Urinary Tract Infection - Term Paper Example

?INTRODUCTION             This purpose of this paper is to critically appraise a research article d “A prospective, controlled, randomized studyof the effect of a slow-release silver device on the frequency of urinary tract infection in newly catheterized patients” written by Reich, T., Lisby, G., Jorgensen, S., Christensen, B., & Nordling, J. (2000) and published in the British Journal of Urology International. The reason of selection of this research article is that the presence of an indwelling urethral catheter allows continuous access of organisms into the urinary bladder. Analysts and researchers have found out that the duration of catheterization is very important risk factor in the development of catheter-associated bacteriuria. Urinary Tract Infection refers to the presence of germs in the urinary tract. It is a very common type of infection like respiratory tract infection. Having a catheter within a urinary tract increases the chances of a urinary tract infection. It also makes it harder to treat the original infection for which catheter was using. Bacteria will grow in it if the urinary catheter is left in place for a long time. A large number of bacteria in the urinary tract may result in a harmful infection. Most catheters associated urinary tract infections are caused by bacteria. Wilson and Jenner (2007) stated: “The presence of a urethral catheter interferes with the natural mechanism. The urethral catheter is thus a major predisposing factor in urinary tract infections in health services.” (P: 217) Researches done in the filed of nursing practices improve the practice of nursing and health services along with raising the standards of the profession but not every research is properly done and can be considered to bring a change in nursing practice. Such researches must be evaluated to estimate the worth of the study and the evidence provided in it to critically appraise the study.   CRITIQUE The title of the study, ‘A prospective, controlled, randomized study of the effect of a slow-release silver device on the frequency of urinary tract infection in newly catheterized patients’ explains what the study is about. The title does not include the population covered under this study but includes the major outcome being measured. The study population here is the people experiencing urinary tract infection due to catheterization. The major outcome being measured is the occurrence of urinary tract infection due to the use of catheters. The aim of this study paper is to test the effectiveness of a “newly designed urine-collecting system containing an antibacterial device which slowly releases silver ions onto the inner surface of the system” to prevent or reduce the chances of UTIs due to the use of catheters. The purpose of this research is feasible, relevant, healing and interesting. The study provides an abstract of the complete study which gives a quick view of its objective, study population and the conclusion derived. The abstract is usually considered as an essential part of an article in order to convey its important points to users with very limited time. The writers divide the abstract into five parts i.e., objective, patients and methods, results, conclusions and keywords. Abstract also reveals the focus and important aspects of the study according to the researchers. The actual study begins with the part of introduction. The introduction part is important because it defines the problem that is to be resolved and the reason why it is important to resolve that particular problem. In a standard research study, this part is divided into three parts which are background, rationale, and conceptual framework of the study. But this paper does not provide such a consistent introduction. The introduction is lengthy and not divided into these formal parts. The next part in a standard research paper should have been the literature review which is a collection of information about former researches conducted in relevance with the topic of the research. However this paper does include the part of literature review which could be useful in justifying the need of this research. In the presence of a quite lengthy introduction, the researchers may consider that all the information and justifications have been provided in the introduction part so there is no need of a separate part of literature review. The researchers again did not follow the formal outline of a research study. The introduction explains the question that is to be answered very thoroughly and also the reason for finding a solution for the problem. Several researchers including David Schlossberg (2008) reasoned out that: “The most effective means of preventing catheter-associated infection is not to use a catheter or, if there is a compelling clinical indication for use, to limit the duration of catheterization to as short a period as possible.” (P: 765) The methodology part comes next in a standard research study. Again the formal outline is not followed and research methodology is not mentioned as a separate part. However it explains the method used to collect relevant data, how the data was collected and analyzed, the participants on whom the test was conducted and criteria of exclusions. One significant weakness in this paper is that it did not justify its choices, priorities and criteria. It also does not explain that why a control trial was used to conduct this research and why it is considered appropriate for this particular type of study. It appears that the article is written by keeping only medical people in mind as the researchers do not explain the reason of choosing a particular study design. Several other non-medical people may become curious in order to understand the rationale of the research conducted. As per the standard research study format, the part of methodology includes sub-headings of design, analysis and method of data collection to provide specific and relevant information to its readers. A standard research paper should also include the study design, study population, and the plan for data analysis which this particular research paper strongly provides but with different sub-headings. In the patients and methods part, a description is given regarding the set up of the environment where research was conducted, the criteria of selecting samples and the criteria of exclusions of certain patients. It also provides that how the data will be collected and analyzed. However, again the rationale of the research procedure is not given by the researchers. Such a weakness may undermine the capabilities of the researchers. The results part of the research study presents the results in a statistical format of how many in the total population. The main characteristics of the study population as a whole, and as comparative groups are described thoroughly. Results are presented textually and also in the form of tables along with the use of diagrams for better understanding of readers. The results are appropriately summarized and the choice of diagrams is highly effective. It provides the characteristics of the study population “170 patients were eligible for analysis, 83 in the AB group and 87 in the control group”. It also explains that how many patients were selected initially but due to other circumstances, the research was narrowed down to those 170. The results are presented in text and also in the table format to supplement the text conclusions. The table format also concisely present the quantified result of the test conducted and the variations are more distinct to understand in this format of data presentation. The article does not include any part or information regarding an important part of research papers which is internal validity. In the last part of discussion, the results are formed in the light of the statistics obtained through tests and analyzed in the light of the general schema of general medical practices. The pattern of study design is effective and one of the strong points of this research study. It is also observed that the discussions on the impact of other factors like effect of antibiotics on the urinary tract infection are lengthier than the effect of anti-bacterial device. In this part of the study, results should have been compared with similar information from other sources and researches and the differences should be identified. But this is not the case for this study and here we see another lack of the study. The ultimate impact of the study and the result derived through it is also discussed, structured and helpful. After the discussion part, there must be a section on conclusion. In an ideal research paper, the conclusion should be the last part in the paper including the final observations and recommendations. However there is a conclusion mentioned in the abstract at the start of the paper. It is a very precise conclusion but at least provide the conclusive answer of the research question.   CONCLUSION The research on “A prospective, controlled, randomized study of the effect of a slow-release silver device on the frequency of urinary tract infection in newly catheterized patients” by Reich, T., Lisby, G., Jorgensen, S., Christensen, B., & Nordling, J. (2000) has its strengths and weaknesses. The authors of the research should provide a scholarly discussion of the research activity that they conducted in which the results indicate a mastery of the topic. In this particular paper, the authors did present a mastery of the topic researched. However, the authors presented a mastery of the topic but the results are not useful enough to provide benefit to the entire medical and the nursing services system. The biggest weakness of the study is flaws in the article form due to improper presentation. Its redeeming point is only that the data collection and measurement is very focused and result-oriented. Although the results achieved are not very relevant to the medical community. Precisely, this particular study is not useless overall but the problem of urinary tract infection due to catheterization is still unresolved. REFERENCES David Schlossberg, (2008), Clinical Infectious Disease (illustrated), Cambridge University Press; Stickler DJ, Morris NS, Williams TJ, (1996), An assessment of the ability of a silver-releasing device to prevent bacterial contamination of urethral catheter drainage systems. Br J Urol; 78: 579-88. Read More