While the implementation plan prepares students to apply their research to the problem or issue they have identified f

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

Title page
Introduction section
A comparison of research questions
A comparison of sample populations
A comparison of the limitations of the study
A conclusion section, incorporating recommendations for further research

1
Unsatisfactory
0.00%

2
Less than Satisfactory
75.00%

3
Satisfactory
79.00%

4
Good
89.00%

5
Excellent
100.00%

80.0 %Content

10.0 %Introduction

An introduction is not present.

An introduction is present, but it does not relate to the body of the paper.

An introduction is present, and it relates to the body of the paper. There is nothing in the introduction to entice the reader to continue reading.

An introduction is present, and it relates to the body of the paper. Information presented in the introduction provides incentive for the reader to continue reading.

An introduction is present, and it relates to the body of the paper. Information presented in the introduction is intriguing and encourages the reader to continue reading.

20.0 %Comparison of Research Questions

No comparison of research questions is presented.

A comparison of research questions is presented, but it is not valid.

A cursory though valid comparison of research questions is presented.

A moderately thorough and valid comparison of research questions is presented.

A reflective and insightful comparison of research questions is presented.

20.0 %Comparison of Sample Populations

No comparison of sample populations is presented.

A comparison of sample populations is presented, but it is not valid.

A cursory though valid comparison of sample populations is presented.

A moderately thorough and valid comparison of sample populations is presented.

A reflective and insightful comparison of sample populations is presented.

20.0 %Comparison of the Limitations of the Study

No comparison of the limitations of the study is presented.

A comparison of the limitations of the study is presented, but it is not valid.

A cursory though valid comparison of the limitations of the study is presented.

A moderately thorough and valid comparison of the limitations of the study is presented.

A reflective and insightful comparison of the limitations of the study is presented.

10.0 %Conclusion and Recommendations for Further Research

No conclusion and recommendations for further research are presented.

A conclusion and recommendations for further research are presented, but they are not valid.

A conclusion and recommendations for further research are valid, but they are cursory.

A conclusion and recommendations for further research are valid and moderately thorough.

A conclusion and recommendations for further research are reflective and insightful.

15.0 %Organization and Effectiveness

5.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

5.0 %Argument Logic and Construction

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

5.0 %Format

2.0 %Paper Format (use of appropriate style for the major and assignment)

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

3.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

100 %Total Weightage


1
PICOT Statement
PICOT Statement
Laura Kilmer
Grand Canyon University: NRS-490
December 23, 2018
2
PICOT Statement
PICOT Capstone Project
According to the Centers for Disease Control and Prevention (CDC) there are 80,000
central Line-associated Bloodstream infection (CLABSIs) every year exclusively in Intensive
Care Units (ICU). This estimate rises to 250,000 CLABSIs every year when entire hospital
values are incorporated (CDC, 2011). CLABSIs have been observed to be the second most fatal
type of hospital acquired infection. CLABSIs are a predominant and expensive issue in human
services and are a preventable contamination. The effects of Chlorhexidine Gluconate (CHG)
bathing on decreasing infection rates of central venous catheter (CVC) has heightened showing
healthcare-related infections prompt mortality and restorative expenses. In the United States
alone, each year 75,000 individuals with hospital acquired infections die (Zimlichman et al.,
2013). The purpose of this paper is to present PICOT statement related to prevention of
infection by implementation of daily CHG baths in patients with central lines.
PICOT
Does Using CHG baths prevent Central line infections performed daily during
hospitalization compared to patients that received typical bath daily?
Population: Patients with Central lines
Intervention: Give CHG wipe bath with proper technique daily during hospitalization
Comparison: Patients not receiving CHG baths or receiving them improperly
Outcome: Decrease in Central line infections
Timeline: 5 weeks
Evidence-Based Solution
3
PICOT Statement
Evidenced-based interventions can be implemented with a specific end goal to decrease
CLABSIs, such as daily CHG baths. Musuuza (2017) noted that “Healthcare associated
infections (HAIs) lead to increased morbidity, mortality and medical costs. “In the United States
alone, about 722,000 people get a HAI every year and 75,000 people with HAIs die.” There is a
substantial need for a daily chlorhexidine bath to be established as an economic and preventative
practice to support the innovation’s permanence (Musuuza et al., 2017 p. 1). According to
(Musuuza et al., 2017) questions such as

How does a nurse communicate that CHG baths were completed during the shift?

What do you know about the policy for CHG bathing?
informs logical components that affect execution and maintainability of the intervention.
Nursing Intervention
Mandatory daily CHG bathing encounters many nursing practice challenges. Research
has demonstrated that chlorhexidine prevents infection, yet there is conflicting evidence on CHG
bathing preventing CVC infections better than customary bathing techniques in these articles.
Although, these studies provide considerable amounts of evidence supporting obstacles in
compliance, decreased CVC rates were also indicated. Musuuza et al., (2017) identifies factors
such as

Nurse burn out related to patient load

Delegation

Communication deficiency

Supplies

Patient compliance

Perception of CHG impregnated wipes
4
PICOT Statement

General hygiene of the patient
have a direct effect on whether the CHG bath is proven effective. Each of these factors proposed
its own set of dilemmas. Although the barriers where widely assessed and documented, “Daily
use of CHG in the ICU has been shown to be effective in reducing the rate of MRSA and VRE
acquisition and bloodstream infections associated with these organisms” (Lowe et al., 2017 p.
256). Chlorhexidine has been reported to have few negative consequences and showed
inconclusive evidence of decreasing CVC infections related to CHG bathing. The CLABSI rates
decreased among the neonates receiving CHG baths (Quack et al., 2014).
Patient Care
All patients with CVC will bath daily utilizing moistened CHG wipes. A few studies have shown
an extreme decline in CLABSIs from every day utilization of CHG washing. Lowe et al., (2017)
reported that, “Despite daily CHG bathing compliance of 58%, rates of hospital-associated MRSA
and VRE were significantly reduced compared with bathing with soap and water” (p. 257). Thus,
research supports the nursing care; utilization of CHG showering over soap and water.
Health Care Agency
This Capstone Project will Utilize BayCare Health System Inpatient hospital. This
facility is not for profit center that serves the community. St. Joseph’s Hospital has been a part of
the community since 1934. The research will be performed in the Pediatric population of this
hospital.
Nursing Practice
PICOT Statement
Being that the CDC creates central line infection guidelines and one of the
recommendations outlined is CHG bathing in patients with central lines I think it is safe to say
daily chlorhexidine impregnated wipes should be utilized for all patients with central venous
access that meet the guidelines of administration.
5
6
PICOT Statement
Reference
Musuuza, J. S., Roberts, T. J., Carayon, P., & Safdar, N. (2017). Assessing the sustainability of
daily chlorhexidine bathing in the intensive care unit of a Veteran’s Hospital by examining
nurses’
perspectives
and
experiences. BMC
Infectious
Diseases, 17(1).
doi:10.1186/s12879-017-2180-8
Karki, S., & Cheng, A. C. (2012). Review: Impact of non-rinse skin cleansing with chlorhexidine
gluconate on prevention of healthcare-associated infections and colonization with multiresistant organisms: a systematic review. Journal of Hospital Infection, 82, 71–
84. https://doi-org.lopes.idm.oclc.org/10.1016/j.jhin.2012.07.005
Quach, C., Milstone, A. M., Perpête, C., Bonenfant, M., Moore, D. L., & Perreault, T. (2014).
Chlorhexidine Bathing in a Tertiary Care Neonatal Intensive Care Unit: Impact on
Central Line–Associated Bloodstream Infections. Infection Control & Hospital
Epidemiology,35(02), 158-163. doi:10.1086/674862
Zimlichman E, Henderson D, Tamir O, et al. Health care–associated infections: A meta-analysis
of costs and financial impact on the us health care system. JAMA Intern Med.
2013;173(22):2039–46.

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