Answer

Introduction

            The Clinical Pharmacist aims to conduct as study at the Royal General Hospital to investigate on whether the observed rise in cases of Clostridium difficile-associated diarrhea is correlated with usage of new antibiotic, known as Cefblaster. The Hospital has been experiencing abnormal high incidences of C. difficile-associated diarrhea; thus, it is an issue of concern that must be investigated. The outcome of the study may identify the cause or factors that play a role in increasing the incidences of C. difficile infections to inform practice and improve patient safety. The investigator will also assess on whether C. difficile-associated diarrhoea is greater in certain groups. Use of Cefblaster is associated with increased incidences of C. difficile-associated diarrhea and the risk is greater among the elderly population and people with weakened immunity.

Aim: the aim of the proposed study is to identify whether the rising cases of C. difficile-associated diarrhea is associated with use of Cefblaster and determine on whether the risk is greater in certain groups.

Objectives

1. To investigate whether there is significant relationships between use of Cefblaster and incidences of C. difficile-associated diarrhea?
2. To identify whether Cefblaster-associated incidences of C. difficile infections?

Background

1. difficile (also known as Clostridioides difficile) is a bacterium that is known to cause diarrhea. It can also cause colitis, which is an inflammation of the colon. It is estimated that C. difficile infections causes about half a million illnesses in the United States every year. Approximately, 1 in every 6 patients who are infected and treated for C. difficile infections are likely to be re-infected within 2 to 8 weeks. In worse case scenarios, 1 in every 11 individuals aged 65 years die of healthcare-associated C. difficile infections. Risk factors for C. difficile infections include being 65 years, a weakened immune system, recent hospitalization, and previous infection with C. difficile or history of exposure to pathogens (Centers for Disease Control and Prevention 1).

Methodology

Research Design

            Quantitative experimental research design is appropriate for the proposed study since the investigator plans to collect and analyze quantitative data in order to test for the hypothesis and respond adequately to the research questions. In quantitative research design collected data must be subjected to statistical analyses in order to test the hypotheses (Boeren 2). Research participants will be divided into the experimental and the control group. The experimental group will receive Cefblaster; whereas, the control group will use other standard antibiotics apart from Cefblaster. Research will be conducted over period of 1 year so as to get sufficient number of study participants since it is impractical to get 200 subject participants who meet the inclusion criteria in one particular time.

Research Participants

            The investigator plans to recruit 200 study participants from hospitalized patients at the Royal General Hospital. As such, a convenient sample will be used in the proposed study. A convenient sampling method is a non-random or non-probabilistic sampling approach in which members of a targeted study population are included into the study based on accessibility, willingness, geographical proximity, and availability for the purpose of the study (Etikam 3).  Efforts will be made during the process of recruited of research participants to involve a heterogeneous and diverse group of study participants in terms of age, gender, race and ethnicity, reason for hospitalization, and/or existing chronic health conditions. The rationale for recruiting a diverse set of participants is to be able to get a valid response on whether the risk of C. difficile-associated diarrhea as a result of use Cefblaster is greater in certain groups or not.  Inclusion criteria for this study will include patients who will sign inform consent forms, no current or history of Cefblaster use or C. difficile infections, and hospitalized patients. Patients with who have used or currently use Cefblaster will be excluded from the study. Similarly, patients with a history of C. difficile infections and those who refuse to sign informed consent forms will be excluded from the study.

Data Collection

            Data on the relationship between use of Cefblaster and the rising cases of C. difficile-associated diarrhea will be drawn from patients’ records on follow-up. The investigator will review both the hospital electronic health records and the paper-based healthcare records.

Data Analysis

            SPSS (Statistical Program for Social Sciences) tool will be used for analysis of data. Chi Square Test will be necessary for testing of the null hypothesis; on whether there is a significant correlation between use of Cefblaster and C. difficile-associated diarrhea. Z-test will help the investigator to determine on whether the group receiving Cefblaster are at an increased risk of experiencing C. difficile infections and the associated diarrhea compared to the control group. The value of the test statistic will be calculated using SPSS tool (Kaur 4). On the other hand, data will be expressed in terms of tests of central tendency such as means as well as percentiles.

Results

            Findings will be evaluated in an objective manner, published in a peer-reviewed journal and shared with the hospital administration and healthcare providers in order to inform practice or policy change.