NR 439 Week 3 Problem/PICOT/Evidence Search (PPE) Worksheet
Student Name
Chamberlain University
NR-439: RN Evidence-Based Practice
Prof. Name
Date
NR439 PPE Worksheet
Chamberlain College of Nursing
Problem/PICOT/Evidence Search (PPE) Worksheet
Name:
Date:
Clinical Nursing Practice Problem
The focus of this investigation is healthcare-associated infections (HAIs), which present a significant challenge in hospital settings. These infections often lead to prolonged hospital stays, increased patient discomfort, and additional financial burdens for healthcare facilities. Among the different types of HAIs, this study concentrates on catheter-associated urinary tract infections (CAUTIs).
CAUTIs are among the most frequently reported HAIs, primarily occurring due to prolonged use of indwelling urinary catheters. Many healthcare institutions have developed preventive protocols aimed at minimizing infection risk, such as frequent perineal care, daily cleansing of the catheter site with chlorhexidine gluconate (CHG) wipes, and prompt removal of catheters when they are no longer clinically necessary.
The selection of CAUTIs as the focal problem is based on their prevalence, preventability, and significant impact on patient safety and healthcare costs. By addressing CAUTI prevention, nurses can directly contribute to improving patient outcomes and reducing hospital expenses.
Clinical Nursing PICOT Question
In (P) patients with an indwelling catheter in a hospital setting, does (I) cleansing the catheter with chlorhexidine compared to (C) cleaning with soap and water (O) reduce the incidence of catheter-associated urinary tract infections (CAUTIs) over (T) a two-week period?
Defining the PICOT Elements
| PICOT Element | Definition from the Question |
|---|---|
| P – Patient Population | Hospitalized patients with an indwelling urinary catheter |
| I – Intervention | Daily perineal cleansing with chlorhexidine |
| C – Comparison | Daily perineal cleansing with soap and water |
| O – Outcome | Reduction in CAUTI incidence |
| T – Timeframe | Two weeks |
Evidence Retrieval Process and Summary
A peer-reviewed article retrieved from the Chamberlain College of Nursing library examined the effectiveness of daily CHG bathing in reducing CAUTI rates. The study, authored by DePrez et al. (2019), demonstrated a 28% reduction in infection rates when CHG wipes were incorporated into daily catheter care protocols.
This evidence aligns closely with the proposed PICOT question, as it directly evaluates the effectiveness of CHG versus standard cleansing methods. The selection of this article is based on its strong methodological design, relevance to nursing practice, and publication within the last decade.
APA Citation:
DePrez, B., Schreeder, C., Davidson, S., et al. (2019). Implementation of chlorhexidine gluconate bathing to reduce HAIs. Nursing Management, 50(1), 13–17. https://doi.org/10.1097/01.NUMA.0000602824.95678.0a
Implications of the Evidence
The reviewed evidence supports the integration of CHG in daily catheter care as a strategy for significantly lowering CAUTI rates. Since patients remain at risk for infection as long as the catheter remains in situ, early and consistent preventive measures are critical.
From an administrative perspective, preventing CAUTIs also has financial benefits, as hospitals cannot bill patients for expenses related to HAIs. By prioritizing CAUTI prevention through evidence-based interventions—such as sterile catheter insertion, CHG cleansing, timely catheter removal, and routine Foley care—healthcare organizations can improve patient safety and reduce avoidable costs.
Given these findings, the nursing evidence-based practice committee should continue researching interventions aimed at reducing HAIs, with CAUTI prevention as a high-priority initiative.
Evidence Search Terms
| Search Term | Description |
|---|---|
| CAUTI | Catheter-associated urinary tract infection |
| Hospital-acquired infections | General term for infections acquired in healthcare settings |
| CAUTI prevention | Strategies to reduce CAUTI incidence |
| Chlorhexidine gluconate | Antiseptic agent for infection prevention |
NR 439 Week 3 Problem/PICOT/Evidence Search (PPE) Worksheet
Evidence Search Strategies
| Strategy | Applied (Yes/No) | Notes |
|---|---|---|
| Full-text access | Yes | Ensured the article was accessible in full for review |
| Boolean operators | Yes | Combined keywords using AND/OR for precise results |
| Publication date limit (last 10 years) | Yes | Ensured research relevance and recency |
| Subject/title/author search | Yes | Narrowed down to CAUTI-specific studies |
| Truncation (*) | No | Not applicable for this search |
| Peer-reviewed journals | Yes | Ensured scholarly credibility |
| Quotation marks for key phrases | Yes | Used for exact matches of “catheter-associated urinary tract infection” |
| Selected PICOT terms | Yes | Integrated terms from PICOT question for targeted results |
References
DePrez, B., Schreeder, C., Davidson, S., et al. (2019). Implementation of chlorhexidine gluconate bathing to reduce HAIs. Nursing Management, 50(1), 13–17. https://doi.org/10.1097/01.NUMA.0000602824.95678.0a