Professor Peggy Melloh
Catheter-associated urinary tract infection (CAUTI) is a fairly common complication in hospitalized patients. Nosocomial infection prevention and patient safety promotion has been issued and many researches have been conducted to improve patient’s quality of life. In this article, Saint et al. (2005) hypothesize that using a paper-based urinary catheter reminder can reduce the incidence of urinary catheterization, and consequently this will enhance the patients’ safety.
Critique Part 1
Research Questions or Hypotheses
The background and significance of this study are properly presented in the introduction. The research question is presented at the end of the introduction of this article. Saint et al. (2005) develop the research question based on the scientific backgrounds they selected and reviewed: “Is a urinary catheter reminder effective in reducing the incidence of indwelling urethral catheterization in the hospitalized patients?” (p. 456). The Independent variable is “a urinary catheter reminder” and the dependent variable is “the incidence of indwelling urethral catheterization.” The research question appropriately states the relationship between “a urinary catheter reminder” and “the incidence of indwelling urethral catheterization,” thus the research question is specific to one relationship. The research question is generated from PICO information which means population, intervention, comparison, and outcome (LoBiondo-Wood & Haber, 2010, p. 63). In this study, population is the hospitalized patients in the University of Michigan Medical Center and a total of 5,678 patients participate in the study. Intervention is ‘using’ a catheter reminder and comparison is ‘not using’ a catheter reminder. Outcome is the effectiveness of a use of the reminder. Although hypothesis is not directly written in the article, Saint et al. (2005) imply that a paper-based reminder of indwelling urinary catheter might help reduce improper catheterization. The research question is not placed in a theoretical framework; however, the conceptual framework is enclosed in the literature review of the article. Two conceptual frameworks are applied to develop the research question: one is patient safety promotion and the other one is infection prevention. The rate of catheter-associated urinary tract infection (CAUTI) is relatively high among the nosocomial infections. Although indwelling urinary catheters are common and essential for some hospitalized patients, sometime these are unnecessarily applied. In this paper, a simple written reminder might cut down the use of indwelling urinary catheters and consequently this can reduce the rate of CAUTI and improve patient safety. The purpose of this study is not directly stated, but it can be inferred from the research question. The purpose of this study is to test the effectiveness of a indwelling catheter reminder in decreasing the use of indwelling urinary catheter. The level of evidence of the research does not explain the significance of the study completely, but this is one of the skills that can assist the readers to evaluate the strengths and weaknesses of a research (LoBiondo-Wood & Haber, 2010). This research is Level III because of its quasi-experimental design which tests cause-and-effect relationships. Saint et al. (2005) investigate the relationship between the use of a urinary catheter reminder and the incidence of indwelling urethral catheterization. In order to apply evidence in practice, the nurses should assess the potential for applicability first. Saint et al. (2005) bring up the problem that indwelling urinary catheter-associated infection “accounts for up to 40% of nosocomial infections.” Another problem they find is that many physicians are often unaware of urinary catheterization in their patients. Unfortunately, these overlooked catheters are unnecessarily applied in some...
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