The formulation of answerable research questions is a significant challenge for graduate nurses. Clinical research varies from the traditional forms of research because it requires the use of the evidence-based practice model (Davis, 2011). The research question plays an essential role in all the aspects of the research including the determination of the appropriate research design, data analysis tools, and theoretical framework adopted by a study (Ioannidis, 2016). The PICOT model, which encompasses five variables including patient population, intervention of interest, comparison intervention, outcomes, and time, provides the guidance for the construction of researchable questions in clinical areas of interest.
Area of Interest
Nosocomial infections affect millions of patients globally. They refer to hospital-acquired infections (HAIs) that affect patients admitted to healthcare sectors for treatment of other diseases. Patients face many risks of acquiring nosocomial infections including the length of hospital stay, age, gender, surgical procedures, urinary catheter, and intubation among others (Thoa et al., 2015). Examples of common nosocomial infections are pneumonia, gastrointestinal infections, and urinary tract infections. Nosocomial infections are highly prevalent in the Intensive Care Unit (ICU) where critically ill patients are admitted and require round the clock care and treatments. Many hospital-acquired infections are resistant to antibiotics and result in high patient mortality rates. For the patients, they suffer from excruciating pain and irritation and are forced to contend with a lengthier hospital stay. Moreover, nosocomial infections require costly treatment. Therefore, it is important to identify the control procedures that can be used to stop the spread of HAIs.
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Problem Identification and Significance
The problem of the study is establishing the role of hand hygiene as the first step to preventing nosocomial infections. Healthcare workers are the principal agents of transmitting nosocomial pathogens in the hospital (Thoa et al., 2015). The situation is attributable to the handling of many patients suffering from different illnesses, thus touching a patient without disinfecting the arms transmits the pathogens collected from another patient. Numerous studies have found out that observance of hand hygiene reduces the number of reported nosocomial infections. Hand hygiene is a simple activity that increases patient safety and care and at the same time reduces the huge cost burden of HAIs (Cornejo-Juárez et al., 2015). However, many healthcare workers are ignorant of the importance of hand hygiene in their routine activities in hospitals. Therefore, it is important to study how hand hygiene aids in the prevention of HAIs.
Research Questions and Feasibility Analysis
Several research questions can be formulated for the investigation of the identified problem:
1. What are nosocomial infections and their signs and symptoms?
2. What is hand hygiene?
3. What are the benefits of hand hygiene?
4. How do healthcare workers maintain hand hygiene?
5. How does the observing of hand hygiene among healthcare works help in reducing the prevalence of nosocomial infections among hospitalized patients in the ICU?
Analysis of these questions is critical in the identification of an answerable research question in the clinical study on hand hygiene and nosocomial infections. The questions were analyzed for three key aspects including significance, feasibility, and interest, and the question that met these requirements was selected as the best for conducting the research.
The significance of a research question refers to the extent to which the research question helps to acquire new knowledge in the area of study and is relevant to nurses and doctors. Moreover, a significant question should facilitate the development of new hospital policies by showing the importance of improving a particular aspect of the environment (Polit, & Beck, 2017). The first two questions focus on the definition of the constructs in the research question that is hand hygiene and nosocomial infections. Answering these questions provide essential background information about the study but they are not relevant to answering the research question. The third and fourth question provide new evidence on the topics as the signs and symptoms of nosocomial infections remain constant, and there is a standardized process of hand washing and disinfection adopted by hospitals worldwide. On the other hand, the fifth question is significant because it examines the relationship between hand hygiene and nosocomial infections, researching the link between the variables can lead to the generation of new knowledge.
Feasibility is another critical aspect of examining research question. The characteristics of a feasible research question include the availability of sufficient resources for collecting data, manageable scope, appropriate expertise, and enough number of research subjects (Polit, & Beck, 2017). The first question meets all the feasibility features apart from the manageability of scope, the financial budget for identifying nosocomial infections and their symptoms would be prohibitive. The second question and the third questions also have an unmanageable scope as different healthcare workers attach different meanings to hand hygiene and the benefits of hand washing are immeasurable. For the fourth question, the main problem would be the accumulation of sufficient resources to investigate the various ways that healthcare workers use to practice hand hygiene. The fifth question is specific and has a manageable scope, there is adequacy of research subjects among a large number of employees in the healthcare sector, and the investigation of the phenomenon is affordable.
Personal interest was the last criteria for analyzing the research question. As earlier stated, there is a personal interest to determine whether hand hygiene is the first measure of controlling the transmission of HAIs in hospitals. Finding the answer to this question is the primary motivation for conducting the study (Bandholm et al., 2017). From the five research questions developed above, it is only questioned five that focuses on the impact of hand hygiene in reducing nosocomial infections. Following this analysis, the best question of the study is how hand hygiene helps to reduce nosocomial infections in hospitals.
PICOT Analysis
Additionally, it is vital to conduct a PICO analysis of the research questions to determine the availability of adequate evidence-based theory and knowledge to answer the question (Bandholm et al., 2017). The first variable is the patient problem that is the development of nosocomial infections during the hospital stay. It is easy to identify patients suffering from HAIs by their signs and symptoms. The research question will need to reliably establish the number of patients reported to have developed HAIs during the research.
The second variable controls intervention. Nosocomial infections can be prevented through hand hygiene, where the healthcare workers wash and disinfect their hands before touching a patient. Therefore, the study will focus on observing how healthcare workers wash their hands and their frequency. The third variable is the outcome of the study. It is expected that the study will prove that hand hygiene reduces the risk of nosocomial infections among hospitalized patients.
Keywords help in the process of conducting the literature review by ensuring that the most relevant research information is collected on the study. There are at least ten possible keywords that can be used for the current research question how does the observance of hand hygiene among healthcare works help in reducing the prevalence of nosocomial infections among hospitalized patients in the ICU. The keywords include hand hygiene, nosocomial, infections, prevalence, ICU, hospitalized, patients, ICU, and healthcare workers. By using these keywords, all searches about the topic on the Internet and school libraries will yield the most relevant articles containing information on the topic. Therefore, by using the chosen research question, the relationship between hand hygiene and nosocomial infections will be reliably established.
References
Bandholm, T., Christensen, R., Thorborg, K., Treweek, S., & Henriksen, M. (2017). Preparing for what the reporting checklists will not tell you: the PREPARE Trial guide for planning clinical research to avoid research waste. Br J Sports Med, bjsports-2017.
Cornejo-Juárez, P., Vilar-Compte, D., Pérez-Jiménez, C., Namendys-Silva, S. A., Sandoval-Hernández, S., & Volkow-Fernández, P. (2015). The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit. International Journal of Infectious Diseases, 31, 31-34.
Davies, K. S. (2011). Formulating the evidence-based practice question: a review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75-80.
Ioannidis, J. P. (2016). Why most clinical research is not useful. PLoS medicine, 13(6), e1002049.
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice. 10th Edition
Thoa, V. T. H., Van Trang, D. T., Tien, N. P., Van, D. T., Wertheim, H. F., & Son, N. T. (2015). Cost-effectiveness of a hand hygiene program on health care–associated infections in intensive care patients at a tertiary care hospital in Vietnam. American journal of infection control, 43(12), e93-e99.
