Posted: November 4th, 2022
Nursing Practice Problem and PICOT Questionnaire Discussion
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.
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) Nursing Practice Problem and PICOT Questionnaire Discussion.
In 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 Change
Discuss 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.
Prepare this assignment according to the APA guidelines found in the AP
Research Critiques and PICOT Question Guidelines – Final Draft Use this document to organize the content from your four studies into your final draft. Quantitative and Quantitative Studies Nursing Practice Problem and PICOT Question 1. What is your identified nursing practice problem? 2. List your PICOT question, following one of the templated formats reviewed in the course. Background 1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question. How do these four articles support the nurse practice issue you chose? 1. Discuss how these articles will be used to answer your PICOT question. 2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question. Method of Study: 1. State the methods of the articles you are comparing and describe how they are different. 2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method. Results of Study 1. Summarize the key findings of each of the studies into a comprehensive summary. 2. What are the implications of the four studies you chose in nursing practice? Ethical Considerations 1. Discuss two ethical consideration in conducting research. 2. Describe how the researchers in the four articles you choose took these ethical considerations into account while performing their research. Outcomes Comparison 1. What are the anticipated outcomes for your PICOT question? 2. How do the outcomes of the four articles you chose compare to your anticipated outcomes? Proposed Evidence-Based Practice Change 1. What is the link between the PICOT question, the research articles, and the nursing practice problem you identified? 2. Based on this information, propose an evidence-based practice change for your identified setting. © 2021. Grand Canyon University. All Rights Reserved. 1 Quantitative Articles Critique Name Institution Date 2 Quantitative Articles Critique Background The cholera outbreak is a worldwide health menace associated with poor hygiene, unsafe drinking water, and food. Although the World Health Organization records between three and five million cholera cases annually, most cases come from third-world countries. For instance, Sub-Saharan Africa recorded over 86% and 90% of global cholera cases and deaths, respectively, between 2000 and 2009 (Nguyen et al., 2014).
As such, Cholera infections are a threat to community health and, therefore, a subject of significance in the nursing field. Therefore, community nursing professions are required to understand cholera spread and control measures as the frontline fighters of the epidemic. The articles evaluate the relationship between consumption of untreated water and cholera outbreaks while reflecting on how regular handwashing and water treatment could impact cholera control. The studies will be substantial in helping prove the importance of water disinfection and handwashing exercise in the control of the spread of cholera. The purpose of the studies is to help measure the risk of cholera among people with access to safe drinking water against those with no access. The objective of the articles is to help prevent cholera spread by providing sustainable and reliable interventions that promote hygiene and reduce the risk of transmission of vibrio cholerae infections. The articles aim to prove that consumption of untreated water, contaminated food, and poor hygiene practices are major causes of cholera transmission. Consequently, interventions targeting improved water treatment and hygiene are significant in reducing cholera transmission. Relevance of the Articles to Contaminated Hands, Water and Cholera The PICOT research focuses on unearthing the relationship that exists between Cholera outbreaks and contaminated hands and water.
The question seeks answers to whether 3 handwashing and disinfection of drinking water among households and school children helps control the rate of cholera outbreak. Both articles are therefore fully relevant to the PICOT question, and they adequately address the question. In the first study, the researchers interview cholera positive patients and their negative counterparts concerning their access to treated water. The article will provide the answer to the PICOT question by giving the rate of use of safe drinking water among the cholera cases as opposed to the control cases or the uninfected samples. The article demonstrates the high prevalence of cholera among people with little access to disinfected water. The study further appreciates that point-of-use chlorination, adequately maintained water networks, sewage systems, and safe hygiene practices must be adhered to prevent future cholera outbreaks. The second article reflects on a combination of hand washing hygiene and water treatment interventions which are both hospital-based. Just as in the PICOT question, two groups are used to illustrate how effective the interventions could be. The study evaluates two groups, intervention contacts, and control contacts, under two varying accesses to stored drinking water and handwashing with soap (George et al., 2016) Nursing Practice Problem and PICOT Questionnaire Discussion.
The article will answer the PICOT question by determining the difference in prevalence rate among the two groups of people. Method of Study Both articles used similar research methods. The first article applied the matched casecontrol study, where cholera cases and controls were sampled from two communities of free towns in Sierra Leone. Cholera patient samples were drawn from a Cholera treatment unit. After that, control samples were drawn randomly from among the patients’ neighbors whose households did not register Cholera symptoms in the recent past. Both were evaluated for accessibility and consumption of safe drinking water. The second article applied randomized 4 controlled trial to evaluate the efficacy of Cholera-Hospital-Based-Intervention for 7-days also abbreviated as CHoBI7. In the study, cholera patients’ intervention contacts and control contacts were randomly selected in Dhaka Hospital, Bangladesh (George et al., 2016). The intervention team received both the oral rehydration solutions (ORS) and CHoBI7, while the control team received the ORS alone. Cholera-Hospital-Based-Intervention provided water storage safety and promoted consistent handwashing with soap. Further randomly selected days of the week were made intervention days, and the other half made control days. The advantage of the first method is that selecting controls from neighbors of a patient gave accurate results of a common environment eliminating the bias on the basis of geographical advantage. Random Matched case study has its limitations as it can be challenging to evaluate a large population in a short time. The advantage of the method in the second article is that it limited the probability of seasonal variations and selection bias. The limitation of the second method is that it would put the control group at risk of spreading cholera infections amid the experiment. Results of Study In their research, Nguyen et al. (2014) concluded that untreated water significantly contributes to the outbreak of cholera Nursing Practice Problem and PICOT Questionnaire Discussion.
Their statistics indicated that chlorinated or boiled water among Cholera patients was lower than those who did not have Cholera symptoms. The researchers found out that 20% of the Cholera cases used unimproved water sources as opposed to 11% of control cases or those from uninfected samples (Nguyen et al., 2014). Equally, only 89% of cholera cases stored drinking water instead of 95% of the control population in Sierra Leone. Street vended food, drinks, and water were also significantly associated with cholera. 5 In their study, George et al. (2016) found out that intervention contacts had a 47% lower incidence of symptomatic and asymptomatic vibrio cholerae infection than control contacts during the intervention period. The odds of handwashing in the intervention group in key events were 14 times higher than in the control arm. Equally, a higher proportion of the household visits in the intervention arm had soap present at the latrine area compared to control arm counterparts. The researchers further found out that vibrio cholerae was present in 6% of stored water samples in the control arm and none in the intervention arm households. The articles are vital in addressing the cholera outbreak in the community. The findings will positively impact the trend on how stakeholders in the community health career will handle cholera in treatment and prevention. The articles will enhance society’s awareness to sufficient measures against cholera. The study enhances understanding of the importance of thorough and frequent hand wash, drinking safe treated water, and general hygiene as the prime factors in the control of cholera. The studies have also efficiently illustrated the effectiveness of the public collective participation and adherence to hygiene as an important measure of success against cholera. Outcomes Comparison The agenda of the PICOT question is the role of handwashing and drinking safe treated water in the control of cholera. The question also suggests that households and school children who do not carry out regular hand washing and drink disinfected drinking water are likely highly susceptible to cholera and other bacterial diseases. The outcomes of both studies completely match the PICOT question. The two studies anonymously conclude that contaminated water causes cholera and that regular hand washing and drinking treated water are among the major 6 solutions to the spread of cholera. Thus both the articles have illustrated high relevance to the PICOT question, and they have also converged to a common outcome. 7 References Nguyen, V. D., Sreenivasan, N., Lam, E., Ayers, T., Kargbo, D., Dafae, F., & Brunkard, J. M. (2014). Cholera epidemic associated with consumption of unsafe drinking water and street-vended water—Eastern Freetown, Sierra Leone, 2012. The American journal of tropical medicine and hygiene, 90(3), 518-523. Retrieved from https://www.ajtmh.org/content/journals/10.4269/ajtmh.13-0567 April 17th, 2021. George, C. M., Monira, S., Sack, D. A., Rashid, M. U., Saif-Ur-Rahman, K. M., Mahmud, T., & Alam, M. (2016). Randomized controlled trial of hospital-based hygiene and water treatment intervention (CHoBI7) to reduce Cholera. Emerging infectious diseases, 22(2), 233. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734520/ April 17th,2021.
Running head: OUTBREAKS OF CHOLERA Outbreaks of Cholera Student’s Name Institutional Affiliation OUTBREAKS OF CHOLERA 2 Diseases are caused by harmful microorganisms that include germs, viruses, or bacteria. Most of these infections are caused due to poor hygiene and are transmitted from one person to another through hand-to-hand contact, either directly through greetings or indirectly through objects like door handles, pens which other contacts. Handwashing involves a thorough cleaning of hands with soap and water or hand sanitizer with 60% alcohol concentration. This removes any harmful microorganisms that might cause disease and hence interrupting the transmission cycle. Furthermore, drinking water can contain fecal coliforms and can be a significant cause of an epidemic. Gastrointestinal infections among high school-going children are prevalent, especially in cases where there are poor handwashing practices. This PICOT research mainly focuses on the relationship that exists between Cholera outbreaks and contaminated hands and water. PICOT Question Do handwashing and treatment of drinking water among Households and School children help control the rate of Cholera epidemic outbreaks compared to those who neither treat drinking water nor have practice regular hand washing? P- Schools and Households who treat drinking water and practice handwashing. I- Handwashing practices and treatment of drinking water. C- Schools and households that practice handwashing and treatment of drinking water O- Control and prevention of cholera outbreak. T- Between 2014-2021 OUTBREAKS OF CHOLERA 3 Criteria Article 1 Article 2 Article 3 Article Citation (links attached on the reference page) Dajaan, D. S., Addo, H. O., Ojo, L., Amegah, K. E., Loveland, F., Bechala, B. D., & Benjamin, B. B. (2018). Hand washing knowledge and practices among public primary schools in the Kintampo Municipality of Ghana. Int J Community Med Public Health, 5(6), 2205-2216. Evaluates how handwashing can help control outbreaks of communicable diseases. Villeminot, N. (2018).
Strengthening market systems that provide water and hygiene items for cholera mitigation and emergency preparedness in Haiti. Waterlines, 37(4), 307-18. Nguyen, V. D., Sreenivasan, N., Lam, E., Ayers, T., Kargbo, D., Dafae, F., … & Brunkard, J. M. (2014). Cholera epidemic associated with consumption of unsafe drinking water and street-vended water—Eastern Freetown, Sierra Leone, 2012. The American journal of tropical medicine and hygiene, 90(3), 518523. Evaluates the relationship between street-distributed untreated water and cholera outbreak Relation of the article to the PICOT question Is the article Qualitative or Quantitative research? Why? Quantitative study design- descriptive study by use of questionnaires and observation checklist The study was conducted to evaluate the tendency of people to purchase handwashing products and chlorine-based water disinfection commodities. Qualitative- a field survey of Pre-Crisis Market Analysis Quantitative-Use of questionnaires with structured questions. -Testing of stored water in control households. OUTBREAKS OF CHOLERA 4 Aim of the Study The Aim was to determine how hand washing is impacted by the knowledge of handwashing and the availability of handwashing facilities in African public primary schools To come up with interventions to eradicate cholera through market based approach. To determine if the street distributed water was safe for drinking Research Question How is the practice of What is the rate of handwashing affected purchase of hygieneby the availability of based products? handwashing facilities and knowledge in public primary schools Ghana Is there a relationship between cholera cases and drinking unsafe water? Nursing Practice Problem and PICOT Questionnaire Discussion
Outcome The results obtained were: 1. Children did not practice hand washing. -96% people knew the importance of water disinfection and disinfected their drinking water. -Most households had hand washing products in their homes. Untreated water was a significant cause of Cholera outbreaks as it contained fecal coliforms. Setting (where the research was conducted) Kintampo Municipality, Ghana. Haiti, America Eastern Freetown, Sierra Leone OUTBREAKS OF CHOLERA 5 Sample Population Class 1-6 Primary school-attending children and Headteachers in 10 selected schools in Kintampo Municipality attending school between November 2017- March 2018. 301 Households randomly selected. Households that had a member admitted in hospital with a confirmed case of Cholera. Method. Through random selection of 10 schools and 300 children in the selected schools in Kintampo Municipality. Cases were identified in hospital wards, and a follow-up was done after discharge. Key Findings Though a majority of the children were informed on the importance of handwashing, most rarely practiced it. Recommendations of the researcher. Effective handwashing education should be done. Residual chlorine was measured in household stored water. Direct observation of presence of hand washing products and water storage containers. Majority of the households had a bar of soap and a supply of water. Most people did not understand the importance of handwashing Provision of adequate water Collaboration of the Haiti Water and Sanitation Agency with NGOs to provide hand washing and water disinfection products. The people were not well informed on the importance of water treatment. Effective water treatment before distribution. Coming up with proper distribution channels which do not contaminate the water.
Nursing Practice Problem and PICOT Questionnaire Discussion
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