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“Koeman et al. (2006) sought to determine the effects of oral decontamination with placebo CHX and CHX/COL. The researchers were investigating the effect of varying development time on ventilator-associated pneumonia. Koeman et al note that ventilator-associated pneumonia is the most frequently occurring nosocomial infection and a leading cause of death among those infected. The researchers cite the extent of damage caused by ventilator-associated pneumonia as the main reason why the trial was carried out. They sought to gain an insight into how the infection causes social and physical damage to patients.
Citing the National Nosocomial Infection Koeman et al explained that ventilator-associated pneumonia accounts for 30% of the total deaths caused by nosocomial infection. In Europe the ailment accounts for 65% of new infections and causes an increase in morbidity. Patients under intensive care unit treated for ventilator-associated pneumonia using antibiotics. This costs an average of $11897. The purpose of the research was to find a better means of preventing and treating the disease with a higher success rate and that is cost effective.
The trial was original as the author outlines clear objectives and hypothesis which had not been studied before. It contributes to a better understanding of already existing literature review about the spread and cure of ventilator-associated pneumonia. The author further lists a number of challenges which arise from previous works on the ailment that includes limited therapeutic use which can lead to decontamination.
Purposes and Hypotheses:
The hypothesis was not clearly defined within the trial but readers can associate the trial objectives with the purpose and hypothesis. As stated the primary purpose of the trial is was to determine the oral decontamination of CHX within the trial that would be carried out through different methods. The objective is meaningful and measurable through an effective trial. The primary purpose is only to determine oral decontamination while the secondary purpose which is to prevent the occurrence of ventilator-associated pneumonia seems to be more important and feasible within the trial.
Methods
The success of any research depends on the research design adopted by the research. The researchers have clearly stated their research design. Participants of the trial were to be randomly selected through a computerized system which offered each participant a fair chance of representation within the research. The researchers further describe the use of a double-blind approach in the selection of participants within the trial. The method used was effective as selection of participant by stratification was not biased in any way during the actual trial. The amount of medication prescribed to each participant was clearly stated within the method. Each participant was clearly captured within the design method by the research assistant and the researchers themselves.
The stated design was appropriate for the outlined objective. By selecting participants randomly through the proposed selection method the researcher will deduce the truth about the already existing facts in relation to ventilated associated pneumonia. Patients were prescribed with CHX randomly to give the desirable results in accordance with the trial. The use of CHX on selective participants within the research and use of control group gave consistent results. In research there exists competing designs but it was setting the perfect design in a trial that is projected and intended results. Therefore the design applied within this trial was appropriate and gave accurate result.
Variable Definitions
Important variables were defined within the research to give a clear understanding of the trial. No actual quantitative cultures were involved in the trial that is usually the case with cohorts in intensive care units. Participating patients were reviewed on a daily basis through the phone. Analyzing the patients progress without being physical in conduct as was the case in this research (which was done by phone) dented the researchs objectivity. The information acquired was compared with available literature review.
The outcome is in line with stated objectives as the trial aims to come up with an effective mechanism to prevent the effects and spread of ventilator-associated pneumonia. The trial analyzes blood components after the prescription of CHX antibiotics to the participating patients. The results collected were consistent with the trial design. The trial needs to formulate a better method of data collection to record credible information which forms a solid ground for the conclusion and recommendation. However the trials operational definitions were not clearly stated leading to differences in interpretations.
Validity and reliability are not applicable to this operation definition in the trial. The case needs a better trial parameter to illustrate its validity and reliability to the process. Reporting of the validity and reliability were not satisfactorily done. The case has compromised data collection methods by relaying on literature review and telephone consensus. The author needs to make an alteration in the reporting design for it to be appropriate and sufficient within the trial.
Sample and setting
Sampling procedures describe in detail the time of medication participants age and sex at the time of admission. The trial was more reliable due to the random selection of participants within the trial. The sampling approach was convincing and calculated through mean deviation which minimizes the occurrence of type 1 and 2 errors. The use of mean deviation in data analysis frees statistical information from biased conclusion and recommendations. All participants were given a fair chance through random participation in the entire process. Response rate was high especially for participants who were subjected to the CHX antibiotics within the trial. The setting was well described in accordance with trial objectives and design.
Data Collection
Data collection was not bias to any participant within the trial. Statistical information and data collected within the trial were gathered from randomly selected participants. Data collected was based on a number of patients in the intensive care unit. The data was not changed according to patients status. The experimental procedures were all random and blinding to case conditions. Besides ethics and other rights issues were all addressed in the research as patients within the trial had to give consent for them to be included in the trial. Ethically patients who denied consent for the admission of a prescribed medication were excluded from the trial. In cases where patients refused to accept oral paste researchers had no option but to terminate their services within the trial and work with only cooperative participants through the trial. The trial thus fulfilled all ethical issues concerns. One participant was disqualified from the trial due to an edema infection of the tongue. At the conclusion of the trial participants had complied with all prerequisites for the trial.
Analysis and Results
The analysis and results of the procedures were appropriate within the trial. The trial intended to deduce the effects of ventilator-associated pneumonia among patients in intensive care units. The data was statistically analyzed by the use of different variables which included age sex and ailment. The data has been analyzed through different scientific methods which rule out bias. The mean deviation used to calculate the baseline gave a clear analysis of the effects and characteristics to patients administered with different types of antibiotics. The case results were presented in a different mode for easy understanding and enabling a further analysis to be carried out. In the article figure 2 illustrates a graph obtained from patients who were prescribed with different types of antibiotics combination within the trial.
The results were clearly represented in charts graphs and tables. This made for easy analysis and understanding. Data represented in graphs offers an excellent illustration and comparison point after the trial. Results and data collected from the trial have been properly interpreted through the charts graphs and literature discussion. The analysis is comprehensive in accounting for all confounding variables within the trial. This attributes to the fact that the data analysis was carried out by the use of mean deviation.
Discussion
The author has clearly made a critical evaluation on the existing literature before carrying out the trial. Literature appraisal carried out by the author was the basis of this trial and its objectives. The existing literature works are marked with challenges which need to be experimental addressed. The author has made proper recommendation in accordance with the data and statistics from the trial.
The recommendations were in line with the case objectives and hypothesis. The conclusion strongly recommends for prescription of CHX antibiotics to patients who suffer from ventilator-associated pneumonia. The trial data concludes that ventilator associated-pneumonia can be prevented and hence reduce of the increase of mortality rate with intensive care units can be achieved. The trial acknowledges a number of limitations including that lack of case design; hence it could not foretell the effects of patients survival and estimates that involve ventilator-associated pneumonia.
General factors
The title of the paper was relevant to the trial but the writing style could have been improved to make it more understandable to a wider population. The current format is suitable for scholars with a scientific background. The references are in order as they are all recent resources in accordance with the timing of this article. Besides no conflict of interest was declared.