Search Strategy on the Incidence of Hospital-Acquired Pneumonia Paper

Search Strategy on the Incidence of Hospital-Acquired Pneumonia Paper

Search Strategy on the Incidence of Hospital-Acquired Pneumonia

Patients seek medical help looking forward to comprehensive diagnosis and treatment to promote a smooth recovery. Accordingly, health care providers should evaluate patients’ problems adequately and recommend appropriate interventions. Despite this general approach, health care problems that hamper care effectiveness are rampant in the health practice. The most effective way is to address these problems using current and relevant evidence. The purpose of this paper is to describe the search strategy for getting evidence on reducing the incidence of hospital-associated pneumonia.

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The Clinical Problem

The problem is the incidence of hospital-acquired pneumonia in patients admitted in the hospital within two to three days. In particular, the focus is on how the incidence can be reduced through evidence-based practices. Hospital-acquired pneumonia can be ventilator-associated (VAP) or non-ventilator-associated (nvHAP). Despite the cause, the effects are far-reaching, particularly on costs, mortality, and hospital stay. Using appropriate interventions and evidence-based guidelines is critical to reducing the incidence.

Significance of the Problem

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The impacts of hospital-acquired pneumonia in hospitals cannot be underestimated. It is a significant problem due to its prevalence and multidimensional effects. According to Damas et al. (2022), VAP is the most common hospital-acquired infection (HAI) in intensive care units (ICUs). Unless effectively prevented and treated, it leads to other adverse outcomes such as extended hospital stays and patient dissatisfaction. The cost associated with hospital-acquired pneumonia prevention and treatment is also a worry. It costs the US health care system billions of dollars to control HAIs. Furthermore, the mortality rate attributed to hospital-acquired pneumonia is higher than in other HAIs, at 33-50% in ICUs (Rosario et al., 2021). Different populations are affected differently, with older adults a high-risk population.

PICOT Question and Purpose of the Paper

PICOT Question: for patients hospitalized with hospital-acquired pneumonia (P), can the use of pneumonia prevention bundle (I) compared to no intervention (C) reduce hospital-acquired pneumonia (O) in six months? (T)

Answering this question requires an in-depth search and appraisal of current, peer-reviewed evidence. Accordingly, rigorous database search is crucial from the library and other sources of peer-reviewed nursing and health care articles. The purpose of this paper is to describe the search strategy, particularly databases used and refinement decisions.

Search Strategy

The type of evidence required to answer a clinical question differs according to the question’s domain. For instance, evidence for questions in the meaning domain comes from qualitative studies, while treatment questions use randomized controlled trials (Hariton & Locascio, 2018). The question guiding the current search process is from the prevention domain. In clinical practice, the prevention domain deals with questions about the effectiveness of an intervention that health care providers use in preventing morbidity and mortality. Hospital-acquired pneumonia prevention bundles belong to the prevention domain since the objective is to reduce the incidence to avoid adverse outcomes associated with the condition, including extended hospital stays and mortality rates.

The best evidence to answer a question in the prevention domain is randomized controlled trials (RCTs) or prospective studies. RCTs are also used for questions in the treatment and diagnosis domains (Hariton & Locascio, 2018). RCTs are experiments of impact evaluation where the experimental group (population receiving intervention or treatment) and the control group are randomly selected from an eligible population. The two groups help to determine the effectiveness of interventions through a comparative analysis.

Search Terms, Databases, and Refinement

The initial search term was “use of pneumonia bundle in preventing hospital-acquired pneumonia.” It produced over 100 articles that explored the problem from multiple dimensions. Some articles focused on preventing VAP while others on nvHAP. Articles’ types also differed, including narrative reviews, systematic reviews, and experimental studies. Databases included the CU library, PubMed, Google Scholar, CINAHL Plus, and Cochrane Library. They were selected since they allow search by topic, and articles can be filtered to be more relevant. Refinement decisions to cut the articles down to a reasonable number included searching for peer-reviewed RCTs only. The publication was also custom ranged from 2018 to 2022.

Most Relevant Articles

The first article is a multicenter, RCT prospective study for ventilator-associated pneumonia. In this study, 168 patients were in the experimental group and 155 in the control group (Damas et al., 2022). The second article is an RCT in patients aged 65 and above in a tertiary hospital geriatric unit. Here, 123 participants were randomized: 85 received a multicomponent intervention, and 59 were in the control group (Rosario et al., 2021). These articles meet the criteria for evidence used to answer a clinical question in the prevention domain. Preventing hospital-acquired pneumonia reduces its incidence.

Conclusion

Hospital-acquired pneumonia profoundly impacts the quality of care, satisfaction, and costs. Like other HAIs, the problem can be effectively addressed using evidence-based strategies focusing on treatment, prevention, or effective management. Evidence for evidence-based practices should be sourced from current, peer-reviewed, and relevant evidence. As a result, a rigorous search and evidence appraisal are vital from the leading nursing and health care databases. The search process should also be refined using article types, search terms, and publication dates to get suitable articles.

References

Damas, P., Legrain, C., Lambermont, B., Dardenne, N., Guntz, J., Kisoka, G., …&Misset, B. (2022). Prevention of ventilator-associated pneumonia by noble metal coating of endotracheal tubes: A multi-center, randomized, double-blind study. Annals of Intensive Care12(1), 1-10. https://doi.org/10.1186/s13613-021-00961-y

Hariton, E., &Locascio, J. J. (2018).Randomised controlled trials – the gold standard for effectiveness research: Study design: Randomised controlled trials. BJOG : An International Journal of Obstetrics and Gynaecology125(13), 1716. https://doi.org/10.1111/1471-0528.15199

Rosario, B. H., Shafi, H., Yii, A. C., Tee, L. Y., Ang, A. S., Png, G. K., … &Taha, A. A. (2021). Evaluation of multi-component interventions for prevention of nosocomial pneumonia in older adults: A randomized, controlled trial. European Geriatric Medicine, 1-11. https://doi.org/10.1007/s41999-021-00506-3

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Clinical Question
Required criteria
1. Describe the problem. What is the focus of your group’s work?
2. Explain the significance of the problem in terms of patient outcomes. What health outcomes result from your problem? Or what statistics document this is a problem? You may find support on websites for government or professional organizations.
3. PICOT question in support of the group topic.
4. State the purpose of your paper. What will your paper do or describe? This is similar to a problem statement. “The purpose of this paper is to
This criterion is linked to a Learning OutcomeLevels of Evidence
Required criteria
1. Identify the type of question being asked (therapy, prognosis, meaning, etc.).
2. What is the best type of evidence to answer that question (e.g., RCT, cohort study, qualitative study, etc.)?
This criterion is linked to a Learning OutcomeSearch Strategy
Required criteria
1. List search terms and results.
2. Databases used (start with the CU library). Link your search with the PICOT question described above.
3. Refinement decisions. As you did your search, what decisions did you make in refinement to get your required articles down to a reasonable number for review? Were any limits used? If so, what?
4. Identification of two (2) most relevant articles (primary sources published within the last 5 years).
Organization and APA Style
Required criteria
1. Correct grammar and spelling.
2. Include a title page.
3. Use of headings for each section.
4. Clinical Question, Levels of Evidence, Search Strategy, and Conclusion
5. Adheres to current APA formatting and guidelines.
6. 3-4 pages in length, excluding title and reference pages.

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