Evidence-Based Project, Part 3: 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? 

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. 

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 for the Assignment.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level related to your research question.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

I recreate a different PICOT question: This is my discussion

In my observation, the practice problem is nurses are focused on administering medications, completing paperwork and working on care plans resulting in lack of engagement with their patients. The scope of this issue is nursing needs to educate themselves and find therapeutic ways to engage patients. The need for change arose in my practice related to increase violent incidents on staff, nurses and patients. 

Psych patients become extremely bored when they are not engaged. An idle mind is a playground for negative and unconstructive thoughts and actions. When mentally ill patients are admitted to hospitals; the goal along with maintaining safety is to provide a therapeutic environment so patient can learn or enhance positive coping skills when dealing with the symptoms of their mental illness. According to Melnyk & Fineout-Overholt, 2015, “ The type of study that would provide the best answer to an intervention or treatment question would be systematic reviews or meta-analyses, which are regarded as the strongest level of evidence on which to base treatment decisions.

“One of the most challenging aspects of EBP is to actually identify the answerable question. This ability to identify the question is fundamental to then locating relevant information to answer the question”(Davies, 2015). An unstructured collection of keywords can retrieve irrelevant literature, which wastes time and effort eliminating inappropriate information. Successfully retrieving relevant information begins with a clearly defined, well-structured question.

My scenario is for inpatient psychiatric hospitals patients with a lot of therapeutic activities within the hospital and outside hospital activities. The organization are now concerned about increase violent behaviours if there are lack of therapeutic activities over hospital stay.

PICOT question:  In inpatient psychiatric Hospitals does the lack of therapeutic activities and or groups increase violent behaviors over a 2 week period?

P– (Patient, population, or problem): All Inpatient psychiatric patients

I– (Intervention): Increase groups and structured activities to engage patients to decrease boredom when patients have down time

C– (Comparison with other treatment/current practice): Compare patient behaviors during the week and day shift when groups are provided vs patient behaviors on evening shifts and weekends

O– (Desired outcome): Decrease violent incidents among patients and staff and increase patient engagement during hospitalization

T– (Time Frame): 2 weeks

After formulating a proper PICOT question, the search begins by using the most appropriate database. The University Library (n.d.-a.) has specific databases that contain several nursing related journals that will definitely be helpful in my research. Database search defines essential aspects based on the underlying issue as well as how the information is searched.  Therefore different approaches can help manage inpatient psychiatric patient. The leading search terms that were included, were preventing violent incidents among patients, staff and increase patient engagement during hospitalization. where more than  500 search results were returned. 

Increasing the accuracy of the findings is essential and provide a unique emphasis on significant changes which help define a strong focus on research outcomes. Therefore growing efficacy of the results will focus on the reduced year of publication to understand the latest publications that provide information on the research issue. Another approach would be to focus on the identified interventions individually to achieve positive outcomes. The main databases that were involved are Medline and Ebsco Host. These databases contain peer-reviewed research, which is of high quality.

References   

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. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144 

Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing (4th ed.). Philadelphia, PA: Wolters Kluwer. 

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. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2010/03000/Evidence_Based_Practice,_Step

 University Library. (n.d.-b).  Keyword searching: Finding articles on your topic: Boolean terms. Retrieved from http://academicguides.waldenu.edu/library/keyword/booleanI

The Assignment (Evidence-Based Project)

Part 3: 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.

Rubric:

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.–

Levels of Achievement:  Excellent 81 (81%) – 90 (90%)    Good 72 (72%) – 80 (80%)    Fair 63 (63%) – 71 (71%)    Poor 0 (0%) – 62 (62%)   

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.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)   

Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)