Treasure Hunt, Pico Question

Title: Treasure Hunt Assignment ? Pico Question The PICO question used in this assignment is In adult patients with short term voiding problems, what is the effect of urethral catheter design compared with standard latex catheters on the rate of urinary tract infection? Define Systematic Review A systematic review is a scientific approach that combines results from a group of original research studies and looks at the studies as a whole (Nieswiadomy, 2012).

Systematic reviews are pertinent for evidence-based practice (EBP) because it brings together research on the effectiveness of treatments or interventions and helps clinicians decide which treatments or approaches are supported by evidence (Nieswiadomy, 2012). Titles Found-First Search The following are five titles found: •Cranberries for preventing urinary tract infections. •Methenamine hippurate for preventing urinary tract infections. •Cranberries for treating urinary tract infections. Prophylactic antibiotics to reduce the risk of urinary tract infections after urodynamic studies. •Routine neonatal circumcisions for the prevention of urinary tract infections in infancy. Systematic Review Found-Second Search The systematic review that was found on the second search that specifically answers the PICO question is Types of urethral catheters for management of short-term voiding problems in hospitalized adults by Katie Schumm and Thomas Lam. Summary of the Systematic Review

Describe how the systematic review applies to the PICO Question (1) The systematic review answers the PICO question in that it addresses risk and rate of urinary tract infections associated with types of indwelling catheters in adult hospitalized patients with short term voiding problems. Types of Studies Reviewed (2) Cochrane Incontinence Group Specialized Register of trials (May 24, 2010) was searched in addition to bibliographies of relevant articles.

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Catheter manufacture representatives were also contacted for trials (Schumm & Lamm, 2008). How the Review was conducted (3) Selection Criteria Selection criteria were compromised of all randomized and quasi-randomized trials that compared types of indwelling urinary catheters for short-term use in hospitalized adults (Schumm & Lamm, 2008). Data collection Data collected was reviewed and then independently verified by a second reviewer (Schumm & Lamm, 2008).

Clarifications were sought and disagreements were resolved as described in the Cochrane Handbook (Schumm & Lamm, 2008). Subjects Twenty three trials were conducted. Those meeting criteria were 5,246 hospitalized adults in parallel groups trials and 27,878 adults in one large cluster-randomized cross-over trial (Schumm & Lamm, 2008). Important Terms Defined and Significance (4,5) Urinary catheters were defined as “small tubes inserted through the urethra (outlet for urine)” (Schumm & Lamm, 2008).

The review further states that urinary catheters are used short term post-surgery or to monitor urine output in hospitalized patients (Schumm & Lamm, 2008). It is important to define this term because it is a main component of the subject of study. Also, defining a term in a systematic review provides clarity and a clear-cut definition of the subject for those not familiar with medical terminology. Studies Reviewed (6) Full access to this review is restricted without a membership.

The abstract and information cited by is accessible for free. From what can be gathered, thirteen different studies were reviewed for this systematic review. Primary Recommendation and Significance (7,8) What this review concluded is that antiseptic or antibiotic coated urinary catheters might reduce the presence bacteriuria of hospitalized adults, and that siliconized catheters might cause the least side effects in men (Schumm & Lamm, 2008). However the review stated the evidence was weak.

It suggested that more rigorous trials are needed to make a valid conclusion as to if antibiotic or antiseptic coated urinary catheters reduce the rate of urinary tract infections (Schumm & Lamm, 2008). This conclusion is important to nursing care because it addresses some possible interventions/treatments to reduce the most common hospital acquired infection which ultimately leads to providing excellent patient care to promote and abstain optimal health.

If further research does conclude that antibiotic or antiseptic coated urinary catheters are effective at reducing the rate of urinary tract infections, health care has yet advanced another step in resolving the huge of issue nosocomial-acquired infections. References Nieswiadomy, R. M. (2012). Foundation of Nursing Resarch (6th ed. ). Boston: Pearson. Schumm K. , Lam, B. L. (2008). Types of urethral catheters for management of short-term voiding problems in hospitalized adults. Cochrane Database of Systematic Reviews 2008 (2). DOI: 10. 1002/14651858. CD004013. pub3 ?

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