NURS 362 Research Critique Form

In evidence based practice the literature is not only critiqued, it is graded.

Author: H.P Loveday, J.A. Wilson, R.J. Pratt, M. Golsorkhi, A. Tingle, A. Bak, J. Browne, J. Prieto, M. Wilcox

Title: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in

England

Citation:

H.P. Loveday , J.A. Wilson, R.J. Pratt, M. Golsorkhi, A. Tingle, A. Bak, J. Browne, J. Prieto, M. Wilcox.

National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in

England. January 2014. Journal of Hospital Infection. Volume 86, Supplement 1. Pages 1-70.

Study Question: (What is being studied?)

Preventions to Healthcare-Associated Infections in NHS Hospitals in England. A cardinal feature of evidence-based

guidelines is that they are subject to timely review in order that new research evidence and technological advances

can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended

guidelines.

Study Design: Location: England

There are different categories in preventing HAIs and have a specific group of protocols to follow. For example, in

hang hygeine, RCTs and other quasi-experimental studies have generally demonstrated alcohol-based preparations

to be more effective hand hygiene agents than non-medicated soap and antiseptic handwashing agents, although a

small number of studies reported no statistically significant difference.

Sampling: Depending on what category the patient is, like those with CVC (central venous catheter)and PICC lines

they will take the data from those group of patients and populate results from there.

Data Collection: Evidence examined by HICPAC suggested that PICCs are associated with a lower rate of infection

than that associated with other non-tunneled CVCs. However, there is little recent robust evidence regarding

comparison of rates of CR-BSI in PICCs vs other long-term central venous access devices. A prospective study that

compared the use of inpatient PICCs indicated a similar rate of CR-BSI to non-tunneled catheters placed in the

internal jugular or subclavian veins and a higher rate than cuffed and tunneled (CT) catheters (PICC 3.5 CR-BSI per
1000 catheter-days vs non-tunneled 2.7 CR-BSI per 1000 catheter-days vs cuffed and tunneled 1.6 CR-BSI per 1000

catheter-days). A systematic review of 200 studies indicated that when used in inpatients, PICCs pose a slightly

lower risk of CR-BSI than standard noncuffed and non-medicated CVCs placed in the subclavian or internal jugular

vein

Findings: Neither we (authors) nor HICPAC identified any additional evidence of acceptable quality whilst

updating our systematic review.

Limitations: The authors may see limitations such as not having thorough research due to multiple sample groups to

analyze. It would be helpful if there were a more specific target instead of general practices in preventing the

different types of HAIs in England.

Mosby Research Tool and Synthesized Articles

Level of Evidence Description Articles

Reviewed
I Meta-analysis
II Experimental design/Randomized Control Trial
III Quasi-experimental design
IV Case controlled, cohort studies, longitudinal studies
V Correlation studies
VI Descriptive studies including surveys, cross sectional design,
developmental design, and qualitative studies
VII Authority opinion or expert committee reports
Other Performance improvement, review of literature

Internal Validity: Indicate which category of internal validity applies to the study____

Good (meets all the criteria for the study design)

Fair (does not meet all criteria but is judged to have no fatal flaw that invalidates the results)
Poor (contains fatal flaw)

General Comments: This was a long EBP article and it was difficult looking for the right information.

Applicability to Practice: It takes a long period to form a study of preventions to HAIs because there are so many
types. As a nurse, it would be important to be updated with the latest preventions to diseases so that the numbers in
HAIs for patients will decrease as time goes on.

Three Key Points:

- By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of
patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimized.
- National evidence-based guidelines are broad principles of best practice that need to be integrated into local
practice guidelines and audited to reduce variation in practice and maintain patient safety.
- By being proactive with our patients, we are able to deliver quality patient care and are able to treat not only the
problem but their overall health.