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Daniel Nweke
Research Critiques and PICOT Statement Final Draft
Summary
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Student: Submitted to Grand Canyon University
Research Critiques and PICOT Statement Final Draft
Daniel Nweke
NRS-433V Introduction to Nursing Research
Professor Tijana Zelenovic
Grand Canyon University
April 22, 2022.
Research Critiques and PICOT Statement Final Draft
Nursing Practice Problem and PICOT Question
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mask (Dukes et al., 2019). The effectiveness of mask-wearing in reducing the spread of covid-19
is determined by mask availability, the willingness of people to comply, and the mask aerosol
reduction rate (Li et al., 2020).
How do these four articles support the nurse practice issue you chose?
Covid-19 is an emerging disease and limited research is available to help improve clinical
practice. These studies are important in nursing because it provides proof and evidence of what
works concerning the containment of covid-19. The results of these studies also help nurses in
getting prepared for future similar pandemics that may occur. In addition, research on covid-19
has been useful in dealing with the global pandemic. The research provides knowledge that
reduces maladaptive beliefs about the disease.
Method of Study.
(Chiu et al., 2020) and (Li et al., 2020) used quantitative research methods while
(Bundgaard et al., 2020) and (Dukes et al., 2019) used qualitative research methods. The impact
was calculated by Li et al. (2020) determined the impact of containment measures on reducing
the spread of Covid-19 by calculating the transmission risk per contact rate (numbers per period)
between infected and susceptible persons in the community. The effectiveness of wearing masks
was determined using viral transmission and the infectious dosage. Chiu et al. (2020) used an
electronic database of the Taiwan National Infectious Disease Statistics System to obtain
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Passive voice: impact was calculated by
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Web Content: https://www.jmir.org/2020/8/e21257/
My picot question: Will the spread of Covid-19 in PG county reduce after the Implementation of Early preventive measures of social Distancing, mask-wearing, and Nursing
education, compared to Neighboring counties with more cases where such actions were not
implemented to reduce the spread of the virus over the next few months? Both the qualitative and
quantitative research studies supported my PICOT question. According to the articles, Covid-19
prevention measures such as wearing masks, social distancing, washing hands with soap and
water, and nursing education have a significant impact on reducing the spread of the disease.
Masks play a critical role in reducing the spread of Covid-19 by either blocking gases released
through coughing or filtering the gases by releasing them in a less harmful form (Li et al., 2020).
A study by Chiu et al. (2020) showed that the Covid-19 containment measures like mask-
wearing, social distancing, isolation, and hand hygiene were effective not only to reduce the
spread of covid-19 but also other diseases like enterovirus, influenza, and pneumonia.
Background
Covid-19 can be easily transmitted from an infected person to a susceptible host. The
virus is spread from person to person through the nose, mouth, or eyes via aerosols, fomites, or
respiratory droplets. The virus can survive on a surface for up to 72 hours and can be transmitted
through hands after touching a contaminated surface. Prevention measures such as social
distancing, mask-wearing, hand hygiene, and isolation are effective in reducing the spread of the
disease (Bundgaard et al., 2020). Wearing of face mask is an effective measure to reduce covid-
19 transmission by minimizing the possibility of infected droplets reaching a person wearing a
COVID-19, influenza virus, enterovirus, and all-cause pneumonia occurrences. The occurrences
were represented on a map based on weekly statistics and linear regression analyses performed
for each year. Bundgaard et al. used qualitative research methods. The limitation of the study by
Bundgaard et al. includes inconclusive results, variable adherence, missing data, patient-reported
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findings on home tests, lack of blinding, and lack of assessment of whether masks could reduce
disease transmission from those wearing a mask to others. The advantage of the research by
(Chiu et al., 2020) and (Li et al., 2020) is that the results can be tested and checked. The research
by Li et al had one limitation; the percentage of the population could be asymptomatic meaning
that they could have validated the effectiveness of wearing masks simply because they studied
asymptomatic individuals.
Results of Study.
The results from these studies supported my PICOT question that wearing masks, social
distancing, and nursing education are effective in reducing the spread of covid-19. The
quantitative study by Li et al. (2020) determined that wearing masks is an effective NPI to
reduce the spread of diseases caused by a rival agent through droplet or aerosol transmission
routes. Wearing masks reduces the viral production rate in the population. The combination of
mask-wearing, avoiding crowding, and social distancing significantly reduces the burden of
covid-19 in the population. Prevention of diseases like covid-19 requires containment measures
of reducing spread. Before the introduction of covid-19 vaccination, most countries applied
measures such as the closure of schools, avoiding crowding, social distancing, home quarantine,
and isolation (Dukes et al., 2019). Mask wearing played a critical role, however, its effectiveness
depends on factors like mask availability, government policies, and public awareness.
The research by Chiu et al. showed that in addition to covid-19, the containment
measures had a significant impact on the spread of enterovirus, influenza, and all-cause
pneumonia. Infection control measures like hand hygiene, mask-wearing, and social distancing
are effective in preventing the spread of aerosol and droplets spread of disease agents. Chiu et al.
complimented the contribution of technology to the control of covid-19. Various new
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technologies such as big data, web-based dashboards, social media, and mobile technology
platforms were used in different ways to increase awareness and control the pandemic. The
research utilized a technological method that is effective in generating timely data. According to
the findings, universal masking is the most important strategy because asymptomatic patients can
spread the disease.
High-quality surgical face masks provide a 98% filtration rate (Bundgaard et al., 2020).
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Adherence influences the protective effects of mask-wearing. Droplets are a major source of
transmission of SARS-CoV-2. Infected droplets can be further transmitted by touching
contaminated surfaces followed by touching your eyes, mouth, or nose. Therefore, hand hygiene
is another important containment measure that had a significant impact on reducing the spread of
covid-19. In such transmission, face masks are not effective in reducing the spread of the
pandemic. This takes us to the importance of using multiply prevention measures. Bundgaard et
al. also investigated the impact of lack of eye protection on the spread of covid-19. Based on the
findings, there was no statistically significant difference between eyeglasses wearers and non-
wearers concerning the spread of covid-19.
Ethical considerations.
The four ethical principles in research are autonomy, beneficence, Nonmaleficence, and justice.
the principle of beneficence obligates the researcher to act for the benefit of the respondent.
Nonmaleficence requires that the research does not harm participants. The principle of
beneficence is evident in all the articles reviewed because the outcome of the studies was
beneficial to the general public. None of the articles included a process that caused harm to the
participants, this shows that the study participants were protected from harm as per the principle
of Nonmaleficence.
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Outcomes Comparison.
The expected outcome for my PICOT question is that covid-19 early prevention measures
such as wearing masks, social distancing, and nursing education are effective in reducing the
spread of the disease. Based on the analysis of the three articles, early interventions and
containment measures are effective in reducing the spread of covid-19. Li et al. showed the
importance of isolation, the social distancing of seniors, home quarantine, the social separation
of the entire population, as well as the shutdown of schools in reducing the spread of covid-19.
Chiu et al proved that the early prevention interventions are not only effective for reducing the
spread of covid-19 but also for other diseases spread through respiratory droplets and aerosol.
Apart from containment measures, health education is another important strategy that helps in
improving adherence to the measures put in place to prevent the spread of covid-19. Bundgaard
et al. determined that wearing masks outside along with other measures like social distancing and
hand hygiene are effective in reducing the spread of covid-19.
Masks play at least two roles in the prevention of covid-19 in the general population
(Dukes et al., 2019). The first role is that masks influence the respiratory pathogen emission and
cloud formation. Secondly, masks can filter viral particles such as droplets. Also, masks protect
against the spread of viral droplets from asymptomatic patients. Social distancing protects
infected individuals from getting close to others. Social distancing methods include; quarantine,
the closing of schools, travel restrictions, and closing of workplaces, theaters, or shopping
centers. People apply the social distancing measures by staying at home, avoiding crowded
places, limiting travel, physically distancing in public places, and avoiding contact with other
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people. Many governments used the containment measures early during the covid-19 pandemic to contain the disease. As an emerging disease, the Covid-19 pandemic brought new challenges
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to clinical professionals. Nursing education is one of the important measures to empower nurses
in dealing with the pandemic. Nursing education in both practical and classroom is critical in
improving how nurses deal with such diseases.
Proposed Evidence-Based Practice Change.
Early interventions to prevent the spread of covid-19 such as mask-wearing, social
distancing, isolation, home quarantine, avoiding crowding, health education, and nursing
education are effective strategies to prevent the spread of the disease. Ideally, people wear masks
to protect themselves but a strong public health rationale is needed to protect others from
respiratory droplets. This is especially important because of the existence of asymptomatic
patients who are likely to cause even more transmission of the virus. The wearing of masks in
non-health settings had been used previously to protect non-wearers from influenza and other
similar infections. The effectiveness of mask-wearing to protect against the spread of covid-19
greatly depends on compliance by the general public. Mass masking is supported by public
health principles that have not been appreciated by the public and the authorities. The most
important step in protecting the public from infections such as covid-19 is controlling harm at the
source which is as important as hand hygiene measures. Such interventions as mass masking are
more effective in protecting the entire population rather than protecting an individual.
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References.
Bundgaard, H., Bundgaard, J. S., Raaschou-Pedersen, D., von Buchwald, C., Todsen, T., Norsk,
J. B., Pries-Heje, M. M., Vissing, C. R., Nielsen, P. B., Winsløw, U. C., Fogh, K.,
Hasselbalch, R., Kristensen, J. H., Ringgaard, A., Porsborg Andersen, M., Goecke, N. B.,
Trebbien, R., Skovgaard, K., Benfield, T., Ullum, H., … Iversen, K. (2021).
Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to
Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled
Trial. Annals of internal medicine, 174(3), 335–343. https://doi.org/10.7326/M20-6817
Chiu, N., Chi, H., Tai, Y., Peng, C., Tseng, C., Chen, C., Tan, B. F., & Lin, C. (2020). Impact of
Redundant phrase: general public public
Passive voice: masking is supported by
Student: Submitted to Grand Canyon University
Student: Submitted to Grand Canyon University
wearing masks, hand hygiene, and social distancing on influenza, enterovirus, and all-
cause pneumonia during the coronavirus pandemic: Retrospective national
epidemiological surveillance study. Journal of Medical Internet Research, 22(8),
e21257. https://doi.org/10.2196/21257
Dukes, K., Bunch, J. L., Chan, P. S., Guetterman, T. C., Lehrich, J. L., Trumpower, B., Harrod,
M., Krein, S. L., Kellenberg, J. E., Reisinger, H. S., Kronick, S. L., Iwashyna, T. J.,
Nallamothu, B. K., & Girotra, S. (2019). Assessment of Rapid Response Teams at Top-
Performing Hospitals for In-Hospital Cardiac Arrest. JAMA internal medicine, 179(10),
1398–1405. https://doi.org/10.1001/jamainternmed.2019.2420
Li, T., Liu, Y., Li, M., Qian, X., & Dai, S. Y. (2020). Mask or no mask for COVID-19: A public
health and market study. PLOS ONE, 15(8),
e0237691. https://doi.org/10.1371/journal.pone.0237691
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Student: Submitted to Grand Canyon University
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Student: Submitted to Grand Canyon University
Student: Submitted to Grand Canyon University
