Texas Tech University Endotracheal Tubes Pilot Test Paper This is a research assignment, The topic focuses on discovering a gap in research on the topic of

Texas Tech University Endotracheal Tubes Pilot Test Paper This is a research assignment, The topic focuses on discovering a gap in research on the topic of using silver coated endotracheal tubes in preventing ventilated associated pneumonia. I have provided 3 resources but am also in need of 1 more additional prospective research article. The article has to be current within the last 5 years. There is a guide and further instructions attached if needed as well as a template to put all information. N5366 Principles of Research in Nursing
Instructions for Completing Your Assignment
Step one: Choose the topic, identify a nursing clinical practice problem that you would like to
explore. You should have done this in week one.
Step two: Complete the readings from Module 1, 2 & 3, focusing on Chapter 7 Stages of a
Literature Review pp.126-134, Chapter 18, and information provided by the nurse librarian.
Step three: Using the information that you discussed in Module 1 Discussion- Research
Problem, briefly discuss the significance and identify the gap in the literature. (Why do you need
to study this problem?) Enter into the template. Make sure that it identifies a gap in the
literature and has a citation.
Step four: Use your four articles that you found in Module 4 for the PINCH Table. These
studies need to relate to your topic and clinical problem. Your studies must be quantitative
research articles (for example: quantitative descriptive, correlational or quasi-experimental or
experimental designs). At least two studies must be prospective (data actually collected at
the time of the study). The other two may be retrospective or prospective. Your studies
may NOT be a qualitative study, a quality improvement study, a systematic review, metasynthesis, meta-analysis, meta-summary, or integrative review. Do not use a thesis or
dissertation. No animal studies or pilot studies. The article should not be a general information
article without the elements of a study (e.g.: must include a review of literature and a methods
section with results and discussion).
• Studies/ articles must be current, within 5 years.
• Include a References page at the end of the paper; citations are to be written in APA
format.
• The articles you use must meet the following mandatory requirements noted in Chapter
3 (Types of Quantitative Research).
Step five: Find the elements in your articles that are named in the PINCH table and type them
into your table. Be sure to note anything of interest in the article outside of the required
elements and add them to the notes column for use in your Module 5 ROL Synthesis.
Step six: If you have questions about your work, post them to the Q & A discussion board for
feedback from your peers / instructor.
Step seven: Write up your assignment.
Pinch Table – Write up your findings in the template and submit them to CANVAS by the due
date and time listed in your syllabus. Here’s how to write up your findings:
o This is to be submitted in the table format provided.
o Complete sentences are not necessary in the Pinch Table, but the
information must be clear on the template of what information belongs to
©2017 UTA College of Nursing
Page 1 of 4
N5366 Principles of Research in Nursing
which article in order to grade (without question). In other words, separate the
articles in the table.
Don’t forget to use the group discussion board for additional questions about your paper.
Turn in your table (docx format only) and the four articles (PDF format only) in to the assignment
submission link under the Assignments Tab in Module 4 at the due date and time listed in your
syllabus.
Grading Rubric
Use this rubric to guide your work the assignment. Points are awarded for each section based on content
and clarity of expression.
Accomplished
(Maximum points awarded)
PINCH TABLE
Problem
(10 pts)
Article #1
Appraisal
If the study does
not meet design
criteria outlined in
the assignment
instructions, 10
points will be
deducted.
5 points deducted
if article PDF not
attached with
assignment.
There are 20 points
Clinical problem is discussed
with citations. Gap in the
research literature is
identified and described.
10 points
Uses the PINCH Table to
identify current studies and
describe the elements
presented in the study.
Proficient
Needs Improvement
(Points awarded based
on content)
(Minimum points
awarded)
Significance of problem
vague. Gap in the
research literature is not
well described. No citation
given.
9-3 points
Vague explanation of
elements given. Missing
article.
Problem or gap is not
discussed.
3-0 points
Study does not meet
the criteria for the
assignment.
-Elements for each article
include: author(s)/year,
study purpose (2 points),
-sample description including
size and demographics (2
points),
-study design type 4 points),
-variables listed and identified
by type (research, DV and/ or
IV) (4 points),
-measurements of the
variables (4 points),
©2017 UTA College of Nursing
Page 2 of 4
N5366 Principles of Research in Nursing
allotted for each
article.
(20 pts)
Article #2
Appraisal
If the study does
not meet design
criteria outlined in
the assignment
instructions, 10
points will be
deducted.
5 points deducted
if article PDF not
attached with
assignment.
There are 20 points
allotted for each
article.
(20 pts)
Article #3
Appraisal
If the study does
not meet design
criteria outlined in
the assignment
instructions, 10
points will be
deducted.
5 points deducted
if article PDF not
attached with
assignment.
There are 20 points
allotted for each
article.
-major study findings/results
(4 points).
Elements are described fully
and any important notes are
included.
Article is included.
20 – 16 points
Uses the PINCH Table to
identify current studies and
describe the elements
presented in the study.
16-10 points
Vague explanation of
elements given. Missing
article.
10- 0 points
Study does not meet
the criteria for the
assignment.
-Elements for each article
include: author(s)/year,
study purpose (2 points),
-sample description including
size and demographics (2
points),
-study design type 4 points),
-variables listed and identified
by type (research, DV and/ or
IV) (4 points),
-measurements of the
variables (4 points),
-major study findings/results
(4 points).
Elements are described fully
and any important notes are
included.
Article is included.
20 – 16 points
16-10 points
Uses the PINCH Table to
identify current studies and
describe the elements
presented in the study.
Vague explanation of
elements given. Missing
article.
10- 0 points
Study does not meet
the criteria for the
assignment.
-Elements for each article
include: author(s)/year,
study purpose (2 points),
-sample description including
size and demographics (2
points),
-study design type 4 points),
-variables listed and identified
by type (research, DV and/ or
IV) (4 points),
-measurements of the
variables (4 points),
-major study findings/results
(4 points).
Elements are described fully
and any important notes are
included.
©2017 UTA College of Nursing
Page 3 of 4
N5366 Principles of Research in Nursing
(20 pts)
Article #4
Appraisal
If the study does
not meet design
criteria outlined in
the assignment
instructions, 10
points will be
deducted.
5 points deducted
if article PDF not
attached with
assignment.
There are 20 points
allotted for each
article.
(20 pts)
APA Style
Article is included.
20 – 16 points
16-10 points
Uses the PINCH Table to
identify current studies and
describe the elements
presented in the study.
Vague explanation of
elements given. Missing
article.
10- 0 points
Study does not meet
the criteria for the
assignment.
-Elements for each article
include: author(s)/year,
study purpose (2 points),
-sample description including
size and demographics (2
points),
-study design type 4 points),
-variables listed and identified
by type (research, DV and/ or
IV) (4 points),
-measurements of the
variables (4 points),
-major study findings/results
(4 points).
Elements are described fully
and any important notes are
included.
Article is included.
20 – 16 points
See instructions below.
16-10 points
10- 0 points
(10 pts)
APA STYLE grading
APA formatting for this assignment will follow the guidelines for general formatting, for example: in textcitations, margins, headings alignment and line spacing, font type and size, paragraph indentation, page
headers, grammar, punctuation and the reference page as explained in the 2nd edition of APA the Easy
Way or the 6th edition of the APA Manual. Complete sentences are not required in the Pinch Table
Helpful Hints:
• Do not use 1st person in a formal paper.
• Do not use direct quotes, instead summarize and paraphrase what you are reading. More
than two quotes will receive multiple point deductions.
• Reference page in APA format.
The first time an APA error is discovered, it will be pointed out to you and a point will be deducted from
your paper. Maximum number of points deducted for APA errors, 10 points
©2017 UTA College of Nursing
Page 4 of 4
Module 4 Assignment: Pinch Table Template
PINCH Table
Research Problem (identify a gap in the literature); detailed and citation included:
_________________________________________________________________
Author(s)
last name
and year
Study
Purpose
Sample
(N=xx) and
Demographics
Describe the
sample in
detail.
Study Design
type (describe
in detail)
& Variables
(List variables
and label as
Research, IV,
DV) Define
your variables.
Measurement
methods of
variables
(tools,
surveys or
scales). Give
detailed
descriptions,
reliability and
validity.
Major Study Notes
Findings /
Results
(include
some
statistics
and whether
they are
significant or
not)
Björling et al. BMC Anesthesiology (2015) 15:174
DOI 10.1186/s12871-015-0156-z
RESEARCH ARTICLE
Open Access
Tolerability and performance of BIP
endotracheal tubes with noble metal
alloy coating – a randomized clinical
evaluation study
Gunilla Björling1,2*, Dorota Johansson3,4, Linda Bergström3,4, Shah Jalal5, Ivar Kohn6, Claes Frostell2
and Sigridur Kalman6,7
Abstract
Background: Hospital acquired infections worsen the outcome of patients treated in intensive care units and are
costly. Coatings with silver or metal alloys may reduce or alter the formation of biofilm on invasive medical devices.
An endotracheal tube (ETT) is used to connect the patient to a ventilator and coated tubes have been tested in
relation to bacterial colonization and respiratory infection. In the present study, we aimed to evaluate and compare
a coated and uncoated ETT for patient symptoms and local tracheal tolerability during short term clinical use.
Degree of bacterial colonization was also described.
Methods: A silver-palladium-gold alloy coating (‘Bactiguard®’Infection Protection, BIP) has been extensively used
on urinary tract catheters and lately also on central venous catheters. We performed a randomised, single-blinded,
controlled, first in man, post Conformité Européenne (EC) certification and CE marking study, focused on Bactiguard®
coated ETTs (BIP ETT). Thirty patients at a tertiary university hospital scheduled for upper abdominal elective surgery
with an expected duration of anaesthesia of at least 3 h were randomised; BIP ETT (n = 20) or standard ETT (n = 10).
The tolerability was assessed with a modified version of Quality of Life Head and Neck Module, QLQ-H&N35 and by
inspection of the tracheal mucosa with a fibre-optic bronchoscope before intubation and at extubation. Adverse
Events (AE) and bacterial adherence were also studied. Statistical evaluations were carried out with the Fisher’s Exact
Test, the Clopper-Pearson method, as well as a Proportional Odds Model.
Results: Differences between groups were identified in 2 of 8 patient related symptoms with regard to tolerability by
QLQ-H&N35 (cough, p = 0.022 and dry mouth, p = 0.014 in the treatment group.). No mucosal damage was identified
with bronchoscopy. A low level of bacterial colonization with normal flora, equal between groups, was seen after
short-term of intubation (median 5 h). No serious Adverse Events related to the use of an ETT were observed. The
results should be treated with caution due to statistical confounders, a small study size and large inter-individual
variability in bacterial adhesion.
(Continued on next page)
* Correspondence: gunilla.bjorling@ki.se
1
The Swedish Red Cross University College, P.O. Box 55676SE-10215
Stockholm, Sweden
2
Karolinska Institutet, Department of Clinical Sciences, Division of Anaesthesia
and Intensive Care, Danderyd Hospital, SE-18288 Stockholm, Sweden
Full list of author information is available at the end of the article
© 2015 Björling et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Björling et al. BMC Anesthesiology (2015) 15:174
Page 2 of 10
(Continued from previous page)
Conclusions: The new device BIP ETT is well tolerated and has good clinical performance during short-term
intubation. Studies with larger sample sizes and longer intubation periods (>24 h) in the ICU-setting are needed and
can now be planned in order to identify possible differences in clinical outcomes.
Trial registration: Registered in ClinicalTrials.gov, Registration number: NCT01682486, Date of Registration:
August, 30, 2012
Keywords: Endotracheal tube, Colonization, bacterial, Complication, Clinical method, Anaesthesia, Airway,
Noble metal alloy coating
Background
Hospital acquired infections (HAI) are a global problem
and among the four major causes of death in the Western
world. Generally, 10 % of hospitalised patients in the
Western world acquire HAI [1–4]. Medical devices are
rapidly colonized with bacteria during the formation of
biofilm, which in turn can lead to health care-related infections [5–8]. But as the usage of medical technical
equipment is necessary within the health care system, it is
a particularly important area to study and optimize [9, 10].
To reduce the biofilm formation on endotracheal
tubes, coatings with pure silver or silver compounds
have been evaluated. The efficacy and safety of endotracheal tubes (ETTs) coated with pure silver or silver
compounds have been reported in three randomised
controlled clinical [11–13]. No safety issues were reported. The studies reported significant reduction of biofilm formation [12, 13] and as well as a delay of VAP.
The noble metal alloy coating has been extensively used
on urinary catheters and central venous lines [14–16].
This is a first in man study on an endotracheal tube with
the Bactiguard® noble metal coating (BIP ETT).
The primary objective was to determine the tolerability
of the medical device BIP ETT compared to standard
uncoated ETTs in a small selected population of patients
undergoing elective surgery. The secondary objective
was to assess the overall safety and performance related
to the medical device. The hypothesis was that the
coated tube (BIP ETT) would be similar to the standard
endotracheal tube with regard to patient-experienced
symptoms and that the tracheal mucosa would be similarly affected by contact with the BIP ETT as by contact
with a standard endotracheal tub. The primary endpoint was patient-reported symptoms in the throat and
mouth, as well as visual appearances of the upper tracheal mucosa the day after tracheal intubation.
Though bacterial colonization is of major interest
when it comes to medical devices inserted in the human
body, this study is focused on the tracheal safety and tolerability when exposed to the new coating. Bacterial
colonization after a few hours of endotracheal tube
usage is described here and can be considered as a
baseline in future studies with coated endotracheal tubes
used for longer clinical periods (days).
Methods
Study design
This was a single-centre, randomised, single-blinded,
and controlled, first in man, post Conformity Europermit (EC) certification and CE marking study. Patients
undergoing elective surgery of the upper gastrointestinal tract with an expected duration of at least 3 h
were asked to participate. The study was conducted
at a Karolinska University Hospital in Sweden and
approved by the Ethical Review Board in Stockholm (Dnr
20121205–31, protocol number 1842-2026-CDOC). Written informed consent from each patient was obtained
before entry into the study. All patients signed a written
informed consent before participating in the study. The
study is outlined in clinicaltrials.gov database with the
identifier: NCT01682486.
Investigational device BIP ETT
BIP ETT is an endotracheal tube designed for insertion
through the mouth or nose. The, in- and outside surfaces are coated with the Bactiguard® coating (Sweden)
which consists of a noble metal alloy of silver, palladium
and gold, which reduces bacterial adhesion in-vitro. The
latter phenomenon is a contributing factor to microbial
colonisation and biofilm formation, which in turn increases the risk for VAP. The BIP ETT is made from
medical grade polyvinyl chloride (PVC). It is a sterile
single use 100 % latex free, two-lumen tube (one lumen
connected to a high volume low pressure cuff with a
standard connector), has a Magill curve and rounded tip
with a Murphy eye.
Control device
Standard uncoated ETTs made of PVC, normally used
for intubation at the investigators site (Mallinckrodt™
ETT) with standard labelling, were used as reference
devices. They were sterile single use 100 % latex free,
two-lumen tubes (one lumen connected to a high
Björling et al. BMC Anesthesiology (2015) 15:174
Page 3 of 10
volume low pressure cuff with a standard connector),
had a Magill curve and rounded tip with a Murphy eye.
bacteria from a defined area of the ETT surface ex vivo
(quantification and typing).
Study population
Data collection
Inclusion criteria were adults ≥18 years of age, requiring
endotracheal intubation ≥3 h needing an endotracheal
tube sized 7 or 8 mm. Exclusion criteria were cognitive
dysfunction (i.e., inability to understand and fill out the
study questionnaires), transmissible blood disease, multiresistant bacterial colonization, current or continuous
treatment with immune modulating therapies, e.g., systemic (or inhalation) use of cortisone or non-steroid
anti-inflammatory drugs (NSAID), on-going respiratory
infection, as well as deficient poor skills in writing and
or speaking Swedish.
Demographics, smoking habits, medical history of significance, and concomitant medication were assessed
prior to surgery. The study comprised of four visits; a
telephone contact by a study nurse to inform the patient
about the study and send the written patient information
to the patient up to 28 days prior to screening (Visit 1);
a screening visit 1 to 14 days prior to surgery when also
the informed consent form was signed and demographic
data, medical history gathered and physical examination
was performed (Visit 2); the actual day of surgery/intubation (Visit 3), and a follow-up on the day after surgery
(Visit 4).
The study intervention was carried out at Visit 3. As
the patient arrived in the operating theatre, local routines were followed. No lidocaine or lubricating jellies
were used in conjunction with the ETT. Prior to intubation of the ETT, the endotracheal cuff was inflated as a
test. The intubation was carried out after a bronchoscopy where the ETT was pulled over the fiberscope, and
the cuff pressure was kept below 20 cmH2O if possible.
Endotracheal cuff pressures were recorded using an
intra-cuff monitor, and the pressure was recorded during
the anaesthesia. After induction of anaesthesia, the number of intubation attempts and the need for other intubation devices were recorded, as well as any injuries to
lip, tongue or teeth. The ETT was not to be repositioned
unless necessary. During extubation, a bronchoscope
was again placed in the trachea through the ETT. The
ETT was then removed and the trachea inspected. The
time for intubatio…
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