Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052

Evidence-Based Project Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052
Sample Answer for Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052 Included After Question

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?
In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.
WEEKLY RESOURCES

To Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:

Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide
Evidence-Based Project Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052
examples.

A Sample Answer For the Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052
Title: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052
Currently, I work on an Oncology floor and most of our patients have deteriorating disease processes. A lot of our patients will develop pressure ulcers even when placed on strict turn schedules and nutrition requirements. This problem led me to wonder if there is a better way to prevent pressure ulcers in patients who are hospitalized for long periods of time. Due to this being my area of interest, I wanted to start my research on different methods to prevent pressure ulcers and which methods or multiple methods have proved to be the most effective.
I am most familiar with the EBSCO database so I started my search there and found an article pertaining to education surrounding pressure sore prevention. This study actually took two sample groups from India and gave them both differing levels of education and then monitored the groups for a year to determine which education methods were effective (Kaur, et.al, 2018). I started my search by searching for information on pressure sores and added the prevention component. I also limited my search to research that had been done between 2018 and 2022.
I continued my search in PUBMED, as that is another database that I was familiar with and had good experience with in the past. I found two articles on PUBMED using pretty broad search terms. I again searched for pressure sore prevention and found articles that discussed the topic. The first study took place in a Brazilian hospital and used the Braden scale to determine patients at risk for sores, and then placed pressure dressings on the patients. These dressings were placed in the same areas and changed at the same times the only thing that differed was the type of dressing used on the two groups of patients (da Silva et. al, 2019). Another study compared different types of pressure sore preventing mattresses and the effects that they had on the skin that is most commonly affected by pressure injuries (Tomova-Simitchieva et. al, 2018). For both of these articles I also limited my search time frame to ensure that I was getting the most recent data available as health care technology is constantly changing.
Improving Data Search 
As I continue in my research, I hope to find more specific information on the prevention of pressure injuries. As I develop my PICOT question, this will also aid in the finding of research material and searching on more specific topics. I plan to search more specific topics which may include pressure injury prevention beds, pressure injury prevention dressings, and pressure injury prevention turn schedules. I would also like to do more research on how length of stay may contribute to pressure injury formation in patients.
References
da Silva Augusto, F., Blanes, L., Ping, P. Z. X., Saito, C. M. M., & Masako Ferreira, L. (2019). Hydrocellular Foam Versus Hydrocolloid Plate in the Prevention of Pressure Injuries.Wounds : a compendium of clinical research and practice, (31(8), 193–199.
Kaur, S., Singh, A., Tewari, & Kaur. (2018, January 1). Comparison of Two Intervention Strategies on Prevention of Bedsores among the Bedridden Patients: A Quasi Experimental Community-based Trial. ebscohost.com. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=rzh&AN=127438747&site=ehost-live&scope=site&custid=s6527200
Tomova-Simitchieva, T., Lichterfeld-Kottner, A., Blume-Peytavi, U., & Kottner, J. (2018). Comparing the effects of 3 different pressure ulcer prevention support surfaces on the structure and function of heel and sacral skin: An exploratory cross-over trial.International wound journal,15(3), 429–437.

A Sample Answer 2 For the Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052
Title: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052

In healthcare, telehealth is a broader term that refers to the delivery of healthcare services using various mediums such as traditional phone calls and video calls. However, although there are claims that telehealth results in reduced usage of costs, still there is the usage of large amounts of money in the implementation phase (Melnyk et al., 2018). Despite the positive reports regarding the use of telehealth in providing mental health services, still there are concerns about the potential impact of the therapeutic relationships between the patient and the healthcare providers. Despite the diverse advantages of telehealth, the implementation has been met with mixed reactions from healthcare providers, for instance, COVID-19 had significantly altered patient perceptions and other staff during clinical sessions.
In the United States, about 15 million people who live in rural areas have either mental illness or substance dependence. Most rural setting lack proper psychiatric settings. The emergence of a global health pandemic greatly disturbed the mental health treatment system. As a result, there was a need to train more rural mental health providers to improve service delivery (Stillwell et al., 2010). Despite the rapid emergence of telehealth in the United States, mental health agencies have been slow to adopt it. the COVID-19 pandemic resulted in the integration of mental health services as there was a need. Urban areas have higher utilization of mental health services due to increased access to mental health services. However, rural areas have limited access to these services due to various factors like brand barriers and technology illiteracy. With the increased number of mental health issues, there has been a delocalization of mental health to remote areas.
According to Turfah et al. (2022), the PICOT question is the best method used for formulating a clinical question. Well-written clinical questions help the researchers to gather information and evidence to support their findings. My PIOT question followed the same criteria where P is for population/ problem, I is for the interventions, C is for comparison, O is for the outcome, and T is for the estimated time frame. Therefore, my PICOT question I would formulate is in the patients with mental conditions, how do telehealth visits compared to face-to-face visits affect compliance with medication adherence and adherence on follow-up visits? Therefore, I initiated a search using italics of keywords.
The initial step of my search for the evidence was to find information about telemedicine or telehealth and mental health using the databases of Medline and CINAHL. I then applied filters to my search to those that were peer-reviewed and published within the past five years. The initial search of telehealth produces about 55,000 articles, however, they decreased to 7,000 as I combined with terms of mental health. When specific strategies are used, they help to increase precision and effectiveness. Most of them ensure that the most relevant keywords are in the question (Walden University, 2018). Having a clinical question helps in guiding the search and making them relevant and up to date. The search ensures that there are the most relevant and up-to-date for easier practice. Therefore, a clearly stated clinical question is needed to enhance the relevance of the current practice with little effort.
References
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.https://www.amazon.com/Evidence-Based-Practice-Nursing-Healthcare-Guide/dp/1496384539
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. Links to an external site.American Journal of Nursing, 110(3), 58–61.
Turfah, A., Liu, H., Stewart, L. A., Kang, T., & Weng, C. (2022). Extending PICO with Observation Normalization for Evidence Computing. Studies in health technology and informatics, 290, 268–272. https://doi.org/10.3233/SHTI220076
Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching Links to an external site. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/searching-basics
A Sample Answer 3 For the Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052
Title: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews NURS 6052

Introduction
The provision of safe, high quality and efficient care in nursing is important for the health and wellbeing of the patients. Often, nurses utilize practice interventions such as patient centeredness and evidence-based practices to ensure that the care needs of the patients are met. They also use the interventions to minimize the risk of occurrence of safety and quality issues in patient care. An example is the use of best practice interventions to ensure that the risk of medication errors in nursing practice is reduced. Despite the efforts adopted by nurses to ensure safety and quality, institutional and provider factors may still predispose patients to unintended safety and quality issues. For example, provider factors such as burnout due to the influence of institutional factors such as staff shortage may threaten the safety and quality of patient care. Therefore, this presentation examines the proposed intervention that can be used to reduce and prevent burnout among registered nurses.
Selected Clinical Issue
The selected clinical issue that relates to nursing practice is burnout among nurses. Burnout has been defined as the consequence of prolonged, persistent and chronic exposure of nurses to work-related stressors. The prolonged exposure to work stressors result in depersonalization, exhaustion, and reduced personal accomplishments. Nurses affected by burnout experience challenges in undertaking their clinical roles due to low levels of motivation and job satisfaction. Burnout among nurses has an adverse effect on the quality and safety of patient care (Ahola et al., 2017). For example, it increases the risk of medication errors by nurses due to lack of concentration in the care giving process. Burnout also causes low level of job satisfaction and motivation among the nurses. As a result, the rate of turnover among them increases significantly. In addition, the operational costs in healthcare organization rises due to the need for frequent hiring of new staffs to replace those who left the organization. Therefore, burnout among nurses should be addressed to ensure safety, quality and efficiency in healthcare organizations (Melnyk et al., 2020).
Development of PICOT
The developed question is: In acute care nurses, does the use of cognitive interventions result in the reduction of burnout levels when compared to no intervention, within eight month period?
I developed the above PICOT question through a number of steps. The first one was performing a clinical inquiry of the common issues that affect quality and safety of patient care in healthcare settings. I also utilized knowledge from my clinical experience to identify issues in practice that can be addressed by adopting evidence-based interventions. This led to the identification of the clinical issue of burnout in nursing. The second step entailed the determination of the populations that the problem affect. This led to the identification of nurses as the most prone group of professionals to be affected by burnout. The other step was performing a literature search of the databases to determine practice interventions that can be used to address the issue. This stage led to the identification of cognitive therapies as the most effective intervention to address burnout in nursing. The next step was determining a way in which I could determine the effectiveness of the intervention. As a result, I considered a comparative intervention to be no use of any approach to address the issue of burnout among nurses. I then developed the outcomes to be achieved by the implementation of the intervention and the timeline of evaluating its effectiveness.
Identified Articles
The database search led to the above articles that explore the effectiveness of cognitive interventions in reducing and preventing burnout among nurses.
´Ahola, K., Toppinen-Tanner, S., & Seppänen, J. (2017). Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. Burnout Research, 4, 1–11.
´Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. (2017). Burnout Research, 4, 1–11. https://doi.org/10.1016/j.burn.2017.02.001
´Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., Hoying, J., McRae, K., Ault, S., Spurlock, E., & Bird, S. B. (2020). Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review. American Journal of Health Promotion, 34(8), 929–941. https://doi.org/10.1177/0890117120920451
´Nayeri, N., Nukpezah, R., & Kiwanuka, F. (2021). Article no.AJRNH.71848 (1) Prof. Sharon Lawn, Flinders University, Australia. (2) Dr. Asmaa Fathi Moustafa Hamouda. Asian Nursing Research, 18–36.
´Zhang, X., Song, Y., Jiang, T., Ding, N., & Shi, T. (2020). Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses. Medicine, 99(26), e20992. https://doi.org/10.1097/MD.0000000000020992
Levels of Evidence
The study by Ahola et al., (2017) provides level I evidence. The study was a systematic review of randomized controlled trials without meta-analysis. The study by Melnyk et al., (2020) provided level I evidence too. It was a systematic review of randomized controlled trials without meta-analysis. The study by Nayeri et al., (2021) provided level III evidence. It was a systematic review of a combination of quasi-experimental, randomized controlled trials, and non-experimental studies. It also lacked meta-analysis. The study  by Zhang et al., (2020) provided level II evidence. The study was a systematic review of quasi-experimental and randomized controlled trials with meta-analysis.
Strengths of Using Systematic Reviews
One of the strengths of using systematic reviews is the transparency in its processes. The processes of each of the phases of a systematic review are transparent, increasing the trust towards the obtained findings. Transparency also enables readers to determine the merits and demerits of the decisions that the authors made in synthesizing the data. The other benefit of using systematic reviews is that they provide comprehensive review of a topic. The use of multiple sources of data on a topic increases the relevance and implications of the data reported in a systematic review. The review of multiple studies also assists in the identification of gaps in research and practice. As a result, nurses can use the information from systematic reviews to inform their future research and practice. The last strength of systematic reviews is that it provides highly reliable results. The results have minimum bias due to the transparency in methods used. The focus on the results obtained in multiple studies also eliminates potential threats to validity and reliability of the obtained results.
References
Ahola, K., Toppinen-Tanner, S., & Seppänen, J. (2017). Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. Burnout Research, 4, 1–11.
Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. (2017). Burnout Research, 4, 1–11. https://doi.org/10.1016/j.burn.2017.02.001
Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., Hoying, J., McRae, K., Ault, S., Spurlock, E., & Bird, S. B. (2020). Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review. American Journal of Health Promotion, 34(8), 929–941. https://doi.org/10.1177/0890117120920451
Nayeri, N., Nukpezah, R., & Kiwanuka, F. (2021). Article no.AJRNH.71848 (1) Prof. Sharon Lawn, Flinders University, Australia. (2) Dr. Asmaa Fathi Moustafa Hamouda. Asian Nursing Research, 18–36.
Zhang, X., Song, Y., Jiang, T., Ding, N., & Shi, T. (2020). Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses. Medicine, 99(26), e20992. https://doi.org/10.1097/MD.0000000000020992
 

Rubric

NURS_6052_Module03_Week05_Assignment_Rubric

NURS_6052_Module03_Week05_Assignment_Rubric

Criteria
Ratings
Pts

This criterion is linked to a Learning Outcome Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Create a 6- to 7-slide PowerPoint presentation in which you do the following: · Identify and briefly describe your chosen clinical issue of interest. · Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. · Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. · Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

80 to >71.0 pts
Excellent
The presentation clearly and accurately identifies and describes in detail the chosen clinical issue of interest. …The presentation clearly and accurately describes in detail the developed PICO(T) question. …The presentation clearly and accurately identifies four or more research databases used to conduct a search for the peer-reviewed articles selected. …The presentation includes specific and relevant examples that fully support the research. …The presentation provides a complete, detailed, and accurate synthesis of two outside resources related to the peer-reviewed articles selected, and fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.

71 to >63.0 pts
Good
The presentation accurately identifies and describes the chosen clinical issue of interest. …The presentation accurately describes the developed PICO(T) question focused on the chosen clinical issue of interest. …The presentation accurately identifies at least four research databases used to conduct a search for the peer-reviewed articles selected. …The presentation includes relevant examples that support the research presented.

63 to >55.0 pts
Fair
The presentation inaccurately or vaguely identifies and describes the chosen clinical issue of interest. …The presentation inaccurately or vaguely describes the developed PICO(T) question focused on the chosen clinical issue of interest. …The presentation inaccurately or vaguely identifies at least four research databases used to conduct a search for the peer-reviewed articles selected. …The presentation includes inaccurate or vague examples to support the research presented.

55 to >0 pts
Poor
The presentation inaccurately and vaguely identifies and describes the chosen clinical issue of interest or is missing. …The presentation inaccurately and vaguely describes the developed PICO(T) question or is missing. …The presentation inaccurately and vaguely identifies less than four research databases used to conduct a search for the peer-reviewed articles selected or is missing. …The presentation includes inaccurate and vague examples to support the research presented or is missing.

80 pts

This criterion is linked to a Learning Outcome Resource Synthesis

5 to >4.0 pts
Excellent
Using proper in-text citations, the presentation clearly and accurately provides at least four peer-reviewed systematic review type articles selected, describes the levels of evidence in each of the four articles selected, including a thorough and detailed explanation of the strengths of using systematic reviews for clinical research.

4 to >3.0 pts
Good
Using proper in-text citations, the presentation accurately provides at least four systematic review type peer-reviewed articles selected including adequate explanation of the levels of evidence, the strengths of using a systematic review for

3 to >2.0 pts
Fair
Using proper in-text citations, the presentation provides a vague or inaccurate synthesis or outside resources related to the systematic review type peer-reviewed articles selected. The response minimally explains the levels of evidence and the strengths of using a systematic review and/or minimally integrates resources that may support the presentation.

2 to >0 pts
Poor
The presentation provides a vague and inaccurate synthesis of no outside resources related to the articles selected and fails to integrate any resources to support the presentation or is missing.

5 pts

This criterion is linked to a Learning Outcome Resource FormattingAppropriate peer-reviewed articles are included and citations use APA format.

5 to >4.0 pts
Excellent
Presentation includes 4 or more peer-reviewed articles selected using systematic reviews for clinical research. …Citations use correct APA format with no errors.

4 to >3.0 pts
Good
Presentation includes 3 peer-reviewed articles selected using systematic reviews for clinical research. …Citations use correct APA format with few (1-2) errors.

3 to >2.0 pts
Fair
Presentation includes 2 peer-reviewed articles selected using systematic reviews for clinical research. …Citations contain several (3-4) APA format errors.

2 to >0 pts
Poor
Presentation includes 1 or no resources. … Citations contain many >5 APA format errors.

5 pts

This criterion is linked to a Learning Outcome PowerPoint Presentation:The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

5 to >4.0 pts
Excellent
The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

4 to >3.0 pts
Good
Eighty percent of the presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

3 to >2.0 pts
Fair
Sixty to seventy nine percent of the presentation follows these guidelines: presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

2 to >0 pts
Poor
Less than sixty percent of the presentation follows these guidelines: presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting—English Writing Standards:Correct grammar, mechanics, and proper punctuation.

5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts
Good
Contains a few (one or two) grammar, spelling, and punctuation errors.

3 to >2.0 pts
Fair
Contains several (three or four) grammar, spelling, and punctuation errors.

2 to >0 pts
Poor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

Total Points: 10