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Question
You are the nurse educator and an EBP mentor for the Medical Intensive Care Unit (MICU) at your hospital. Central Line Associated Bloodstream Infections (CLABSI) rates have been on the rise. You and your staff nurses decide to take an evidence-based practice approach to try to mitigate this issue. You create a PICOT question (Step 1), use your PICOT question to identify key words you used to search the databases with (Step 2) and discover literature that explores possible solutions to bringing down your CLABSI rate (Step 3). The articles your team discovers are mostly quantitative research studies (three randomized controlled trials (Level 1), two cohort studies (Level IV), and five descriptive studies (Level IV) but also includes several qualitative research studies (two phenomenology studies) and cover everything from giving patients daily baths with chlorhexidine to using alcohol-impregnated caps on the ends of your central lines and from implementing practice guidelines to using care bundles to address CLABSI. Several of the more senior nurses from the unit just returned from the American Association of Critical Care Nurses' (AACN) national conference where they attended a luncheon presentation where data from a research study funded by the company that sells alcohol impregnated caps reported a decline in the incidence of CLABSI when the caps were used on central lines. The nurses were very impressed with the presentation and the reported impact these caps had on CLABSI rates in the randomized controlled trial study that was presented. They are strongly advocating to implement these caps, and only want to appraise the articles that discuss use of these caps. Other nurses aren't so comfortable limiting articles chosen for appraise to just one intervention and ignoring other studies they retrieved. What do you think about the senior nurses' request to only appraise the articles that discuss the use of alcohol-impregnated caps?
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