Chapter 8: Critical Thinking; Scientific Method in Practice

Question 1

Clinical Problem

Answer 1

The incidence of a health care associated infection, C-Diff has increased on a hospital general medicine unit. The nursing staff on the unit practice committee, an infection control specialist, and a clinical nurse specialist in medicine have met to discuss factors that may be influencing the problem, They note that visitors are inconsistent in the use of antiseptic hand rubs. A staff member questions if use of hand rubs is the best approach for this type of infection.

Question 2

Identify Problem

Answer 2

-C-Diff has increased among patients on a general medicine unit

Question 3

Collect Data

Answer 3

• Staff members review the literature about the nature of C-Diff infection and the hand antiseptic techniques that are recommended to prevent the infection
• Staff review the literature for any studies that have investigated hand-hygiene practices of visitors of hospitalized patients
• Staff review performance improvement reports for occurrence of C-Diff on the unit
• The infection control specialist is asked to discuss the trends being seen within the hospital regarding incidence of C-Diff

Question 4

Form a Research Question to Study the problem

Answer 4

Does visitor use of antiseptic hand rub vs. chlorhexidine vs. hand washing with soap and water reduce incidence of C-Diff infection in medical patients?

Question 5

Answer the Question

Answer 5

• The nurse specialist and a small team of staff plan a 4-month study approved by the hospital research board
• Patients’ visitors are asked to use a chlorhexidine rub on their hands before entering and leaving rooms
• Visitors switch to performing hand washing with soap and water for the next 2 months
• Infection control tracks the incidence of C-Diff infection over the 4 months

Question 6

Evaluate the Results of the Study

Answer 6

Compare the incidence of C-Diff infection over 2 months for each of two hand-hygiene methods