Question

This pre- and post-interventional study was conducted at a metropolitan, not-for-profit, Magnet®-designated facility in the northwestern United States. Registered nurses (RNs) and certified nurse assistants (CNAs) from a medical-surgical PCU were invited to participate. The intervention included an educational in-service for nursing staff, implementation of an oral care protocol, and adoption of a daily oral hygiene kit located at the bedside. Data were collected via retrospective chart audit for patients who met inclusion criteria. Staff knowledge was assessed using an online questionnaire developed by the investigators. The seven-item multiple-choice questionnaire was used to determine staff knowledge regarding the importance of oral care practices on the unit and barriers encountered in providing regular oral care. The questionnaire was developed after team members conducted an extensive literature review. A master’sprepared nurse manager with ex pertise in the care of high-acuity patients with respiratory disorders determined face validity of the staff survey. In addition, the survey was evaluated for readability and clarity by content experts from among clinical staff not participating in the study as well as staff from the Speech Pathology Department. It was determined to be appropriate for administration to nursing staff. An external clinical nurse specialist (CNS) with national recognition in acute and critical care was invited to provide the intervention education. After the literature re view, the research team suggested content and collaborated with the CNS in development of the education intervention. This CNS conducted an original 1-hour presentation on the impact of oral hygiene practices in eliminating NV-HAP in the acute care setting. Included were methods to ease adoption of practice im provements. The session was recorded and a digital video disc copy made available to staff members who were unable to attend. The CNS also provided personalized education to staff members who were involved in direct patient care at the time of the presentation. A convenience sample of pat ients was selected from the daily census before the intervention and at 5, 7, and 9 weeks after intervention. An electronic health record data collection tool was developed to assess the frequency of patient refusal and completion of oral care documentation by nursing staff. Inter-rater reliability for chart audits was established after researchers independently reviewed charts and achieved 100% agreement. Addit ionally, the data collection tool was used to identify the frequency of factors that place patients at higher risk for aspiration pneumonia: being unable to take anything by mouth, having a modified diet texture or liquid consistency, and/or using a tube feeding (Maeda & Akagi, 2014). To enhance the ability of staff members to deliver oral hygiene, the study site trialed a pre-packed kit (Q•Care®; Sage Products LLC) consisting of four tear-off oral hygiene kits to be used throughout a 24-hour period. All four sections contained a combination antiseptic cleanser and mouth moisturizer. Two of the kits contained a suction toothbrush and the other two kits contained a suction swab. The product was placed at the head of the patient’s bed each morning by night staff to provide a visual cue for oncoming staff to perform oral hygiene. A representative from the manufacturer was trained on the study protocol and provided justin-time training over 1 week for day and night shift staff before implementation of the intervention. An oral hygiene guideline (adapted with permission from Quinn & Baker, 2015) was implemented for patients without a tracheostomy or who were not ventilator-dependent. This protocol specified patients were to receive oral hygiene using the oral care kits four times a day. Patients who were capable of self-administering hy giene were encouraged to use the product with supervision. Staff were trained to document completion of oral hygiene or patient refusal. The protocol was posted strategically around the unit, emailed to staff, and kept at the charge nurse station for easy access and reference

From the above article answer the question:   

1)     Give a complete description of the research design of this study.

Answer 1

Answer: A data collection procedure helps to identify and analyse the collection of data. There are qualitative and quantitative methods of collecting data. Both the methods helps to process the information and analyze the results. Here data was collected through retrospective chart audit for patient who met inclusion criteria. Whereas the seven multiple questionnaires were used to analyze the knowledge of the Healthcare staffs and also regarding the importance of oral care practices on the unit and barriers encountered in providing regular oral care. The data collected for the risk of pneumonia, whereas reform studies were done to analyze the data collected. Inter-rater reliability for chart audits was established after researchers independently reviewed charts and achieved 100% agreement as when an electronic health record data collection tool was developed to assess the frequency of patient refusal and completion of oral care documentation by nursing staff. This kind of data collection, identification of the opportunity has been done after that the issues and the risk that may involved or can occur is being identified. Planning and approach performed and at last data has been collected.