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A team discussion was held to analyze the purpose statement and methodology of each of the studies. The purpose of the first study was to determine the impact of a quality improvement project consisting of five interventions on two outcomes, namely physician adherence to infection control guidelines and the rate of CR-BSI. The use of a prospective cohort method was appropriate for this purpose since it allowed the researchers to determine the effects of the intervention on the two outcomes not only during a one-time measurement after implementation but more importantly, whether outcomes were sustained. The use of two outcomes instead of one also substantiated the findings in that if increased adherence is observed, this should translate into less CR-BSI and conversely, less CR-BSI would imply a higher rate of compliance. At the same time, using two groups helped to further increase the validity of the findings. Differences in outcomes over time in the intervention group and differences found between the intervention and control groups established the certainty of the conclusions that the intervention was effective.

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The purpose of the second study was to evaluate the outcomes of a “resident oversight and credentialing policy for central venous catheter (CVC) placement on CLABSI”. The study used a retrospective analysis of data collected prospectively. This method is also appropriate. Since the intervention was a credentialing policy, it cannot be applied selectively to the physicians in an intervention group. Rather, the policy has to apply to all physicians concerned. Hence, unlike the first study, a control and intervention group was not practical. In order to still increase the validity of findings with controls, retrospective data on CLABSI rates was used as control and was compared to prospective data which corresponded to the time of intervention implementation.

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