I need two separate responses to the discussion


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I need two separate responses to the discussion

1-The clinical quality problem I am trying to improve will be CAUTIs and I will apply a quasi-experimental design for quality improvement. Quasi-experimental designs test cause and effect relationships, but they are missing the random assignment or presence of a control group. I would apply a quasi-experimental design because of the ease for adaptability to the real world setting than the experimental design that’s more of a controlled setting. LoBiondo-Wood and Haber also mention that, “Researchers turn to quasi-experimental designs to test cause-and-effect relationships because experimental designs may be impractical or unethical” (LoBiondo-Wood and Haber, 178). The design for quality improvement may, with some changes, be used with/for other populations, so we have to be specific with the clinical quality problem we are trying to improve, in this case CAUTIs, but at the same time general or have an ease to adapt to other problems that need quality improvement.

Like everything, this design has its strengths and its weaknesses. According to LoBiondo-Wood and Haber, “Quasi-experimental designs are used frequently because they are practical, less costly, and feasible, with potentially generalizable findings” (LoBiondo-Wood and Haber, 176). Unlike experimental designs that are complicated to design and may be costly to implement, some of the strengths of quasi-experimental designs are that they are more practical and affordable to put in action. Zhong and colleagues state that, “Although it was a quasi-experimental study and no adequate control group was set, it controlled the rise and fall trend of the outcome variables before the interventions and still obtained relatively robust results” (Zhong). A known weakness is highlighted by LoBiondo-Wood and Haber, “Quasi-experimental designs are lower on the evidence hierarchy because of lack of control, which limits the ability to make confident cause-and-effect statements that influence applicability to practice and clinical decision making” (LoBiondo-Wood and Haber, 176). Overall, I feel like this design is the best option for the CAUTI quality improvement since it’s more adaptable to the real world setting and the findings can be generalized to other potential problems.

LoBiondo-Wood, G., & Haber, J. (2018). Nursing research: Methods and critical appraisal for evidence-based practice (9th ed.). Elsevier.

Zhong, X., Xiao, L., Wong, D., Yang, S., Mo, L., He, L., Wu, Q., Chen, Y., & Luo, X. (2020). Impact of a quality control circle on the incidence of catheter-associated urinary tract infection: An interrupted time series analysis. ScienceDirect



One of the clinical quality problems I have decided to tackle is the issue of Central Line-Associated Bloodstream Infections (CLABSI). Healthcare settings consider CLABSI important because it may result in critical complications and deaths. A Randomized Controlled Trial(RCT) has been considered a suitable research design for improving the quality of care while reducing the rate of CLABSI in children.
An RCT involves randomly assigning participants (in this case, healthcare facilities or units) into the Intervention and Control Group. For CLABSI prevention, the intervention group would be assigned multifaceted strategies, including specialized training for health professionals, heightened infection control measures, and the application of innovative catheter management technology (Carey, 2023). This group would be allowed to use existing practices as usual.
RCTs play a critical role in fighting CLABSI by providing effective controls for confounding factors obtained through randomization. It helps distribute the potential influences equally among the intervention and control groups, making establishing direct causation between intervention and result easier (Sharma, 2020). RCTs also provide an ideal platform for measuring the real effectiveness of interventions as they remove any prejudice or irrelevant factors. In this way logical approach increases the believability of the results, provides evidential-based decisions and useful strategies for decreasing the number of cases of CLABSI, it promotes the improvement of quality care and safety among patients in organizations (Sharma, 2020).
But we should bear some limitations in mind. Conducting RCTs is also considered resource-intensive and time-consuming, mainly in healthcare settings where instant impacts must appear. Some ethical issues like equipoise and patient allocation can arise in this case. Furthermore, randomization could be opposed by both staff as well as the practical implementation (Sharma, 2020).
Therefore, this design is reliable for improving patient care quality and reducing CLABSI incidence since it employs a randomized control trial. On the one hand, despite being good at offering top-quality proof of interventions’ efficacy, some constraints need to be considered while implementing them to achieve success regarding the delivery of patient care and, ultimately, positive healthcare results.

Carey, S., Men, M., & Cunich, M. (2023). The Impact of Targeted Interventions Aimed to Improve Quality of Life in Patients Receiving Home Parental Nutrition–A Systematic Literature Review. Journal of Human Nutrition and Dietetics. https://onlinelibrary.wiley.com/doi/abs/10.1111/jh…
Sharma, N., Srivastav, A. K., & Samuel, A. J. (2020). Randomized clinical trial: the gold standard of experimental designs-importance, advantages, disadvantages, and prejudices. Revista Pesquisa em Fisioterapia, 10(3), 512-519. https://www5.bahiana.edu.br/index.php/fisioterapia/article/view/3039

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