NURS 3600 Nursing Research

Literature Review Matrix

Name: ____Michael Fairchild_____________________________________________________________________________
AUTHOR,
TITLE,
JOURNAL

YEA
R

#1. Gupta,
2003
N; KaulGupta, R;
Carstens,
M. M; Dion
F;
Martindale,
R. Analyzing
prophylactic
antibiotic
administrati
on in
procedures
lasting
more than
four hours:
Are
published
guidelines
being

METHO
D&
DESIGN
Crosssectional
study.
Existing
data/
Secondar
y
analysis

STUDY
PURPOS
E
Was to
assess
the
concorda
nce with
the
published
guideline
s for
surgical
antibiotic
prophylax
is
recomme
ndations
that
administe
red
antibiotic
should be

VARIABLES
(Omit if a qualitative
study)
Depende Independe
nt
nt
1.
No
Patients
Independen
whom
t variables
received
no
antibiotic
s at all.
2.
Patients
who
received
antibiotic
s too
early or
too late.
3.
Patients
whom
were not
given the

SUBJECTS
Numb
er
300
total
cases

Characteristi
Sample
cs
Method
25 patients
Simple
did not
random
receive
sampling
antibiotic
coverage
85 patients
were not
given the
correct
antibiotic
94 patients
received the
antibiotic too
early or too
late.

RESULTS

The
compliance
with the
guidelines in
regards to
repeating the
dose as often
as necessary
was only 3
percent.

COMMENTS*

I was surprised
by the low level
of compliance
associated with
this study.
Because of the
low level of
compliance this
study did not
answer my PICOT
question about
the effectiveness
of repeating
antibiotic doses. I
will have to
continue to look
at other studies
to find an
answer.

followed?
The
American
Surgeon

#2. Austin,
2004
Thomas W;
Austin,
Marilyn A;
Coleman,
Brenda;
Jamjoom, M;
Al Thaqafi,
A O. Total
knee
replacemen
t surgery
and surgical
site
infection: a
prospective
audit.
Canadian
Journal of
Surgery

Longitudi
nal.
Observat
ional and
secondar
y
analysis

repeated
in a
timely
manner
in lengthy
procedure
s
To assess
if hospital
guideline
s for
periopera
tive
antibiotic
prophylax
is was
being
followed
and the
effects of
complian
ce.

correct
antibiotic
agent.

Infections

1.Patients
whom
received
antibiotics
less than 10
minutes
before cut
time
2. Patients
that did not
receive a
re-dosing of
antibiotic
for longer
surgeries.
3. Patients
receiving
antibiotics
within 2
hours of
incision
time (as per
hospital

38
patient
s were
observ
ed

The
population
was elderly
(average age
64)
22 patients
received
antibiotics
within 10
minutes
tourniquet
inflation and 5
received
antibiotics
after the
tourniquet
was already
inflated.

Convenien
ce
sampling

2 factors were
found to be
associated
with infection:
late
administration
of prophylaxis
(patients who
received
antibiotics less
than 10 prior
to inflating the
tourniquet),
and failure to
"top it up"
during
procedures
longer than 4
hours.

This study did a

pretty good job
of answering my
PICOT question.
However the
study had a
small sample
size and the
hospital was not
in the United
States.

#3.
Classen,
David C;
Evans, R
Scott;
Pestotnik,
Stanley L;
Horn, Susan
D; Menlove,
Ronald L,
The Timing
of
Prophylactic
Administrati
on of
Antibiotics
and the
Risk of
SurgicalWound
Infection
The New
England
Journal of
Medicine
#4.
Sewick, A.,
Makani, A.,

1992

Crosssectional
.
Observat
ional
study

To see
how the
timing of
antibiotic
administr
ation
affects
the risk of
surgicalwound
infection
in actual
clinical
practice.

Rate of
Surgical
site
infections

2012

Retrospe
ctive
case

To
Rate of
determin infections
e whether

requirement
s)
1.Patients
1708
receiving
patient
antibiotics
s
early
2. Patients
who
received
antibiotics
late

Use of one
antibiotic
Use of two

1828
patient
s

Patients
ranged in age
from 11 97
with a mean
age of 53.
There were
more women
than men
1758 to 1089.
1359 clean
operations
and 1488
cleancontaminated
operations.

Simple
random
sampling

Stepwise
logisticregression
analysis
confirmed that
the
administration
of antibiotics in
the
preoperative
(within 2 hours
prior to the
incision) period
was associated
with the lowest
risk of surgicalwound
infection.

This study did

not answer my
PICOT question
because the
inclusion criteria
did not include
surgeries over
four hours so the
need to re-dose
antibiotics was
not sufficiently
addressed.

There were
701 males
and

Simple
random
sampling

The addition of
vancomycin as
a second

The study did

show that the
addition of vanco

Wu, C.,
ODonnell,
J., Baldwin,
K.,
Lee, G. C.
Does Dual
Antibiotic
Prophylaxis
Better
Prevent
Surgical
Site
Infections in
Total Joint
Arthroplasty
? Clinical
Orthopaedi
cs and
Related
Research
470.10
#5.
2013
Nandyala,
Sreeharsha
V;
Schwend,
Richard M.
Prevalence
of
intraoperati

control
study

dual
antibiotic
prophylax
is
reduced
the rate
of SSI
compared
to single
antibiotic
prophylax
is and
altered
the
microbiol
ogy of
SSI.

Retrospe
ctive
case
control
study

To
determin
e
prevalenc
e and risk
factors
for
intraoper
ative

antibiotics

Bacterial
contamin
ation

Age of the
patients
and length
of the
surgeries

1127 females
with an
average age
of 56 years.

114
Patient
s

All patients
received
preoperative
antibiotics
and re-dosing
of antibiotics
every four
hours during
the surgery

Simple
random
sampling

prophylactic
antibiotic
agent
apparently did
not reduce the
rate of surgical
site infections
compared to
cefazolin
alone.

did help to
reduce the
incidence of
MRSA but not
infections as a
whole. This study
did not
adequately
answer my PICOT
question.

Surgery
duration of
greater than
four hours,
regardless of
whether the
antibiotic is redosed, were
associated

Of all of the
studies that I
have looked at to
this point this
one answers my
original question
the best. The
answer is still not
definitive but it is

ve tissue
bacterial
contaminati
on in
posterior
pediatric
spinal
deformity
surgery.
Spine
Ruth,
Stacey
Preoperativ
e antibiotics
and
postoperati
ve
infections.
UMI
Dissertation
s
Publishing,

bacterial
contamin
ation in
posterior
spinal
deformity

2008

Retrospe
ctive
case
study

This
study
looked at
the
timing
and dose
of
preoperat
ive
antibiotic
s to
determin
e if this
affects
the
number
of
surgical
site
infections

and the
incision was
covered with
an antibiotic
Ioban.

Qualitativ
e

Qualitative

100
Patient
s

Orthopedic,
cardiothoracic
, and
neurosurgical
patients
whom
received
surgery
between Jan.
and March
2008 in a
certain
pediatric
hospital.

Purposive
sampling

with surgical
site infections.

better than
everything else I
have found.

The findings
did not
demonstrate
significance in
the
relationship of
antibiotic
timing or
dosage with
the number of
postoperative
wound
infections.

This study
answered my
question but was
contradictory to
the other results
that I have
found. Leaving
me just as
confused as I
was in the
beginning.

*Include under Comments anything that may be of interest to you in the article, would be helpful in considering whether contributes to
answering your clinical question, or to application of the research findings to your practice; e.g. Small sample size, no race info. Subjects
very unlike my patients. Innovative intervention, not sure if my manager would go for it.
Now that you have summarized the articles you obtained, please answer the following questions:
1. Does the evidence answer your clinical question? No, I do not think that I found enough evidence to answer my question one way or
another. It was very difficult to find information on this subject and a lot of the data was inconclusive.
2. If the evidence answered your clinical question, what is the answer?
3. If the evidence did not answer your clinical question, what are your next steps? I think my next step would be to continue to look for
more research that answers my question and if I still cannot find the answers that I am looking for maybe I would contact the research
department and have them evaluate the need to conduct a study of their own on this topic.