NURS 6052 EBP Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

Strengths of Systematic Reviews for Clinical Research

}Focus on a specific clinical question & conduct an literature search

}Method used to find & select the studies reduces bias

}High likelihood of reliable & accurate conclusions

}Reveal where knowledge is lacking

}Improve generalizability & consistency of results

Strengths of Systematic Reviews for Clinical Research

A Systematic Review refers to an article in which the authors have systematically searched for, appraised, and summarized all medical literature for a specific topic. Systematic reviews typically focus on a specific clinical question and conduct an extensive literature search to identify studies with sound methodology (Sriganesh et al., 2016).

An advantage of using systematic reviews in clinical research is that the method used to find and select the studies reduces bias and are highly likely to produce reliable and accurate conclusions (Sriganesh et al., 2016).

A systematic review synthesizes the results of multiple primary studies related to each other using strategies that reduce biases and random errors. It also summarizes findings from multiple studies, making the information easier for the end-user to read and understand.

Systematic reviews follow a strict scientific design based on explicit, pre-specified, and reproducible methods. As a result, they provide reliable estimates about the effects of interventions so that conclusions are defensible (Sriganesh et al., 2016).

Systematic reviews can also reveal where knowledge is lacking. This can then be used to guide future clinical research.

They help to reduce the time delay in the research discoveries to implementation.

Improve the generalizability and consistency of results (Sriganesh et al., 2016).

Reference

Sriganesh, K., Shanthanna, H., & Busse, J. W. (2016). A brief overview of systematic reviews and meta-analyses. Indian journal of anaesthesia, 60(9), 689–694. https://doi.org/10.4103/0019-5049.190628

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

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?

Searching Databases 

 I am a registered nurse who works with HIV-positive and sexually transmitted infectious positive patients. Since my employment, I have gained a lot of knowledge and developed many questions. While employed at an HIV clinic in Houston, I learned that their providers do not start a newly diagnosed HIV-positive patient on highly active antiretroviral therapy (HAART) medications until their lab results are ruled out for opportunistic infections (OI). The practice in the current HIV clinic I work for starts patients on HAART medications as soon as HIV positive results are known and before labs results determine if a patient has OIs. “Questions are the driving force behind evidence-based practice (EBP)” (Davies, 2011). From observing these differences in practices, I developed the clinical question of which method is safer for the patient. 

 The best way to develop a research question is the use the PICOT method (Melnyk and Fineout-Overholt, 2018). In the PICOT method, the letters represent what should be included in the question (P: population of interest; I: intervention or issue of interest; C: comparison of interest; O: outcome expected; and T: time for intervention to achieve an outcome). My clinical interest using the PICOT model is: “In newly diagnosed HIV patients (P), does prescribing HAART treatment before full opportunistic infection workup (I) as compared to prescribing after full workup (C) prove to be safer (O) during the time of entry into care (T)? To find the answers to my question, I must find other works of articles like my question with the help of ProQuest Nursing & Allied Health Database and MEDLINE with Full-Text database. 

 When searching for articles using key terms like “HAART therapy” and “opportunistic infections,” I found 787 results on MEDLINE with Full-Text database and 146 results on ProQuest Nursing & Allied Health Database. To increase the rigor and effectiveness of my database search, I will use Boolean phrases, keywords, and filters. “Boolean operators and nesting help you search for combinations of words or phrases processed in a specific order” (Library of Congress, n.d.). When I narrowed my search to under ten articles, I read each abstract to determine if the article provided the information I needed for my research. 

 

 

Reference

Davies, K. S. (2011). Formulating the Evidence Based Practice Question: A Review of the Frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved March 22, 2022, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

 

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 examples.

By Day 7 of Week 5

Submit Part 2 of your Evidence-Based Project.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK5Assgn+last name+first initial.(extension)” as the name.
• Click the Week 5 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 5 Assignment Rubric

 

Check Your Assignment Draft for Authenticity

To check your Assignment Draft for Authenticity

Submit your Week 5 Assignment Draft and review the originality report

 

Submit Your Assignment by Day 7 of Week 5

To participate in this Assignment:

Week 5 Assignment

 

Next Module

 Module 3: Advanced Clinical Inquiry and PICO(T) Questions (Weeks 4-5)

Laureate Education (Producer). (2018). The Value of Clinical Inquiry [Video file]. Baltimore, MD: Author.

Due By	Assignment
Week 4, Days 1-2	Read the Learning Resources. Compose your initial Discussion post.
Week 4, Day 3	Post your initial Discussion post. Begin to compose your Assignment.
Week 4, Days 4-5	Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment.
Week 4, Day 6	Post two peer Discussion responses. Continue to compose your Assignment.
Week 4, Day 7	Wrap up Discussion.
Week 5, Days 1-6	Continue to compose your Assignment.
Week 5, Day 7	Deadline to submit your Assignment.

Learning Objectives

Students will:

• Create an answerable research question using the PICO(T) question format
• Apply effective search strategies to identify relevant peer-reviewed and systematic reviewed research
• Analyze strategies to increase rigor and effectiveness of database searches for PICO(T) questions
• Analyze levels of evidence in peer-reviewed research

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)
• Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 55–92)

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N

Note: You will access this article from the Walden Library databases.

 

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79

Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58

Note: You will access this article from the Walden Library databases.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e

Note: You will access this article from the Walden Library databases.

 

Required Media

Laureate Education (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD: Author.

Rubric Detail

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Content

Name: NURS_6052_Module03_Week05_Assignment_Rubric

		Excellent	Good	Fair	Poor
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 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.		Points Range: 81 (81%) – 90 (90%) 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 clearly and accurately provides full APA citations for at least four peer-reviewed articles selected, including a thorough and detailed explanation of the strengths of using systematic reviews for clinical research. 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.	Points Range: 72 (72%) – 80 (80%) 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 accurately provides APA citations for at least four peer-reviewed articles selected, including an adequate explanation of the strengths of using systematic reviews for clinical research. The presentation includes relevant examples that support the research presented. The presentation provides an accurate synthesis of at least one outside resource related to the peer-reviewed articles selected. The response integrates at least one outside resource and two or three course-specific resources that may support the presentation.	Points Range: 63 (63%) – 71 (71%) 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 inaccurately or vaguely provides APA citations for at least four peer-reviewed articles selected, including an inaccurate or vague explanation of the strengths of using systematic reviews for clinical research. The presentation includes inaccurate or vague examples to support the research presented. The presentation provides a vague or inaccurate synthesis or outside resources related to the peer-reviewed articles selected. The response minimally integrates resources that may support the presentation.	Points Range: 0 (0%) – 62 (62%) 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 inaccurately and vaguely provides APA citations for at least four peer-reviewed articles selected, including an inaccurate and vague explanation of the strengths of using systematic reviews for clinical research, or is missing. The presentation includes inaccurate and vague examples to support the research presented or is missing. 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.
Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.		Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.	Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	Points Range: 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion are provided.
Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.		Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	Points Range: 4 (4%) – 4 (4%) Contains a few (one or two) grammar, spelling, and punctuation errors.	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) grammar, spelling, and punctuation errors.	Points Range: 0 (0%) – 3 (3%) Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Total Points: 100

Name: NURS_6052_Module03_Week05_Assignment_Rubric