Use the practice problem and a qualitative, peer-reviewed research article you identified.

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required.

This assignment uses a rubric. 

You are required to submit this assignment to LopesWrite.



  1. Background of study including problem, significance to nursing, purpose, objective, and research questions is thorough with substantial relevant details and extensive explanation.
  2.  Discussion of method of study including discussion of conceptual/theoretical framework is thorough with substantial relevant details and extensive explanation. 
  3. Discussion of study results including findings and implications for nursing practice is thorough with substantial relevant details and extensive explanation.
  4.  Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation. 
  5. Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice.
  6.  Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 
  7.  Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 
  8.  Writer is clearly in command of standard, written, academic English. 
  9.  All format elements are correct. 
  10.  Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 

Research Critique Guidelines

To write a critical appraisal that demonstrates comprehension of the research study conducted, address each component below for qualitative study in the Topic 2 assignment and the quantitative study in the Topic 3 assignment.

Successful completion of this assignment requires that you provide a rationale, include examples, or reference content from the study in your responses.

Qualitative Study

Background of Study:

1. Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

1. How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.

1. Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

1. List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

1. Were the purpose and research questions related to the problem?

Method of Study:

1. Were qualitative methods appropriate to answer the research questions?

1. Did the author identify a specific perspective from which the study was developed? If so, what was it?

1. Did the author cite quantitative and qualitative studies relevant to the focus of the study? What other types of literature did the author include?

1. Are the references current? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a qualitative study.

1. Did the author evaluate or indicate the weaknesses of the available studies?

1. Did the literature review include adequate information to build a logical argument?

1. When a researcher uses the grounded theory method of qualitative inquiry, the researcher may develop a framework or diagram as part of the findings of the study. Was a framework developed from the study findings?

Results of Study

1. What were the study findings?

1. What are the implications to nursing?

1. Explain how the findings contribute to nursing knowledge/science. Would this impact practice, education, administration, or all areas of nursing?

Ethical Considerations

1. Was the study approved by an Institutional Review Board?

1. Was patient privacy protected?

1. Were there

lable at ScienceDirect

American Journal of Infection Control 42 (2014) S216-S222

Contents lists avai

American Journal of Infection Control

journal homepage: www.aj ic journal .org

American Journal of
Infection Control

Original article

Facilitating central lineeassociated bloodstream infection
prevention: A qualitative study comparing perspectives of infection
control professionals and frontline staff

Ann Scheck McAlearney ScD, MS a,b,*, Jennifer L. Hefner PhD, MPH a

aDepartment of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH
bDivision of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH

HAI prevention
Health services research
Quality improvement

* Address correspondence to Ann Scheck McAlear
Family Medicine, College of Medicine, The Ohio State
273 Northwood and High Building, Columbus, OH 43

E-mail address: ann.mcalear[email protected] (A.S.
This research was supported by a grant from

Research and Quality (contract #HHSA290200600022
article are solely those of the authors and do not re
agency or any institutions with which the authors ar

Publication of this article was supported by the Ag
and Quality (AHRQ).

Conflicts of interest: None to report.

0196-6553/$36.00 – Copyright � 2014 by the Associa

Background: Infection control professionals (ICPs) play a critical role in implementing and managing
healthcare-associated infection reduction interventions, whereas frontline staff are responsible for
delivering direct and ongoing patient care. The objective of our study was to determine if ICPs and
frontline staff have different perspectives about the facilitators and challenges of central line-associated
bloodstream infection (CLABSI) prevention program success.
Methods: We conducted key informant interviews at 8 hospitals that participated in the Agency for
Healthcare Research and Quality CLABSI prevention initiative called “On the CUSP: Stop BSI.” We
analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to
program facilitators and challenges.
Results: We identified 4 facilitators of CLABSI program success: education, leadership, data, and con-
sistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician
resistance. However, the perspective of ICPs and frontline nurses differed. Whereas ICPs tended to focus
on general descriptions, frontline staff noted program specifics and often discussed concrete examples.
Conclusions: Our results suggest that ICPs need to take into account the perspectives of staff nurses when
implementing infection control and bro

Major article

Effect of chlorhexidine bathing in preventing infections and
reducing skin burden and environmental contamination:
A review of the literature

Curtis J. Donskey MD a,b,*, Abhishek Deshpande MD, PhD c,d

a Geriatric Research, Education, and Clinical Center, Cleveland Veterans Affairs Medical Center, Cleveland, OH
b Case Western Reserve University School of Medicine, Cleveland, OH
c Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH
dMedicine Institute Center for Value-Based Care Research, Cleveland Clinic, Cleveland, OH

Key Words:
Staphylococcus aureus

Chlorhexidine bathing is effective in reducing levels of pathogens on skin. In this review, we examine the
evidence that chlorhexidine bathing can prevent colonization and infection with health care-associated
pathogens and reduce dissemination to the environment and the hands of personnel. The importance of
education and monitoring of compliance with bathing procedures is emphasized in order to optimize
chlorhexidine bathing in clinical practice.

Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and
Epidemiology, Inc. This is an open access article under the CC BY-NC-ND license (http://

Patients colonized or infected with health care-associated patho-
gens often carry the organisms on their skin.1-3 Such contamination
may lead to infection when factors such as devices, catheters, and
wounds provide a route for pathogens on skin to reach normally
sterile sites. Skin contamination may also contribute to transmis-
sion due to environmental shedding and transfer to the hands of
personnel.1-3 Thus, there is a strong rationale for efforts to reduce
the burden of pathogens on skin.

During the past decade, a number of studies have examined
the use of chlorhexidine bathing as an infection prevention strat-
egy. This review examines the evidence that chlorhexidine bathing
can prevent colonization and infection with health care-associated
pathogens and reduce dissemination to the environment and the
hands of personnel. We also consider recent evidence that
chlorhexidine bathing is often suboptimal in clinical practice. The

importance of education and monitoring and feedback on compli-
ance with bathing procedures to optimize chlorhexidine bathing
is emphasized. The review was not conducted as a systematic
review, but the MEDLINE electronic database was searched using
broad search terminologies and recent review articles and their
references were searched.


Chlorhexidine is a cationic bisbiguanide antiseptic that alters mi-
crobial membrane integrity.4 A variety of formulations are available,
with chlorhexidine gluconate being most commonly used in health
care setting

o r i g i n a l a r t i c l e

Preventing Central Line–Associated Bloodstream Infections: A
Qualitative Study of Management Practices

Ann Scheck McAlearney, ScD, MS;1,2 Jennifer L. Hefner, PhD, MPH;1 Julie Robbins, PhD, MHA;1 Michael I. Harrison, PhD;3

Andrew Garman, PsyD, MS4,5

objective. To identify factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated
bloodstream infections.

design. Extensive qualitative case study comparing higher- and lower-performing hospitals on the basis of reduction in the rate of central
line–associated bloodstream infections. In-depth interviews were transcribed verbatim and analyzed to determine whether emergent themes
differentiated higher- from lower-performing hospitals.

setting. Eight US hospitals that had participated in the federally funded On the CUSP—Stop BSI initiative.

participants. One hundred ninety-four interviewees including administrative leaders, clinical leaders, professional staff, and frontline
physicians and nurses.

results. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting
to zero” infections. Although all sites reported this goal, at the higher-performing sites the goal was explicitly stated, widely embraced, and
aggressively pursued; in contrast, at the lower-performing hospitals the goal was more of an aspiration and not embraced as part of the strategy
to prevent infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level
commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
We present these strategies for prevention of healthcare-associated infection as a management “bundle” with corresponding suggestions for

conclusions. Some of the variance associated with CLABSI prevention program outcomes may relate to specific management practices.
Adding a management practice bundle may provide critical guidance to physicians, clinical managers, and hospital leaders as they work to
prevent healthcare-associated infections.

Infect Control Hosp Epidemiol 2015;36(5):557–563

Central line–associated bloodstream infections (CLABSIs)
increase risk of prolonged hospitalization, morbidity, and
death, and result in substantial financial and nonfinancial
costs to health systems and society.1–3 CLABSI rates can be
significantly reduced by implementing a “bundle” of 5 clinical
practices: full-barrier precautions, chlorhexidine antiseptic
and sterile dressing, optimal vein selection, improved hand
hygiene, and prompt removal of unnecessary central line
catheters.2,4,5 This bundle, combined with dedicated line
insertion and maintenance teams, checklists to ensure practice
consistency, and practitioner e