Healthcare Associated Infections: Evidence-Based Practice Presentation

Healthcare Associated Infections: Evidence-Based Practice Presentation

Healthcare Associated Infections Evidence-Based Practice Presentation

Agency for Healthcare and Research Quality identifies four types of common Healthcare-Associated Infections and some of the interventions for dealing with them. The four infections studied include ventilator-associated pneumonia, central line-associated bloodstream infection, catheter-associated urinary tract infections (CAUTI), and surgical site infections. According to AHRQ, these four types of infections are responsible for over eighty percent of all healthcare-associated infections (AHRQ, 2019).

What Was Shown To Be Effective Against Prevention Of Healthcare-Associated Infections And To What Strength Of Evidence?

The several adverse effects of healthcare-associated infections have led to several research efforts to come up with evidence-based practice strategies for preventing the infections as they are the most effective routes to fighting healthcare associate infections (Lorden et al., 2017). Some of the most effective means include removal of unnecessary indwelling catheters, cleaning patient’s skin with chlorhexidine, application of full-barrier precaution when inserting central venous catheters, and handwashing and hygiene. These evidence-based methods of preventing healthcare-associated infections were obtained from systematic reviews, implying that the level of evidence is I.



Locate An Evidenced-Based Research Paper (Less Than Five Years Old). Describe The Following About The Study:


The Title?

The evidence-based research paper that will be considered for the review using guiding questions is an article by Caselli et al. the title of  the article is “Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: A multicentre, prospective, intervention study.”


What Is The Study About?

The Probiotic Cleaning Hygiene System (PCHS) was previously shown to be able to abate surface pathogens without the selection of

Healthcare Associated Infections Evidence-Based Practice Presentation
Healthcare Associated Infections Evidence-Based Practice Presentation

antibiotic-resistant species. So the study wanted to dig deeper into this cleaning system and try and apply it in the control of healthcare-associated infections. The cleaning system replaced conventional chemical-based (chlorine products.

Purpose Of The Study?

The purpose of the study to determine whether the application of the Probiotic Cleaning Hygiene System (PCHS) can impact the incidence of healthcare-associated infection.

What Was The Framework Of The Study?

The study was not based on any specific framework as the authors failed to identify any.

Protocol development?

The researchers developed a protocol for the study, which was a prospective, multicentre and pre-post interventional research. The study simultaneously analyzed surface contamination and the incidence of healthcare-associated infections was done in six Italian public hospitals for eighteen months. The hospitals’ sizes were from medium to large. Having come up with the trial protocol, the trial protocol was then approved by the institutional ethics committees of every recruited hospital.

Describe How The Project Began.

After identifying the research gap of the possibility of using the Probiotic Cleaning Hygiene System in controlling healthcare-associated infections, the research team then established eligibility criteria for the hospitals to be enrolled in the study. One of the inclusion criteria was obtaining approval from the ethical committee prior to entering the research and having a size of more than one hundred in-patient beds. The intervention was then introduced to replace the conventional use of chlorine products for sanitation, with the hospitals agreeing not to introduce any other intervention which could have a potential impact on healthcare-associated infections.

Did The Topic Have Support From Leaders, Clinical Nursing Staff?

Yes, the topic has support from the leaders and the clinical nursing staff as the researchers were given the institutional ethical clearance to proceed with the research. Besides, the staff seemed to buy into the research since they agreed not to use any other intervention that could affect the incidence of healthcare-associated infections.

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Describe The Members Of The Project Team.

The members of the project team included the researchers and dedicated healthcare professionals who were hired and trained in a particular way to help in data collection. The other members of the project team included a central team that was there throughout the period of the study to help in solving informatics problems, ensuring that the data is standardized, complete, and consistent.

How Long Did The Team Meet?

Even though no formal meeting has been described, the authors state that every team member was available throughout the research period. Meaning that even though the meetings are not described, they might have been meeting on a frequent basis to check in the progress of the project.

What Materials, Etc. Were Developed?

Some of the materials developed include electronic clinical records, bioburden data, and quantitative and qualitative characterization of the healthcare facility surface bioburden in the areas surveyed.

Describe The Evaluation Of The Study.

The study met its objectives as it was able to determine the efficacy of the use of Probiotic Cleaning Hygiene System in controlling the healthcare-associated infection


What Were The Findings And Conclusions?

Some of the findings include a significant decrease in cases of healthcare-associated infections upon the use of the Probiotic Cleaning Hygiene System, with incidence rates observed to reduce from 4.8% to 2.3 %. The use of the system also led to decreased amounts of surface pathogens. The study concluded that modulation of environmental microbiota for healthcare setting cleaning could be instrumental in controlling the healthcare-associated infection.


Agency for Healthcare Research and Quality. (2019, October). Ending health care–associated infections. Rockville, MD: Author. Available at:

Caselli, E., Brusaferro, S., Coccagna, M., Arnoldo, L., Berloco, F., Antonioli, P., … & SAN-ICA Study Group. (2018). Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: A multicentre, prospective, intervention study. PLoS One13(7), e0199616.

Lorden, A. L., Jiang, L., Radcliff, T. A., Kelly, K. A., & Ohsfeldt, R. L. (2017). Potentially preventable hospitalizations and the burden of healthcare-associated infections. Health services research and managerial epidemiology4, 2333392817721109.

Catheter Associated Urinary Tract Infection

Problem/PICOT/Evidence Search (PPE) Worksheet



Criteria Hospital acquired infections are not unique to the hospitalized patients and urinary tract infections are not unique. Mostly, the indwelling catheters have been shown to contribute to increased prevalence of the disease. It has been determined that among the UTIs which are acquired in hospitals, about 75% of them are associated with the urinary catheter. The prolonged use of the catheter has been shown to be the risk factor to the development of the infection. In the course of the hospital stay, when there is an indwelling catheter, a film forms and this leads to predisposition to bacteriuria.
Clinical Nursing Practice Problem



Clinical Nursing

PICOT Question

In the hospitalized patients, (P) does the use of alloy coated catheters (I) compared to 100% silicone catheters (C) reduce the rate of catheter associated urinary tract infection (O) during hospital stay? (T)
Define PICOT Elements P– (Patient population/patients of interest): hospitalized patients are ones found in the hospital setting to receive care for a particular disease.

I– (Intervention): catheters are used to drain urine from patients with obstructed urinary tract.

C– (Comparison): the risk of bacteremia has been associated to be lower when alloy catheters are used compared to the pure silicone catheters.

O– (Measurable outcome): reduction in the number of infections is associated with the use of the alloy catheters compared to 100% silicone catheters.

T– (Time frame in months): time during which the patient is in the hospital predisposes to a number of challenges, bacteremia being one of them.

Evidence Retrieval Process and Summary



(Aljohi, Hassan, & Gupta, 2016): this evidence presents findings in about 60 patients in an intensive care unit who use the urinary catheters for about 3 days. I chose the study because it is a complete finding and the sample consists of patients with urinary tract infection, with a key focus on the noble alloy catheters within the ICU.
Implications of the Evidence


From the study, it was evident that the use of noble metal alloy catheters was associated with lower CAUTI and secondary outcomes like polyuria and bacteremia.
Evidence Search Terms



Catheter associated urinary tract infection

Nobel Alloy catheter


Evidence Search


Selected publication dates within last 10 years

Academic or scholarly (Peer Reviewed) journals

Subject, title, or author search box

Selected key terms from PICOT question


Aljohi, A., Hassan, H., & Gupta, R. (2016). The efficacy of noble metal alloy urinary catheters in reducing catheter-associated urinary tract infection. Urology Annals, 8(4), 423–429.