Description
1# Student
The clinical quality problem that needs more attention in healthcare with continuous improvement and monitoring is CLABSI. This is a major patient safety issue as this catheter has access to the major vein of the heart, which can cause serious problems. CDC states that “A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line” (2011). CLABSI is usually an indicator of the ICU’s quality of care. However, “there have been thousands of deaths each year and billions of dollars in added costs in the U.S. healthcare system, but the infections are preventable” according to the CDC (2011). Therefore, we need improvement and monitoring of people who have a central line in them. We can reduce the rate of CLABSI by performing safe/sterile central insertion, staff education, compliance with hygiene, and timely removal of the central venous catheter (CVC). A quasi-experimental study can help measure monitoring effectiveness using a good infection control team and continuous feedback about performance indicators that reduce CLABSI rates. This study compares the selected beds in various wards, including the ICU, measuring the type of infection, the type of intervention, written policies and procedures, and adherence to central venous catheter care (CVC) to measure the reduction rate in the CLABSI quality rate. “Quasi-experimental designs are used to test whether a treatment or intervention affects patient outcomes” (LoBiondo-Wood & Haber, 2022, p.164). The strength of this study is that it uses only experiments to provide high-level evidence without randomization, it helps follow the ethical concern when choosing participants. However, it does not use a randomized trial, which limits the study’s ability to make interventions and achieve the outcome. This is what LoBiondo-Wood & Haber said about the quasi-experimental study’s strengths and weaknesses: “Researchers turn to quasi-experimental designs to test cause-and-effect relationships because experimental designs may be impractical or unethical. Quasi-experiments may lack the randomization and/or the comparison group characteristics of true experiments (2022, p.187). Quasi-experimental study design in CLABSI monitors the behavioral parameters with outcomes indicators, analyzes the benefits of using an infection control program, and finds which strategic plan is significant to promote long-term effects using evidence-based practice for infection prevention.
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2# student
For my clinical quality problem, I am focusing on a hospital-acquired infection (HAI). The hospital-acquired infection that I am focusing on is called a surgical site infections, or also known as a SSI. A patient can acquire a SSI in the surgical incision site, with the infection being superficial, which involves only the skin, or they can also involve tissues under the skin and organs. If it were to involve anything under the skin or organs that would be considered a more serious infection that could possibly affect the patient systemically. To improve the ongoing problem of surgical site infections in the healthcare system, I would apply an experimental design for quality improvement instead of the quasi-experimental design. I chose the experimental design for quality improvement because, as it states in the online e-book “Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice”, “the experimental design is considered the gold standard for providing information about cause-and-effect relationships” (p.g 176). The experimental design also has many strengths that swayed my decision in choosing that type of experiment. The strengths include randomization, control, and manipulation. When talking about randomization in a study, this refers to having the participants be put into the experimental or controlled group at random. The control portion refers to the stipulations of all of the portions in an experiment remaining constant throughout. The manipulation portion refers to changing or doing something different to the independent variable. All of these strengths help a study reduce the error bias. In the experimental design I did not find ay weaknesses, that is why it is the better option for my clinical quality problem of surgical site infections.
