar with the
expectations for successful completion.
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Jagbir Kaur
NUR 433
07/02/19
Literature Evaluation Table
Summary of Clinical Issue: A recent research by the CDC (Centers for Disease Control) demonstrates that in excess of five hundred
thousand patients acquire C. diffs infections every year across the United States. Notably, C. difficile causes critical diarrhea and
colon inflammation. In fact, CDC estimates that C. diffs is major cause of deaths with an estimated population of close to 20,000
directly caused deaths. Leffler & Lamont (2015) claim that unwarranted uptake of antibiotics among the patients is a major factor in
spreading of the C. diffs infections particularly when the patients get transfers to different healthcare facilities. This paper identifies c.
diffs infections across the United States as a major clinical problem since most of the infections occur within a clinical setup.
According to Cooper, Jump & Chopra (2016), C. difficile is continually becoming resistant to the typical clinical procedures while
influencing severe illnesses and somewhat unprecedented rate of transmission.
Following the increased transmissions across the country in the recent years despite the increased efforts to eradicate the
spread, C. diffs is the commonest pathogen associated with infections occurring within clinical settings within the United States.
© 2019. Grand Canyon University. All Rights Reserved.
Dubberke et al. (2018) argue that C. diffs increase healthcare costs with nearly $5 billion every year for only acute healthcare
institutions (Goldstein et al., 2015). Although people also acquire C. diffs in other environments other than the clinical settings,
significant population of the c. diffs infections happen in clinical settings (Ong, Reidy, Huk, & Lane, 2017). Therefore, C. difficile is
a clinical problem that demands a different approach and urgent measures to ensure the wellness and improved healthcare among the
people of the U.S.
PICOT Question: Considering all the C. Difficile infected patients (P), should limiting antibiotics’ prescriptions (I) in relation to
establishing new nursing approaches (C) combat the spread of the virus (O) within 12 months (T)?
Criteria
APA-Formatted
Article Citation with
Permalink
Article 1
Article 2
Dubberke, E. R., Reske, K. A.,
Article 3
Centers for Disease Control and
Cooper, C. C., Jump, R. L., &
Olsen, M. A., McDonald,
Preventions (CDC).
L. C., & Fraser, V. J.
(2016). Vital signs:
(2018). Short-and long-
preventing Clostridium
term attributable costs of
difficile
Chopra, T. (2016).
Prevention of infection
due to Clostridium
2
difficile. Infectious
Clostridium difficile-
infections. MMWR.
Disease Clinics, 30(4),
associated disease in
Morbidity and mortality
999-1012.
nonsurgical
weekly report, 61(9), 157.
inpatients. Clinical
Infectious
Diseases, 46(4), 497-504.
How Does the Article
Relate to the PICOT
Question?
Quantitative,
Qualitative (How do
you know?)
Purpose Statement
Research Question
Outcome
While the PICOT question
The article discusses the costs
This article examines the vital
concerns the intervention of C.
incurred on the treatment of
signs towards prevention of C.
Diffs, the article tells more of the
C.Diffs infections and
diffs infection while examining
prevention of the c. diffs
transmission of the infections
the rate of transmission of c.diffs.
infections
This article is a qualitative study
This article is a quantitative
This article is a qualitative study
because it used simple sample
study because of its larger
because it used simple sample
and the number and the
sample
and the interpretation of the
references
results
To understand the degree of
To understand both short-term
To understand the various signs
infections caused by C. diffs
and long-term costs imposed by
among C. diffs victims for
virus
c. diffs infections
prevention
How would the changes in
What are the costs that C.diffs
How can an individual clearly
nursing procedures impact on the
contribute towards healthcare
identify a C. diff patient?
transmission levels
delivery
The study observed that
The study established the costs of This article establishes unusual
changing the nursing procedures
treating C. diffs infection rose
WBC counts, self-restricted
3
Setting
(Where did the study
take place?)
Sample
Method
and reducing uptake of
antibiotics reduces the infections
of c. diffs
The study was conducted in a
clinical set up
close to three times estimated at
$7,500 by the close of 2017.
This study used a sample size of
25 cases
The convenience methodology
was applied in the study
The sample size in this study was This research used a sample size
105 cases
of 20 persons.
This research used a clustered
This research uses the
method in establishing the cost
convenience sampling method
dynamics in different facilities
and circumstances.
The study established that C.
pseudomembranous colitis
diffs has greatly increased the
influenced by ballicus is a great
costs of treating viral infections. threat to human health especially
US government budgets about
on C. diff infections
$950 million on C.diff infections
There should be improved
Individuals should report
strategies of ensuring quality
immediately any suspicious cases
healthcare. Individuals should
of C.diffs especially with selfhave insurance covers
restricted diarrhea
Key Findings of the
Study
C. diffs virus has become
resistant of the current
intervention
Recommendations of
the Researcher
There should be a change in the
nursing procedures because of
the resistance by the virus to the
current interventions
Criteria
APA-Formatted
Article Citation with
Permalink
The study was conducted in a
clinical set up
Article 4
Leffler, D. A., & Lamont, J. T.
Article 5
Goldstein, E. J., Johnson, S.,
Maziade, P. J., McFarland,
(2015). Clostridium
diarrhea and fever, stomach pains
and tachycardia as the
commonest signs of C. diffs.
The study was conducted in a
clinical set up
Article 6
Ong, G. K., Reidy, T. J., Huk, M.
D., & Lane, F. R. (2017).
L. V., Trick, W., Dresser, L.,
difficile infection. New
Clostridium difficile
… & Low, D. E. (2015).
4
England Journal of
Pathway to prevention of
nosocomial Clostridium
Medicine, 372(16), 1539-
colitis. The American
Journal of
difficile infection. Clinical
1548.
Surgery, 213(3), 565-571.
Infectious Diseases, 60
(suppl_2), S148-S158
How Does the Article
Relate to the PICOT
Question?
Quantitative,
Qualitative (How do
you know?)
Purpose Statement
Research Question
Outcome
Setting
(Where did the study
take place?)
This article explicates the spread
of the C. difficile infections
The article demonstrates that the
survey was a qualitative study
To determine the rate of
transmission of C. difficile in a
clinical set up.
What is the rate of c. difficile
spread within clinical setups
C.difficile spread faster in
clinical setups than in the other
setups
Clinical setup
The article informs the ways of
preventing the nosocomial CDI
as observed in a clinical setup
A qualitative study as observed
from the number and period the
research in the references were
conducted.
To address the critical mortality
and morbidity rates caused by C.
difficile diarrhea.
How is the nosocomial C.
difficile causing deaths in
compared to other infections
Nosocomial CDI is the
commonest cause of deaths
associated with the CDI
infections.
Clinical set up
5
The study examines the impact
of C. diff infection during a
surgery.
A quantitative study majorly
because of the critical
interpretation of the results.
To establish the effects of
diarrhea among C. diffs infected
population while undergoing
surgery.
Does diarrhea reduce the chances
of survival chances among the
CDI patients while undergoing
surgery
Diarrhea decreases the survival
chances among patients with
CDI when undergoing surgery.
In a surgery setting
Sample
Method
The researchers used a sample
size of 30 participants.
Experimental method
Key Findings of the
Study
Nearly every participants who
had c. difficile had at least been
in a clinical set up.
Recommendations of
the Researcher
The current studies should
consider different intervention
mechanisms to avoid high rate of
transmissions
The sample size was 27
The sample size was 100 pqrtidi
The researchers decided to use a
descriptive method to adequately
relate the high mortality rates to
the nosocomial CDI.
Nosocomial C. difficile which is
normally self-restricted diarrhea
the major cause of death caused
by infection of c. difficile.
There should be a change in
intervention strategies to reduce
the current rates of mortality and
morbidity. The use of proton
pump inhibitors
The research employed both
observation and descriptive
methods
6
Self-restricting diarrhea is among
the worst conditions and
symptoms among all the CDI
patients.
The researchers recommends that
physicians should reduce the risk
by using inhibitors among the C.
diffs patients.
Instructors Comments/Feedback: Jagbir, this is a better rewrite. However, is not nursing focused, as nurses do not prescribe
medication/antibiotics. I have provided some suggestions and an article for you. Most of your articles are not nursing but detailed
medical journals. They are good research projects on a medical realm. I would like you to focus on nursing interventions.
Jagbir Kaur
NUR 433
07/02/19
Literature Evaluation Table
Summary of Clinical Issue: A recent research by the CDC (Centers for Disease Control) demonstrates that in excess of five hundred
thousand patients acquire C. diffs infections every year across the United States. Notably, C. difficile causes critical diarrhea and
colon inflammation. In fact, CDC estimates that C. diffs is major cause of deaths with an estimated population of close to 20,000
directly caused deaths. Leffler & Lamont (2015) claim that unwarranted uptake of antibiotics among the patients is a major factor in
© 2019. Grand Canyon University. All Rights Reserved.
spreading of the C. diffs infections particularly when the patients get transfers to different healthcare facilities. This paper identifies c.
diffs infections across the United States as a major clinical problem since most of the infections occur within a clinical setup.
According to Cooper, Jump & Chopra (2016), C. difficile is continually becoming resistant to the typical clinical procedures while
influencing severe illnesses and somewhat unprecedented rate of transmission.
Following the increased transmissions across the country in the recent years despite the increased efforts to eradicate the
spread, C. diffs is the commonest pathogen associated with infections occurring within clinical settings within the United States.
Dubberke et al. (2018) argue that C. diffs increase healthcare costs with nearly $5 billion every year for only acute healthcare
institutions (Goldstein et al., 2015). Although people also acquire C. diffs in other environments other than the clinical settings,
significant population of the c. diffs infections happen in clinical settings (Ong, Reidy, Huk, & Lane, 2017). Therefore, C. difficile is
a clinical problem that demands a different approach and urgent measures to ensure the wellness and improved healthcare among the
people of the U.S.
PICOT Question: Considering all the C. Difficile infected patients (P), should limiting antibiotics’ prescriptions (I) in relation to
establishing new nursing approaches (C) combat the spread of the virus (O) within 12 months (T)?
Criteria
Article 1
Article 2
2
Article 3
APA-Formatted
Article Citation with
Permalink
Dubberke, E. R., Reske, K. A.,
Centers for Disease Control and
Cooper, C. C., Jump, R. L., &
Olsen, M. A., McDonald,
Preventions (CDC).
L. C., & Fraser, V. J.
(2016). Vital signs:
(2018). Short-and long-
preventing Clostridium
term attributable costs of
difficile
Clostridium difficile-
infections. MMWR.
associated disease in
Morbidity and mortality
nonsurgical
weekly report, 61(9), 157.
Chopra, T. (2016).
Prevention of infection
due to Clostridium
difficile. Infectious
Disease Clinics, 30(4),
999-1012.
inpatients. Clinical
Infectious
Diseases, 46(4), 497-504.
How Does the Article
Relate to the PICOT
Question?
While the PICOT question
concerns the intervention of C.
Diffs, the article tells more of the
prevention of the c. diffs
infections
The article discusses the costs
incurred on the treatment of
C.Diffs infections and
transmission of the infections
3
This article examines the vital
signs towards prevention of C.
diffs infection while examining
the rate of transmission of c.diffs.
Quantitative,
Qualitative (How do
you know?)
Purpose Statement
Research Question
Outcome
Setting
(Where did the study
take place?)
Sample
Method
This article is a qualitative study
This article is a quantitative
This article is a qualitative study
because it used simple sample
study because of its larger
because it used simple sample
and the number and the
sample
and the interpretation of the
references
results
To understand the degree of
To understand both short-term
To understand the various signs
infections caused by C. diffs
and long-term costs imposed by
among C. diffs victims for
virus
c. diffs infections
prevention
How would the changes in
What are the costs that C.diffs
How can an individual clearly
nursing procedures impact on the
contribute towards healthcare
identify a C. diff patient?
transmission levels
delivery
The study observed that
The study established the costs of This article establishes unusual
changing the nursing procedures
treating C. diffs infection rose
WBC counts, self-restricted
and reducing uptake of
close to three times estimated at diarrhea and fever, stomach pains
antibiotics reduces the infections
$7,500 by the close of 2017.
and tachycardia as the
of c. diffs
commonest signs of C. diffs.
The study was conducted in a
The study was conducted in a
The study was conducted in a
clinical set up
clinical set up
clinical set up
This study used a sample size of
25 cases
The convenience methodology
was applied in the study
Key Findings of the
Study
C. diffs virus has become
resistant of the current
intervention
Recommendations of
the Researcher
There should be a change in the
nursing procedures because of
the resistance by the virus to the
current interventions
The sample size in this study was This research used a sample size
105 cases
of 20 persons.
This research used a clustered
This research uses the
method in establishing the cost
convenience sampling method
dynamics in different facilities
and circumstances.
The study established that C.
pseudomembranous colitis
diffs has greatly increased the
influenced by ballicus is a great
costs of treating viral infections. threat to human health especially
US government budgets about
on C. diff infections
$950 million on C.diff infections
There should be improved
Individuals should report
strategies of ensuring quality
immediately any suspicious cases
healthcare. Individuals should
of C.diffs especially with selfhave insurance covers
restricted diarrhea
4
Criteria
APA-Formatted
Article Citation with
Permalink
Article 4
Leffler, D. A., & Lamont, J. T.
Article 5
Goldstein, E. J., Johnson, S.,
Maziade, P. J., McFarland,
(2015). Clostridium
Article 6
Ong, G. K., Reidy, T. J., Huk, M.
D., & Lane, F. R. (2017).
L. V., Trick, W., Dresser, L.,
difficile infection. New
Clostridium difficile
… & Low, D. E. (2015).
England Journal of
Pathway to prevention of
Medicine, 372(16), 1539-
nosocomial Clostridium
difficile infection. Clinical
1548.
colitis. The American
Journal of
Surgery, 213(3), 565-571.
Infectious Diseases, 60
(suppl_2), S148-S158
How Does the Article
Relate to the PICOT
Question?
Quantitative,
Qualitative (How do
you know?)
Purpose Statement
This article explicates the spread
of the C. difficile infections
The article demonstrates that the
survey was a qualitative study
To determine the rate of
transmission of C. difficile in a
clinical set up.
The article informs the ways of
preventing the nosocomial CDI
as observed in a clinical setup
A qualitative study as observed
from the number and period the
research in the references were
conducted.
To address the critical mortality
and morbidity rates caused by C.
difficile diarrhea.
5
The study examines the impact
of C. diff infection during a
surgery.
A quantitative study majorly
because of the critical
interpretation of the results.
To establish the effects of
diarrhea among C. diffs infected
population while undergoing
surgery.
Research Question
Outcome
Setting
(Where did the study
take place?)
Sample
Method
What is the rate of c. difficile
spread within clinical setups
C.difficile spread faster in
clinical setups than in the other
setups
Clinical setup
The researchers used a sample
size of 30 participants.
Experimental method
Key Findings of the
Study
Nearly every participants who
had c. difficile had at least been
in a clinical set up.
Recommendations of
the Researcher
The current studies should
consider different intervention
mechanisms to avoid high rate of
transmissions
How is the nosocomial C.
difficile causing deaths in
compared to other infections
Nosocomial CDI is the
commonest cause of deaths
associated with the CDI
infections.
Clinical set up
Does diarrhea reduce the chances
of survival chances among the
CDI patients while undergoing
surgery
Diarrhea decreases the survival
chances among patients with
CDI when undergoing surgery.
In a surgery setting
The sample size was 27
The sample size was 100 pqrtidi
The researchers decided to use a
descriptive method to adequately
relate the high mortality rates to
the nosocomial CDI.
Nosocomial C. difficile which is
normally self-restricted diarrhea
the major cause of death caused
by infection of c. difficile.
There should be a change in
intervention strategies to reduce
the current rates of mortality and
morbidity. The use of proton
pump inhibitors
The research employed both
observation and descriptive
methods
6
Self-restricting diarrhea is among
the worst conditions and
symptoms among all the CDI
patients.
The researchers recommends that
physicians should reduce the risk
by using inhibitors among the C.
diffs patients.
Running head: NURSING
1
Running head: QUANTITATIVE REVIEW AND OUTCOMES
Jagbir Kaur
NUR 433
Grand Canyon University
07/20/19
NURSING
2
Summary of Quantitative Studies
Background
The research by Dubberke et al. (2018) investigates the short-term and long-term costs
brought by C.diff infections posing questions on the costs incurred towards the delivery of
healthcare. The study was motivated by the increasing incidents of diseases associated with
Clostridium difficile. The infections are said to be the most contributors of hospital-acquired
diarrhea and the proportion of hospital discharges prone to CDAD had increased between the
year 2000 and 2003. The purpose of the research is to quantify the magnitude of the CDAD in a
hospital setting and call the health fraternity to action with the aim of reducing the effects of
antibiotics on the patients (Dubberke et al., 2018). This research is useful in nursing as nurses
can regulate the administration of antibiotics on certain patients with the goal of preventing
possible C.difficile infection. The research by Ong et al. (2018) establishes the effects of diarrhea
among C. diffs infected population during surgery. This particular study seeks to answer the
question of whether diarrhea reduces survival chances among CDI patients after surgery (Ong et
al., 2018). This quantitative study is motivated by the increased cases of diarrhea among patients
undergoing surgery and who have been administered with antibiotics as part of their treatment.
This summary compares the aspects of research and findings from the studies in relation to the
nursing practice.
How the Articles Support and Compare to the PICOT question
The PICOT question states that considering all the C.diff infected patients (P), should
limiting …
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