Potential Collaborative Research In Infection Control

Research Critique

Discuss about the Potential Collaborative Research in Infection Control.

Science has made advancements by leaps and bounds which has made our lives less complex and smooth. Credit for this advancement should be given to the research work that has been carried out by various scholars in different domains. The results and findings of these researches are documented in popular journals. It is essential to critically analyze and interpret those reports so that it can be successfully implemented through recommended solution in our everyday life (Schowm, 2003). The findings from different researches if interpreted properly can breakthrough several problems that the world is coping with in the present scenario. This report is aimed at illustrating the critical analysis structure that should be used while investigating the journal or research articles. For that two journal articles from reputed journals have been chosen which are from the domain of medicine and nursing which represents both qualitative and quantitative study (Vargas-Vera, 2015). This report systematically approaches to evaluate the articles step by step. Initially it summarizes the findings of the articles and then it justifies the discussion made in the articles with special concern to the author’s views about the articles. The detailed analysis of the articles has been documented in the following sections (Martin, 2012).

Research critique:

A research critique is a thorough analysis about the strengths and weakness of a research article. There can be several motivations for performing a critique namely, it can be done to assess whether it is a quality work or not before publishing it in a renowned journal, it may be sometimes required for finishing the research as valuable feedback before submission, sometimes it is done to understand the aims and objectives of a research for learning purpose as in this case (Long, Griffith, Selker, & D’Agostino, 1993).

The primary function of research critique is to evaluate the research design that has been followed for a particular study and whether it is legitimate or not. There are cases where one needs to understand if the data that has been gathered are from authentic sources and their interpretation has been carried out properly (Hutnyk, 2007). It is not necessary that it has to be critical in nature, a research critique can be positive in nature admiring the work that has been done. There are several aspects of a research critique like it has to evaluate different sections of the research namely introduction, literature review, research methodology, data collection, findings and discussion, etc. A critique has to analyze the study at each and every step with utmost diligence and precision. These principles have been used while analyzing the two articles of concern from the nursing and medical domain. This report documents a brief critique on both the research articles (Honeycutt, Russell, & Oldridge, 2011).

Article 1

The first article is about infection control and the various aspects associated with it. It describes and delves deep into a particular type of infection control on which research has been conducted. Central-line associated bloodstream infections, in short which is called CLABSIs are considered as one of the most life-threatening diseases which affect the central venous catheters (CVCs) (Harrop, 2010). Given that approx. 41000 cases of the CLABSI is detected in the US each year, each costing an additional $16,550 to the medical system in addition to increased hospital stay, discomfort and loss of life with a mortality rate of 15-25%, it is imperative to undertake research to control and reduce the number of cases. Existing literature indicates that CLABSIs have reduced because of the introduction of CVCs coated with antimicrobials. However there is a gap in the literature with respect to understanding of the impact chlorhexidine (CHG) coated central catheters have on CLABSIs vis-a-vis a non-CHG peripherally inserted central catheter (PICCs). The article under concern makes an attempt to understand the impact of both the PICCs on the health of the patient.

The methodology that had been adopted for research was that 3 high risk units were selected for patient identification over a period of 18 months at a 800 bed tertiary hospital in the mid-west; patients were subjected to either of the PICCs, one of which consisted of the CHG-impregnated one and the other one was non-CHG impregnated one. The data was collected from the laboratory daily and analyzed thoroughly; in fact care was taken to assess the dressing site as well (Ghoulam, Barigou, & Belalem, 2015). The documentation was finally vetted to understand the presence of CLABSI or VTE.

Initially a a-priori method was used to determine requisite sample size based on requirement of 0.80 power and two-tailed alpha of 0.05. Based on the same, a total of 189 samples were chosen out of which 22 were eliminated due to various reasons. A total of 167 patients were involved in this study among which 3 had been diagnosed with having CLABSI among which 2 were through CHG group while others were through non-CHG group. VTE was also developed by 3 patients that was created in the reverse proportion as 2 were from non-CHG group while 1 was from CHG group (Hall & Dornan, 2008). Statistically no correlation was found among the CLABSI or VTE with the CHG or non-CHG usage. However it is justified to mention as per the research there was significant bleeding for the CHG PICC line which ultimately required dressing. The conclusion from the study was that there are no considerable differences in the development of CLABSI or VTE through the use of CHG or non-CHG PICC lines (Gardner, 2008). While the study asserts no discernible correlation of the use of CHG/non CHG with the development of CLABSI, the sample size may be argued to be a constraint to come at any conclusive proof as a result of the study. As a bare minimum to obtain the power of 80% as opposed to the meager 48% in this case, the sample size requisite would have to be around 348. Also, with blinding not possible due to the distinction of the catheters, such an action may have led to the development of the inherent bias in terms of maintenance of the PICC lines by nurses and patients. A proper demographic study and background data collection would have gone a long way in establishing randomness of the study.

Article 2

Overall this can be considered as a genuine attempt to investigate a research problem in the field of infection control (Embi & Payne, 2009) with the limitations as stated above. Potential confounders affecting both dependent and independent variables may include diagnosis or severity of illness. With a better sample size, efficient blinding and demographic randomization the study would hit the mark to a better extent.

The second article talks about the barriers and obstacles faced by nurses while implementing central venous catheter (CVC) guidelines. The aim of the study has been explained clearly at the beginning of the study wherein it is mentioned that the study aims at investigating the barriers faced by nurses while taking care of the central venous catheter practices (Dojat & Pachet, 2005). The premise for this research has been set with the iteration of the fact that CVC care practices are evidence based and there are instances where they have not been adhered which have resulted in infection which can be considered to be nosocomial. 41000 cases of the CLABSI are diagnosed in the US each year with associated cost per case ranging from $5734 to $22939, thus creating a need for efficient control and elimination. There have been several studies conducted to understand the gap in giving the healthcare services through process improvements and other observation based studies. However this research is aimed at plugging the gap with the help of real time monitoring of nurse and understanding their perceptual barriers towards adhering to norms that have been set with respect to CVC.

Data was collected in a systematic approach wherein 10 participants were selected to investigate the matter at hand. Data collection was primarily based on interviews and then the gathered data was subjected to further analysis through the popular Colaizzi’s method (Creedy, Winch, & Vickerstaff, 2002).

The results of the research were quite astonishing as it led to the proper understanding of nurses’ behavior with respect to their mental approach or blockage towards handling CVC practices. The data that was collected was primarily grouped into major themes which included cognitive factors towards a nurse behavior and other consisted of the contextual factors while analyzing the nurse response which was related to the patient condition, materials, processes and culture of the organization. Finally the results were interpreted to come to the conclusion that mental barriers while servicing for CVC practices can lead to errors which limit the quality of the service and as a result recommendations were given with respect to reducing such barriers through training and development of intuitive processes (Cole, 2006).

While critiquing the study conducted, the first factor that comes to mind is the choice of a single site for generalization of the findings which may significantly limit the spectrum of the results arrived at. Smallish sample size and a limited focus may be other factors of concern while evaluating the adaptability of the study. The study complemented the findings from peer studies and that adds credibility to the research and throws light on a hitherto unexplored association regarding active nurses in the acute and critical care settings. The low sample size of the nurses chosen may lead to questions about generalizing the assumptions, and for this purpose, further research with a diverse and wider volume is mandatory. In essence, the cognitive and contextual barriers that came out as a result of the interview seems to be logically consistent with contextual barriers determined to be the organizational behavior, staffing and supplies, leading to external ramifications in the nurse behavior. Again, choice of a single hospital as a setting may be a significant influencer, specially in the case of contextual barriers. For the cognitive barriers, the nurse sample size is an important factor and diversity of selection and randomness should be the priorities for the future descriptive studies.

The research design that has been adopted is also suitable for the investigation of the given topic. It takes into concern all the attributes related to the research and then evaluates step by step to gather relevant data and finally interpret them so that we get a good idea about the results and the way forward to solve the issue at hand (Bender, 2006). Overall, the article provides a fairly logical explanation on the practices at a hospital which may induce conditions pertinent for CLABSI formation, but is limited in the scope and sample size to be generalized to a broader spectrum.    

New Zealand Context:

The research that has been considered is of immense significance to the New Zealand healthcare scenario since it deals with two important infection control mechanisms which need to be addressed. New Zealand population and the entire healthcare system had been grappling with this issue for quite some time now and these two researches if implemented properly will provide a solution for the problems at hand (Bylander, Smith, & Svirbely, 2003). This is the beauty of research studies conducted in the science domain which empowers the industry or domain with new solution or breakthrough technology thereby enabling to deal with complex issues. The critical analysis of the research study helped in validating the research process which is essential for the success of the solution as well as its implementation. The different medication techniques that have been reiterated in the research articles had to be validated by scholars before they can be taken up for implementation and a research critique serves this purpose of validation. Once implemented these research findings will add immense value to the New Zealand healthcare system and therefore improve their services. With this expectation the research studies analyzed in this piece is expected to add immense value to the existing literature of medical domain as well (Bell, 2010).

Conclusion:

This report has been structured in a systematic manner to analyze and understand the research critique process so that it can be conducted in a streamlined fashion later on. It starts off by explaining the process of research critique with special emphasis on defining critique. Then it moves on to critically analyze two research articles of concern from the medical field. It gives a brief summary about the researches and then comments on the different sections of the research like methodology, literature review, etc. Finally it also talks about the significance of the research in the New Zealand healthcare context. Therefore the report has successfully developed a framework for research critique process which can be implemented for other such academic purpose as well.

Reference

Bell, A. (2010). Potential collaborative research in infection control. American Journal of Infection Control, 8(1), 29A. Doi: 10.1016/s0196-6553(80)80082-4

Bender, B. (2006). Thatcherism and anthropological research funding. Critique of Anthropology, 6(2), 91–98. Doi: 10.1177/0308275x8600600209

Bylander, T., Smith, J. W., & Svirbely, J. R. (2003). Qualitative representation of behavior in the medical domain. Computers and Biomedical Research, 21(4), 367–380. Doi: 10.1016/0010-4809(88)90051-1

Bylander, T., Smith, J. W., & Svirbely, J. R. (2009). Qualitative representation of behavior in the medical domain. Computers and Biomedical Research, 21(4), 367–380. Doi: 10.1016/0010-4809(88)90051-1

Cole, M. (2006). Qualitative research: A challenging paradigm for infection control. British Journal of Infection Control, 7(6), 25–29. Doi: 10.1177/14690446060070060701

Creedy, D., Winch, S., & Vickerstaff, J. (2002). Research in infection control practice: A proposed collaborative model. Australian Infection Control, 7(3), 85–92. Doi: 10.1071/hi02085

Dojat, M., & Pachet, F. (2005). Effective domain-dependent reuse in medical knowledge bases. Computers and Biomedical Research, 28(6), 403–432. Doi: 10.1016/s0010-4809(05)80002-3

Embi, P. J., & Payne, P. R. O. (2009). Clinical research informatics: Challenges, opportunities and definition for an emerging domain. Journal of the American Medical Informatics Association, 16(3), 316–327.

doi:10.1197/jamia.m3005

Gardner, A. (2008). Tropical health and infection control research directions. Healthcare infection, 13(4), 107–108. Doi: 10.1071/hi08032

Ghoulam, A., Barigou, F., & Belalem, G. (2015). Information extraction in the medical domain. Journal of Information Technology Research, 8(2), 1–15. doi:10.4018/jitr.2015040101

Hall, J. A., & Dornan, M. C. (2008). Meta-analysis of satisfaction with medical care: Description of research domain and analysis of overall satisfaction levels. Social Science & Medicine, 27(6), 637–644. Doi: 10.1016/0277-9536(88)90012-3

Harrop, M. (2010). Social research and market research: A critique of a critique. Sociology, 14(2), 277–281. Doi: 10.1177/003803858001400205

Honeycutt, M., Russell, C., & Oldridge, C. (2011). A standardized approach to CLABSI elimination. American Journal of Infection Control, 39(5), E157. doi:10.1016/j.ajic.2011.04.266

Hutnyk, J. (2007). Media, research, politics, culture: Review article. Critique of Anthropology, 16(4), 417–428. Doi:10.1177/0308275x9601600406

Long, W. J., Griffith, J. L., Selker, H. P., & D’Agostino, R. B. (1993). A comparison of logistic regression to decision-tree induction in a medical domain. Computers and Biomedical Research, 26(1), 74–97. doi:10.1006/cbmr.1993.1005

Martin, M. (2012). Preventing central line-associated bloodstream infections CLABSI. Nursing, 42(6), 46–47. doi:10.1097/01.nurse.0000415297.39358.d8

Schowm, J. C. (2003). Delayed diagnosis of tuberculosis in patients with human I immunodeficiency virus infection. American Journal of Infection Control, 21(4), 221. Doi: 10.1016/0196-6553(93)90041-2

Vargas-Vera, M. (2015). Methodology for record linkage: A medical domain case study. International Journal of Knowledge Society Research, 6(4), 18–35. doi:10.4018/ijksr.2015100102