Undead Scribe

Meta-Analysis: Infection Research Applicable to Nurses

Infections are a serious problem in the medical field, the rise of anti-biotic resistant bacteria, also known as “superbugs”, a much larger one. It is with this understanding that those in the medical field accept that nosocomial infections are such a problem, going to great lengths to ensure that patients remain in clean environments, doing their best to ensure that not only are the staff clean but ensuring that anything that the staff or patient touches remains clean as well. Nosocomial infections, or simply HAI’s, are defined as infections that patients develop while receiving treatment in a medical facility. These infections are not only dangerous on their own but have been known to cause complications in patients with compromised immune systems or those recovering from surgery. A reasonable estimate posits that in the United States, every twenty-fifth patient develops a healthcare-associated infection. From the amount of people who enter a single hospital in a day, that’s a grievous number of infected patients. Further steps must be taken in order to prevent such falls amongst adults.

Comparison of Research Questions

J. O'Gorman, (2012) mentioned the importance of applying copper, a noted anti-microbial material to resolve the problem of bacterial growth where patients and staff were most likely to contract it from. According to the author, this was to “review the rationale for copper use, the mechanism of its antimicrobial effect, and the evidence for its efficacy. (J. O'Gorman, 2012).” This is not a phenomenon that the wider medical community is unaware of and shouldn’t be thought of that way. In fact, the only thing truly needed was evidence of the efficacy of the biocidal material through rigorous testing in an actual clinical environment.

Lopez (2014) makes strong reference to the ongoing persistence of these infection-causing bacteria and how, despite normal cleaning methods, they may often remain on surfaces. He then discusses their lack of persistence and rapid death, discussing how the silver anti-microbial surfaces and fabrics serve as a deterrent to the growth and persistence of bacteria due to their inherent qualities, ensuring lifelong sustainability of microbial reduction. With this

Salgado, (2013) also referred to copper himself, stating that copper surfaces reduce the rate of healthcare-acquired infections in an intensive-care environment. Sifri (2016) also performed a study saying much the same thing, only utilizing a combination of self-disinfecting copper-impregnated composite hard surfaces and linens instead of copper mixtures or pure copper surfaces as several others did. SS Huang (2016) asked a differing question, specifically the risk of acquiring antibiotic-resistant bacteria from prior room occupants while in the same room with standard surfaces. This was asked in opposed to a method of lowering the risk using different surfaces. Esolen (2017) asked specifically about the efficacy of self-disinfecting bedrail covers in an intensive care unit, aiming his focus specifically on one type of surface that the patient touched the most. Schmidt (2017) asked regarding the use of antimicrobial copper alloys on stethoscopes in a method to decrease bacteria transfer. The aim of this study was to assess the efficacy of antimicrobial copper surfaces to reduce the bacterial concentration associated with stethoscope surfaces. The final study by one EL Marcus (2017) was regarding the reduction of health care-associated infection indicators by copper oxide-impregnated textiles.

Comparison of Sample Population

The articles that have been described above have done research utilizing different sample populations while focusing on generally the same issues, with some slight differences in questioning and method. Lopez (2014) utilized a laboratory as opposed to a clinical environment, ignoring a population entirely. Gorman did something similar, utilizing a meta-analysis to compare different previously tested copper anti-microbial studies. On the other hand, Salgado (2013) selected three different Intensive Care Units from three separate hospitals, utilizing their patient data and performing a randomized control trial from July 12, 2010 to June 14, 2011. Sifri (2016) collected data from a quasiexperimental study utilizing two hospital wings with a total of seventy-two beds. SS Huang (2016) performed a retrospective cohort study utilizing a total of eight ICUs, while Schmidt (2017) focused on retrieving data from both a pediatric emergency room and an adult intensive care facility.

Comparison of limitations of the study.

The article by Lopez (2014) has a few limitations. First, the quantitative aspect of the study provides strong data but the simple fact that it did not take place in a clinical environment leaves it without proper context, especially regarding what methods one would take to properly utilize it. Because this study also did not take into account a hypothesis as opposed to simple data collection, findings are further limited. The meta-analysis of Gorman also suffers from similar reasons, considering that meta-analyses cannot improve the quality or reporting of the original studies. Other limitations come from misapplications of the method, such as when study diversity is ignored or mishandled in the analysis or when the variability of patient populations, the quality of the data, and the potential for underlying biases are not addressed

Conclusion

From the above discussion, it can be concluded that the use of these surface materials in place of the current ones would serve very well in the process of mitigating the growth of infection as well as reducing overall infection rates. Lowering infection rates would lead to saving a great deal of money for the facility itself, funds that would be seen over a lifetime in return for the one-time expense of the biocidal materials themselves. However, several of the studies recommend further testing in clinical environments despite generally positive results across the board. It is clear that public health sectors need to take notice of the issue and take steps before bacteria reach of state of complete resistance to antibiotics, further hurting the field of medicine.

Works Cited

CD Sifri, G. B. (2016). Reduced health care-associated infections in an acute care community hospital using a combination of self-disinfecting copper-impregnated composite hard surfaces and linens. American Journal of Infection Control, 1565-1571.

EC Abboud, T. L. (2014). Do silver-based wound dressings reduce pain? A prospective study and review of the literature. Burns: Journal for the Infection of Burn Injuries, 40-47.

EL Marcus, H. Y. (2017). Reduction of health care-associated infection indicators by copper oxide-impregnated textiles. American Journal of Infection Control, 401-403.

Graves, N. (2004). Economics and Preventing Hospital-acquired Infection. Emerg Infect Dis., 561-566.

Gregor Grass, C. R. (2011). Metallic Copper as an Antimicrobial Surface. Applied and Environmental Microbiology, 1541-1547.

Ilker Uckay, S. H. (2014). Preventing Surgical Site Infections. Expert Review of Anti-infective Therapy, 657-670.

J. O'Gorman, H. H. (2012). Application of copper to prevent and control infection. Where are we now? The Journal of Hospital Infection, 217-223.

LM Esolen, L. T. (2017). The efficacy of self-disinfecting bedrail covers in an intensive care unit. American Journal of Infection Control, 0196-6553.

Maillard, J.-Y. (2005). Antimicrobial biocides in the healthcare environment: efficacy, usage, policies, and perceived problems. Therapeutics and Clinical Risk Management, 307-320.

Matthew P. Muller, C. M. (2015, December). Antimicrobial Surfaces to Prevent Healthcare Associated Infections: A Systematic Review. Open Forum Infectious Diseases.

MG Schmidt, R. T. (2017). Antimicrobial copper alloys decreased bacteria on stethoscope surfaces. American Journal of Infection Control, 642-647.

R Gigosos Lopez, A. M.-B.-L. (2014). Persistence of nosocomial bacteria on 2 biocidal fabrics based on silver under conditions of high relative humidity. American Journal of Infection Control, 879-884.

Salgado, C. D., Sepkowitz, K. A., Cantey, J., Cantey, J. R., Attaway, H. H., Sharpe, P. A., . . . Schmidt, M. G. (2013). Copper surfaces reduce the rate of healthcare-acquired infections in the intensive care unit. Infect Control Hosp Epidemiol., 479-486.

SS Huang, R. D. (2016). Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Archives of Internal Medicine, 1945-1951.