Nurses Knowledge on Ventilated Associated Pneumonia Prevention Synthesizing & Describing: Differences & Similarities of Various Research Components

The study provides the similarities and differences of the three studies (Al-Sayaghi, 2014, Bagheri-Nesami, & Amiri, 2014, Labeau, Vandijck, Claes, B. et al. 2007) by comparing their statement of problems and significant of the studies.

The three studies identify the VAP (Ventilator-associated pneumonia) as the most common HAIs (hospital-acquired infections) among patients in the intensive care unit. (Al-Sayaghi, 2014, Bagheri-Nesami, & Amiri, 2014, Labeau, Vandijck, Claes, B. et al. 2007). All the studies believe that the VAP can lead to high rates of mortality, and morbidity leading to an increase duration of hospitalization. (Al-Sayaghi, 2014, Bagheri-Nesami, & Amiri, 2014, Labeau, Vandijck, Claes, B. et al. 2007). They identify associated problems of VAP as longer stay in hospitals, and increased use of resources. However, Al-Sayaghi, (2014) provide detailed statistics related to VAP problems by pointing out that VAP incidence rate is between 3.6 and 73.4 per 1000 ventilator-days and account for between 27% and 47% of all ICU infections. Moreover, the author points out that VAP increases antibiotic consumption, and extends hospital stay, which consequently leads to additional costs of hospitalization of between $40,000 and $57,000. On the hand, Bagheri-Nesami, & Amiri, (2014) use the U.S. data to discuss the associated problems of VAP. The authors reveal that VAP can increase a patient hospital stay from 4.3 to 13 days and rise in hospital therapeutic costs of between $12,000 and $40,000. However, only Bagheri-Nesami, & Amiri, (2014) discusses various guidelines concerning VAP's preventive measures in various part of the world explaining the European position for discontinuing using the drugs to modify the care procedure and reduce VAP incidence in Europe.

However, all the studies point out that the nurses' knowledge with reference to evidence-based practice is disappointing. They believe the lack of knowledge has been identified as a barrier to EBP (evidence-based practice). Moreover, many ICU nurses lack knowledge on evidence-based strategies that can be employed to prevent VAP. Al-Sayaghi, (2014) use the data collected from ICU in Yemen to demonstrate that nurses lack knowledge about the evidence-based practice to address the associated problem of VAP in Yemen ICU. One study (Bagheri-Nesami, & Amiri, 2014) argues that there is an absence of data to assess the performances of intensive care units in Iran with reference to VAP preventive measures. Similar to other studies, the authors argue that lack of knowledge has been the major barrier to the implementation of VAP prevention. In a healthcare setting, nurses should provide a critical role for VAP preventive measures, Bagheri-Nesami, & Amiri, (2014) point out that nurses' knowledge is essential for VAP prevention; however, low level of nurses' knowledge concerning a preventive measure has been the problems with the application of VAP in the ICU.

Significance of the Study

The three studies evaluate the working knowledge of nurses in the ICU (intensive care units), and believe that the best way to improve standard care in a healthcare setting with reference to VAP prevention is to evaluate nurses' knowledge by developing a questionnaire to evaluate nurses' knowledge for VAP prevention. (Labeau, et al. 2007).

Research Questions

All the studies do not provide the research questions despite the elegant way the authors present the study significant.

Study Design

Bagheri-Nesami, & Amiri, (2014) developed a questionnaire to evaluate the knowledge of professional nurses working in the ICU in Sari's educational hospital in Iran. Labeau, et al. (2007) collected data from a total number of 638 sample population in the United States where 166 (26%) were men and 472 (74%) were female respondents. On the other hand, Al-Sayaghi, (2014) used 387 total sample population where 299 (59.2%) were female, and 155 (40.1%) were male participants. Both Labeau, et al. (2007) and Al-Sayaghi, (2014) provide a detailed demographic data of the sample population. Al-Sayaghi, (2014) provides the age, educational qualification, and total nursing years of experience as well as ICU nursing experience of the sample population in Yemen. Moreover, Bagheri-Nesami, & Amiri, (2014) collect data on nurses years of ICU experience, and their experience in the emergency nursing unit. While Bagheri-Nesami, & Amiri, (2014) provided the demographic data of the population, however, the data were not presented in a tabular form making the data look ambiguous. The other two studies present the demographic data of the sample population in the tabular forms assisting in enhancing the visual presentation of the data. However, the three studies do discuss the theoretical framework related...

(2007) and Al-Sayaghi, (2014) discuss the strategy they employ in carrying out the expert validation of the data collected to enhance the reliability and validity of the research findings. Labeau, et al. (2007) presented the questionnaire to a panel of 8 experts for content validation, and each expert has more than 3 years of working experience and having a master's degree in medicosocial science or nursing science with a special interest the ICU-acquired infections. The experts were able to ascertain the validity of the questionnaire by confirming the questions were well written. The experts unanimously agreed with the clarity and contents of the questionnaires after a verification. On the other hand, Al-Sayaghi, (2014) carried out the validity of the Arabic and English version of the questionnaire, which was reviewed by 5 experts, 4 senior intensive care unit nurses and a specialized nursing educator. Similar to the strategy that Labeau, et al. (2007) experts used to enhance the validity of the questionnaire, the experts also evaluated Al-Sayaghi, (2014) questionnaire to ascertain that all questions were clearly worded. However, the experts modified some wording in the questionnaire to enhance their clarity and readability.
Two of the studies use the questionnaire to collect data and SSPS package for the analysis. (Bagheri-Nesami, & Amiri, 2014, Al-Sayaghi, (2014). However, Labeau, et al. (2007) use the review of evidence-based guideline technique and questionnaire for data collection and however, the author do not discuss the statistical package used for the analysis. Bagheri-Nesami1 et al. (2014) used Test-test to enhance the reliability of the data; the descriptive statistics were carried out to summarize the data in a manageable form. Moreover, the descriptive statistics is provided in mean, standard deviation, and percentages format. Similarly, Al-Sayaghi, (2014) use the descriptive statistics to summarize the data in a manageable form. However, the author used the continuous variables using the standard deviation and means, interquartile ranges and medians to describe the data. Moreover, Al-Sayaghi, (2014) used linear regression analysis, t-test, and F-test for the analysis. Contrarily, Labeau et al. (2007) carries out the data analysis and use the percentage to compare the value of the data. Of all the three studies, only Al-Sayaghi, (2014) discussed the method they employed for the protection of human subjects by seeking the approval of Ethical and Research Committee of the Faculty of Health and Medicine at Sana's University. The Committee approved the study and issued an ethical clearance.

Critique: Strengths & Limitations of Studies

Each of the studies has its strength and limitation. Al-Sayaghi (2014) is the most comprehensive of the three studies by discussing the ethical consideration revealing the method used to protect the privacy of the participants. In the nursing research, protection of human subject is essential to make them releasing their private information without fear. According to Al-Sayaghi (2014), "Participation in the survey was voluntary, and the completion of the questionnaire was assumed to imply consent. Confidentiality of participants (individuals) and participating hospitals was maintained" (p 271).

All the three studies used the expert validators to ascertain the validity and reliability of the research findings. However, none of the studies used the IRB (Institutional Review Board) for the research approval. Moreover, all the three studies use the systematic sampling to select the sample population for the research, the sampling method assists in evaluation the knowledge of nurse on VAP. Both Al-Sayaghi, (2014) and Bagheri-Nesami et al. (2014) presented clear and valid research findings. Al-Sayaghi, (2014) revealed that VAP's nurses knowledge is low and Bagheri-Nesami et al. (2014) revealed that VAP's nurses knowledge is average, however, Labeau, et al. (2007) presented the vague results difficult to interpret.

The limitation of other two studies (Bagheri-Nesami1 et al., 2014, Labeau, et al. 2007) is that they do not discuss the method used to protect the privacy of the participants. Despite this limitation, the strength of the two studies is that they discuss a comprehensive strategy used for the analysis (Nesami1 et al., (2014) and Nesami1 et al., 2014). By using the SSPS for the analysis, the studies are able to eliminate bias from the results, which enhances the research reliability and validity. This has been the limitation of the Labeau, et al. (2007) research by not discussing the software used for the analysis. When a researcher uses a manual method for the analysis, the results can contain error, which may erode the research validity. Despite this limitation, Labeau, et al. 2007) was able to achieve content validity of the questionnaire. The limitation of the Bagheri-Nesami et al. (2014) study was that the authors did not use the…