Intensive Care Unit

Research a public health issue of your choice. Choose three empirical articles from the GCU Library related to your issue. Evaluate the three articles using the “Research Article Comparison Matrix.”

Research Article Comparison Matrix

Criteria and Defining CharacteristicsArticle 1Article 2Article 3
APA Citation and PermalinkCandeloro, C. L., Kelly, L. M., Bohdanowicz, E., Martin, C. M., & Bombassaro, A. M. (2012). Antimicrobial use in a critical care unit: a prospective observational study. International Journal of Pharmacy Practice, 20(3), 164-171.  Kano, K. I., Shime, N., & Nishiyama, K. (2018). Implementation of an empirical antimicrobial protocol in a critical care setting: A single-center retrospective observational cohort study in bacteremic patients. Journal of Infection and Chemotherapy.  Scott K. Fridkin, Rachel Lawton, Jonathan R. Edwards, Fred C. John E. McGowan, Jr.,t Robert P. Gaynes. (July 2002), the Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Project, and the National Nosocomial Infections Surveillance (NNIS) System. Hospitals Emerging Inf.
Abstract After reading the abstract, what do you expect to learn from the article?    After reading the article, I expect to learn about the various indications for anti-microbial use for patients admitted into the Intensive Care Unit (ICU).  Based on the information obtained from the abstract of the article, I expect to learn about the various anti-microbial agents that are used to manage conditions in the ICU. I also expect to learn about the rate of anti-microbial drug resistance. From the article abstract, I anticipate to learning about the various reasons that clinicians use to adjust anti-microbial drug treatment regime for patients admitted into the ICU. Additionally, I anticipate that the article will inform about the clinical outcomes of the various anti-biotic drugs used in managing patients in the ICU.  After read information presented in the abstract of the article, I expect to learn about the application of the traditionally used antimicrobial therapy among patients admitted in ICU. I expect to learn about the effects of treatment duration, the dosage and the type of antibiotics used in managing infections in the ICU.  According to the information presented in the article, I expect that the article will provide evidence on the variation in the clinical outcome to evaluate the effectiveness of the change or modification in the therapy regime of anti-biotics used in the ICU. From the abstract, I expect to find information on the effectiveness of the commonly used anti-biotic treatment protocols for a patient admitted in the ICU.  The article is to describe whether local data monitoring facilitated vancomycin use or vancomycin resistant enterococci in the intensive care units.
Introduction: Summarize the following in paragraph form. What is the purpose of the study?What is the scope of the study?What is the rationale for the study?What is the hypothesis or research question?What key concepts and terms are noted?Is a review of the literature provided?The Purpose. The purpose of the study is to find out the various anti-microbial agents that are used to manage conditions in the intensive care. The study aims at finding out the clinical outcomes of the various anti-microbial treatment modalities used by clinicians to manage ICU patients. Further, the purpose of the study is to establish the various reasons for modifications of treatment modalities involving antimicrobial therapy in the ICU. The Scope. The study included the patients admitted into the ICU and who have been prescribed anti-microbial use with a given period of time. The study involves various aspects of antimicrobial use for ICU patients including the names and the classifications of the drugs used.  The Rationale. The rationale of the study is based on the development of drug resistance. The study is based on the evidence on the common use of antimicrobial drug treatment in managing patients in the ICU. The study is informed by the common invasive procedures performed on patient admitted in the ICU. Nosocomial infections are common in the ICU and thus, form the basis for the development of the study. The study aims to serve as a basis for the choice of antimicrobial agents.  The findings of the study will inform on the effects of the type of the anti-biotic drug, the dosage, route of administration and modification of the regiment on development of drug resistance and clinical outcomes. The results of the study are useful in determining the effectiveness of anti-biotic combination in managing patient admitted into the ICU and on anti-microbial treatment. Research Question. The research study question: what is the antimicrobial consumption, utilization, and resistance in tertiary intensive care? Key Concepts And Terms. The key terms and concepts noted in the study are; antimicrobial use, antimicrobial resistance, and intensive care unit. Review Of The Literature. Literature review is provided. The literature focuses on the evidence of increased anti-microbial drug resistance. The literature review discusses the various and available literature evidence on the factors associated with anti-microbial resistance among the patients admitted into the ICU. The literature review indicates the existing evidence gap concerning the factors associated with antimicrobial drug resistance among the patients admitted in ICU.      The Purpose. The purpose of the study is to compare traditional antibiotic treatment protocols and a newly developed protocol. The study aims at finding out the effectiveness of the changes in the dosage, the type of the antibiotic, the route of drug administration and the duration of treatment on the patient outcomes. The Scope. The scope of the study includes patients in a hospital setting. The study includes the comparison of the patient outcomes, before and after the introduction of new anti-biotic therapy modality within the critical care. The Rationale. The rationale of the study is to evaluate the effectiveness of separate treatment elements of antibiotic regimes among critical care patients. The findings of the study seek to critique the various elements of antimicrobial treatment against infections in ICU. The purpose of the study is to investigate the patient care outcomes when certain changes are introduced into the antibiotic treatment therapy. Research Question. The study question is; what is the impact of new anti-microbial regime for patients in the ICU? Key Concepts And Terms. The key terms that are used in the study include; antimicrobial therapy, carbapenems, and antimicrobial therapy. Review Of The Literature. The review of the literature is provided. The literature discusses on poor patient outcomes when using anti-microbial therapy for critical care patients. The study literature review discusses the differences in the effectiveness of various antimicrobial there pay approaches used in critical care.    The Purpose. The purpose of the study was to find out if the utilization of recorded and maintained data on the use of vancomycin improves the quality of care quality of care and general improvement and whether it decreases the use of   vancomycin or vancomycin-resistant enterococci (VRE).The study is to involve fifty  critical -care departments from twenty United States  hospitals that combine and maintain data on disease causing micro-organisms and anti-microbial use. Rationale. The rationale of the study is to monitor and evaluate the use local guidelines data on the vancomycin use and the relationship with decrease in prevalence of vancomycin use or vancomycin resistant enterococcus. Research Question. Does local data monitoring on vancomycin decrease the use of vancomycin or vancomycin resistant enterococci? Key Concepts And Terms. The key concepts in the study are; antimicrobial use and resistance, vancomycin use Enterococci.   Review Of The Literature. There is review of literature from previous studies done, which relate with the current study.  
Methods: Summarize the following in paragraph form. What is the population being sampled?What data collection procedure is presented?What other procedures are described?  The Population Being Sampled. The population that is sampled for the study includes the patients admitted into the ICU, and who have been on treatment with antimicrobial agents. The study sample includes 61 patients enrolled for the study. Data Collection Procedure. Data was collected through extraction of patient’s treatment records. The investigators collected data on the type of anti-biotic therapy, the dosage of the specific drugs,  the duration of the treatment,  the , clinical outcome of the patients and the modification that was done during the course of the treatment. The clinical treatment using anti-biotic therapy was monitored for the entire period the of the treatment until the patient was discharged, died or the anti-biotic treatment was withdrawn.The Population Being Sampled. The population being sampled for the study is composed of 195 patients. The population study sample includes of patient outcomes before and after the implementation of the developed antimicrobial treatment protocol. The sample includes patients who had been admitted into the critical care unit with the diagnosis of bacteremia. Data Collection Procedure. The data collection procedure is retrospective observational study. The data in the study is collected through the extraction of patient data. The clinical presentation of bacteremia among the patients sampled for the study is observed through the period of the study.    The Population Being Sampled. The population sampled for study is 50 Intensive care units from 20 hospitals in USA. Data Collection Procedure. The data collection involves the participating hospitals giving feedback reports on the antimicrobial use. Other procedures used involve further stratification of the intensive care units into more specific units according to the category of the patients served.
Results: Summarize the following in paragraph form. What are the given findings?How were data collected?Are the findings supported by graphs and charts?What does the analysis of data state?Findings. The results that are provided indicated that anti-microbial drug treatment among ICU patients is carried out for several reasons.  The reasons that the study found out for anti-microbial use is; prophylaxis against infections, the empirical indication on antimicrobial use and directed therapy. The most commonly prescribed anti-microbial agents are vancomycin, cefazolin, and tazobactam. There were several reasons for the modification of the treatment. The reasons for the modification included; safeguarding the patients, safety, to achieve the efficacy of the treatment, and change the route of the drug administration. The most common microorganism that causes anti-microbial drug resistance are Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and Streptococcus pneumonia. Graphs And Charts. The findings of the study are supported by tables and graphs. The tables indicate the type of the drug prescribed and administered and the dosage of the drugs.  The graphs that are used represent the type of the causative microorganism for the conditions in the ICU and the type and the dosage of the antibiotic used. Data Collection. The data was collected through extraction of data from the patients’ records. Analysis. The analysis if the results of the study indicate that there is an association between the type of the anti-microbial drug used, the duration of treatment, the dosage prescribed and the modifications of the development of drug resistance among patients.Findings. The study found out that the survival rates between patient who are managed through various anti-microbial drug therapies is the same. The use of clinical indications for choosing the therapy was identified as the most common reasons for using specific anti-microbial drugs. Carbapenem was the most commonly used antibiotic drug in managing the infections among the patients on the intensive care setting Graphs And Charts. The findingsof the study are support by tables and graphs. The tables indicate the type of the anti-biotic drugs for the several groups of patients. The tables also show the various patient outcomes after the treatment. Data Collection. The data were collected through clinical observation of the symptoms along the sampled patients in critical care and accidents clinical areas Analysis. The analysis of the study states that stewardship in managing infectious conditions in intensive care is appropriate. The analysis states that the stewardship implementation of the clinical treatment guidelines leads to beneficial outcomes. At the same time, the outcomes of the clinical intervention are the similar.  Findings. The findings indicated that Intensive care units using unit-specific changes In practice, had significant decreases in prevalence of vancomycin resistant enterococci compared with those that didn’t. Data collected  through involved healthcare facilities that have data on the pre-determined antimicrobial agents that are administered to patients. The results of the study indicate that the laboratory data on the susceptibility of anti-microbial agents can be obtained from specimens collected from patients within a period of one month. Graphs And Charts. The study findings are supported by graphs and tables. Data analysis states that ICUs using unit specific changes reported significant decreases  in prevalence of  vancomycin resistant enterococci in comparison to those who not are using particular modifications in practice .
Conclusion: Summarize in paragraph form. What is the summary of the study?What is the conclusion of the hypothesis?What are the questions for future research?  Summary. The authors conclude that the study accurately identifies the various anti-microbial agents used in the treatment of infections in the ICU.  Additionally, the authors conclude that the study makes a comparison between the various clinical impacts of different aspects of the type, dosage, and duration of antimicrobial treatment. The results of the study contribute to the recommendations on treatment protocols of antibiotics in ICU. Conclusion. The study concludes that the hypothesis was positively supported by the findings of the research.  The story stresses that future researches should be focused on evaluating the protocols that are developed on previous research findings.    Summary. The study summarizes that adherence to updated and current protocols in management of infection in critical care are beneficial. The study concludes that clinical symptoms should be evaluated after a given period of time of using antibiotics when managing an infection in critical care. Conclusion. The study depicts that the survival rates of patents vary when various antimicrobial treatment protocols are applied.  The graphs are used to present the frequency of the use of the antimicrobial agents.Summary. Summarizing on the study; there is significant decrease in prevalence of vancomycin resistant enterococci from critical care centers using unit specific guidelines compared to those who didn’t use. Conclusion. Concluding on the hypothesis; use of antimicrobial specific guidelines decreases the prevalence of vancomycin resistant enterococci. Question for further research is 1. Which other monitoring strategies that that can decrease prevalence of vancomycin resistant enterococcus?  
References What is the total number of references used in the study?List two of the references used.References The total number of references used for the study is 19. Listing two references used are; Zhanel GG et al. Antimicrobial resistant pathogens in intensive care units in Canada: results of the Canadian National Intensive Care Unit (CAN-ICU)study,2005–2006.Antimicrob Agents Chemother 2008; 52: 1430– 1437. 2. Hanberger H et al. Surveillance of microbial resistance in European intensive care units: a first report from the Care-ICU programme for improved infection control. Intensive CareMed2009;35:91–100.References The total number of references used for the study is 50. Two references used are: 1. Vincent JL et al. International study of the prevalence and outcomes of infectioninintensivecareunits.JAMA2009; 302:2323–2329. 2. Gravel D et al. Point prevalence survey for healthcare-associated infections within Canadian adult acute-care hospitals. J Hosp Infect 2007; 66: 243– 248.References The total number of references used for the study is 50. Listing two references used are; 1. Duncan RA. Controlling use of antimicrobial agents. Infection Control Hospital Epidemiology 1997:18:260-6. 2. Jarvis WR. Preventing the emergence of multidrug-resistant microorganisms Through antimicrobial use controls: the complexity of the problem. Infect Control Hospital Epidemiology 1996:17:490-5.
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