Patients in assisted living facilities are vulnerable to healthcare-related infections (HAIs). The transmission of the diseases results in a poor quality of life for patients. As a result, the problem causes an increasing trend of hospitalization. Catheter-associated urinary tract infections (CAUTI) are a common infection in nursing care homes. Hence this issue requires an application of primary care prevention strategies. The essay will focus on the findings from the articles reviewed and how they relate to the PICOT question.

Background
The studies reviewed show that CAUTI is a common healthcare-related infection that affects individuals living in nursing homes. Smith et al. (2017) explored the link between the safety culture in nursing homes and the prevalence of CAUTI. The objective of the research was to assess the relationship of the nursing home level reports on safety culture and the prevalence of the infection before and after implementation of the technical, as well as socio-adaptive strategies. Smith et al. (2017) examined how safety culture in nursing homes was correlated to the prevalence rates of the infection and other healthcare-related infections in geriatric patients. The article also explores whether prevention intervention strategies can be used to minimize their rate.

The reduction of unnecessary use of indwelling urinary catheters (IDC) is crucial to prevent CAUTI. In a study by Parker et al. (2017), the researchers explore how to minimize the duration of IDC use in geriatric patients in nursing homes and minimize the frequency of inappropriate application of the devices through inducing bundled catheter care. In the study, the researchers have set various objectives, such as identifying the rate, as well as the incidence of the infections before and after the intervention, obstacles to the implementation, effectiveness, and the cost-benefit of the strategy.

The nursing problem is the prevalence of CAUTI in assisted living facilities. The articles seek to explore an effective intervention strategy for catheterization to reduce the rates of infection. The PICOT question has to be relevant to the problem identified. Therefore, the PICOT questions are “in geriatric patients, does the use of IDC when compared to other prevention strategies lower the incidence rates of CAUTI?”

Nurse Practice Issue
The selected readings are important to nursing practice since they add to the existing body of literature on healthcare-related infections in geriatric patients in nursing homes and effective intervention strategies. In articles used, the target intervention group is relevant to the proposed future studies and nursing practice in general. Geriatric patients residing full time in the nursing homes were used as a control group. For instance, Smith et al. (2017), in their study, used facilities that do not practice the proposed intervention strategies as a comparison group. On the other hand, Parket et al. (2017) purposed to include adults who undergo urinary catheterization in their study as a comparison population. However, in the current research, patients in nursing homes will be used to make a comparison to the elderly in other healthcare settings. The selected articles offer vital information about various interventions and the effects of safety culture on the prevalence rates of infection in geriatric patients.

Research Methods
In the selected articles, the researchers have used different research techniques. For instance, in the study conducted by Smith et al. (2017), a prospective cohort study is used to determine whether assisted living facilities intervention strategies are effective in reducing the prevalence rates of CAUTI and other healthcare-related infections. On the other hand, Parket et al. (2017) employed a multiple pre-post control intervention approach that applied a phase mixed-method approach. The methods are related since they require the gathering of baseline data before the beginning of the strategy and after the conclusion.

The use of multiple-pre-post strategy involves two stages where information is collected before and after each stage. The research methods used in the studies have pros and cons. For example, both methods need more time to complete the investigation (Krein et al., 2017). A prospective cohort study is preferred when collecting data at given time intervals, which prevents bias. Although the pre-post method is cost-effective and easy to use, the technique may be challenging when determining whether the changes observed arise due to the interventions examined.
Results of the Study
It is easy to evaluate the outcome of the articles selected. For instance, in the study by Smith et al. (2017), it is evident that applying technical and adaptive prevention strategies can result in a reduction in the incidence rates of infection in geriatric patients. Therefore, the implementation of the schemes described in the selected readings can result in the overall improvement in the safety culture of the sampled nursing homes (Smith et al., 2017). The study by Parker et al. (2017) will assist in determining the barriers to implementing effective intervention strategies. Therefore, the selected articles will highlight the obstacles to offering quality care to geriatric patients residing in nursing homes. Besides, the studies will determine whether technical socio-adaptive and other intervention strategies can assist in reducing the infection rates in patients.

Ethical Considerations
Any medical research conducted on human subjects is required to comply with ethical standards. Therefore, when experimenting, researchers should obtain informed consent from individuals to protect their confidentiality and ensure anonymity (Krein et al., 2017). Therefore, it can be suggested that the selected articles adhered to the required ethical standards because the researchers never disclosed the participants’ confidential information. According to Travers et al. (2015), informed consent was obtained from individuals interviewed, which complies with the first obligation. Overall, the researchers adhered to ethical considerations in their work.

Outcome Comparison
The anticipated outcome for the PICOT question is that the use of other prevention strategies in geriatric patients reduces the chances of CAUTI compared to the use of IDC. Therefore, the outcomes of the selected articles compare to the anticipated outcome since the proposed studies anticipated the anticipated outcome in the findings. For instance, the researchers indicated that the incidence rates of CAUTI and other healthcare-related infections in geriatric patients in nursing homes is higher compared to patients in other healthcare settings. Moreover, the researchers noted that educational intervention strategies for healthcare professionals and patients can assist in reducing the rates of infection. Therefore, the expected outcome can be compared to those of the reviewed readings. For example, Smith et al. (2017) observed a significant reduction in CAUTI and other healthcare-infection rates. As a result, the proposed research will confirm specific obstacles to intervention strategies, which include lack of knowledge on the use of urinary catheters and infections which are addressed. Overall, the anticipated results will be easy to compare with the outcomes of the reviewed research articles.

References
Krein, S. L., Harrod, M., Collier, S., Davis, K. K., Rolle, A. J., Karen E. Fowler, K. E., & Mody, L. (2017). A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: A qualitative assessment. American Journal of Infection Control, 45(12), 1342–1348. Web.

Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): A pre-post control intervention study. BMC Health Services Research, 17(1), 314–325. Web.

Smith, S. N., Greene, M. T., Mody, L., Banaszak-Holl, J., Petersen, L. D., & Meddings, J. (2017). Evaluation of the association between nursing home survey on patient safety culture (NHSOPS) measures and catheter-associated urinary tract infections: Results of a national collaborative. BMJ Quality & Safety, 27(6), 464–473. Web.

Travers, J., Herzig, C. T., Pogorzelska-Maziarz, M., Carter, E., Cohen, C. C., Semeraro, P. K., … Stone, P. W. (2015). Perceived barriers to infection prevention and control for nursing home certified nursing assistants: A qualitative study. Geriatric Nursing, 36(5), 355–360. Web.