NR505 Advanced Research Methods

Week 5: Research Literature, Design, Sampling, and Implementation P URPOSE : This assignment provides the opportunity for the student to continue development of a MSN EBP scholarly project that started with the identification of a nursing concern and PICOT/PICo question from Week 2. The focus of this assignment is to discuss the research-based literature support for the selected concern, identify an appropriate research design, explain the sampling method, and discuss implementation through the use of a change model. C OURSE O UTCOME : This assignment enables the student to meet the following course outcome: CO #1. Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (PO # 1) CO #2. Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare outcomes. (PO #2, 5) CO #4. Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. (PO 1, 2, 3, 5) CO #5. Analyze research findings and evidence-based practice to advance holistic nursing care initiatives that promote positive healthcare outcomes. (PO 1, 2, 5) D UE D ATE Sunday 11:59 PM MT at the end of Week Five T OTAL P OINTS P OSSIBLE : 250 POINTS R EQUIREMENTS Description of the Assignment: This continues the development of a MSN EBP scholarly project by requiring the student to identify the additional elements of the process. The required elements are noted to be:  Research Literature Support (NOTE: Fifteen research-based references related to PICOT/PICo question are required)  Research Approach and Design  Sampling W5 Assignment Research Lit Design Sampling Implementation Rev. 07/27/2017 (AR) Rev. 1/10/18 (AR) 1 Chamberlain College of Nursing NR505 Advanced Research Methods: Evidenced Based Practice  Intervention Criteria for Content 1. Research Literature Support: In this section, comprehensive research literature support for the identified nursing concern and PCIOT/PICo question is to be provided. A minimum of 10 (ten) research-based references are required. The use of a systematic research review article as a reference is NOT allowed. All research studies are to be consistent with the selected concern and PICOT/PICo question. The PICOT/PICOT question is restated before presenting the research literature support. For each research-based reference the following information is to be discussed:  Purpose of the research study  Research approach that was used  Data collection methods used  Results of the research study  One strength of the research study  One limitation of the research study. 2. Research Approach and Design: In this section, the student will identify the research approach that he/she plans on using for the EBP project as being either quantitative or qualitative. In addition, if the selected approach is quantitative, the student needs to identify if the design is experimental, quasi-experimental, or descriptive. NR 505 Week 3 Assignment: Research Summary Table: Reducing Surgical Site Infections (SSIs) with Frequent HCG Bathing RESEARCH SUMMARY TABLE: REDUCING SSIs WITH CHG BATHING 2 Reducing Surgical Site Infections (SSIs) with Chlorhexidine Gluconate (CHG) Bathing – PICO Question: Does increasing frequency of chlorhexidine baths preoperatively decrease the incidences of surgical site infections post-operatively? Citations Purpose of Research Research Designs and Sample Data Collection Methods Results Strengths and Weaknesses ¹ : 8080/login?url=. direct=true&db=ccm&AN= 104061324&site=ehost-live – To evaluate efficacy of chlorhexidine in preoperative to prevent surgical site infections (SSIs) – Meta-analysis to systematically review of 16 published prospective controlled clinical trials; n = 17,932 A search of electronic databases was used to identify prospective controlled trials evaluating whole- body preoperative bathing with chlorhexidine versus placebo or no bath for prevention of SSI. 7,952 patients received a HCG bath, and 9,980 patients were allocated to various comparator groups Overall, 6.8% of patients developed SSI in HCG group compared with 7.2% of the other groups. HCG bathing did not significantly reduce SSI when compared with soap, placebo, or no shower or bath (relative risk, 0.90; 95% confidence interval: 0.77-1.05, P = .19). 10 out of 16 studies had No standardized instruction between groups Possible group selection bias No evidence of instructions provided to patients No compliance Measured. 6/16 showed statistical significance in HCG and SSI reduction. ² : 8080/login?url=. direct=true&db=ccm&AN= 104286731&site=ehost-live – To evaluate the effectiveness of preoperative bathing with chlorhexidine gluconate (CHG) cloths for reducing surgical site infections -Prospective cohort study over a 4 month period. Intervention group n = 335 Non-intervention group – n = 284 -Data obtained from randomized controlled selection for interventional group of 40 patients undergoing surgery per week for 16 weeks = 335. For comparative group, random data collected via EBP of 284 patients from same period of previous year = 284 -Statistically significant finding in that only 7/335 patients in interventional group had SSIs postoperatively as compared to 17/284 SSIs seen in the observation group from previous year. (P = .01) – Treatment interruption when Sage recalled products- but those units were censored from the final analysis -LOS and co-morbidities showed declining curves at time of abstract. ³ : 8080/login?url=. direct=true&db=ccm&AN= 111110761&site=ehost-live -To evaluate effectiveness of preop frequency of baths with CHG to increased concentration to HCG on skin surface to reduce bacterial counts post operatively. One of the many issues from Ironridge was the amount of air pollution in the city. I decided to research diseases and diagnoses that were caused by air pollution. I came up with the research question ‘ Does exposure to air pollution increase the risk of being diagnosed with rheumatic diseases?’ The Quantitative study I discovered was a meta-analysis, meaning it was a systematic review that reviewed quantitative studies to gather information and evidence to answer the research question. Meta-analysis’ integrate and statistically summarize evidence from high level studies through a statistical calculation called effect size (Chamberlain College of Nursing, 2016) . Sun et al. (2016) conducted a quantitative study in which their objective was to summarize the existing knowledge of the relationship between air pollution and the development of rheumatic diseases. They searched databases such as MEDLINE and EMBASE, to find cohort and case control studies that reported risk elements for the development of rheumatic diseases regarding air pollution PICOT Worksheet – Week 3 For Use September 2018 Name: Marly Delatour Gabriel Date: 09/22/18 Your Instructor’s Name: Elli Charneia Purpose : To identify a problem or concern that nursing can change and develop a PICOT question to guide the change project. Directions : Use the required form below to complete the Week 3 Assignment PICOT Evidence Worksheet. This includes filling in the table with information about your research question and your PICOT elements and the second part is filling in the Evidence Worksheet. Step 1 : Select the key PICO terms for searching the evidence. Clearly define your PICOT question. List each element P (problem, population, or problem), I (intervention), C (Comparison with other treatment/current practice), and O (Desired outcome), T (Time Frame). Is the potential solution something for which you (as nurse or student) can find a solution through evidence research? Look in your book for guidelines to developing your PICOT question and also read the required articles. Step 2 : Identify the problem. What have you noticed in your work or school environment that isn’t achieving the desired patient or learning outcomes? What needs to change in nursing, what can you change with the support of evidence in the literature? Describe the problem or practice issue that you. Review the differences in predictive and prescriptive studies and select a predictive or prescriptive articlethat you found in your literature search. What are the independent variables (IV), dependent variables (DV), and mediating variables (MVs) that you find in the article? How do determining IVs, DVs, and MVs help you discern the theory tested in the research? In your particular article, what risk factors are identified, or what recommendations are provided? Anaalysis and Application of Clinical Practice Guidelines & Scoring Rubric Purpose The purpose of this assignment is to provide an opportunity for students to apply and disseminate information based on practice summaries. The most common type of practice summary in healthcare is the clinical practice guideline (CPG). Course Outcomes Through this assignment, the student will demonstrate the ability to (CO 3) Synthesize for dissemination the research findings from nursing and related disciplines (POs 1, 3, 4, 5, 9); and (CO 6) Utilize the principles of evidence-based practice to propose strategies that can address nursing issues (POs 1, 3, 4, 5, 7, 9). Due Date: Sunday 11:59 p.m. MT at the end of Week 7 Total Points Possible: 200 Points R EQUIREMENTS : Through this assignment, the student will Develop summary of a clinical practice guideline. (COs 3, 6) P REPARING THE PAPER You will develop a summary that you could use within an evidence-based practice (EBP) committee or related venue to share with your colleagues.  Select (1) one of the following issues: (1) One of the issues identified in Week 1 in Ironridge or Summerville, (2) An issue pertinent to your practice setting.  Search the literature and evidence-based practice websites and databases to find a recent clinical practice guideline (no more than 5 years) related to the issue you select. The course Webliography provides websites where you can find clinical practice guidelines, but there are many others available in specialty-organization websites. A good place to start is . Chamberlain College of Nursing NR505 Advanced Research Methods  Analyze and critique the clinical practice guideline. Use the Clinical Practice Guideline Summary Template in Doc Sharing to develop your paper. Components include o scope and purpose of the clinical practice guidelines; o stakeholder involvement; o rigor of development; o clarity and presentation o applicability o editorial independence  Attach a .pdf file of the Clinical Practice Guidelines with your handout. If you attach the CPG late, you will receive a late-paper deduction.  Note: The template is to assist you in setting up your paper so you will be sure to address those topics in your paper in addition to other information to meet the criteria for this assignment. Your paper should be in APA 6th ed format. Do not copy and paste the template into your paper. The summary sheet is amended from the AGREE instrument on page 200 of Melnyk & Fineout- Overholt (2015). Your summary should be approximately 5 – 6 pages long (Paper lengths do not include cover page or reference page(s). Category Point s % Description Scope and Purpose 25 12.5 Describes the scope and purpose of the document. Includes the health question(s) covered by the guideline Stakeholder Involvement 25 12.5 Describes the stakeholder involvement in the development of the document. Identifies the target population Refinement of Nursing Issue into Research C REFINEMENT OF NURSING ISSUE 2 Background and Significance of Nursing Issue An evidence-based practice (EBP) is known to improve patient care and outcome in the nursing field. Some EBP could take many years for the evidence that is generated from research then it is to be translated into the clinical practice to improve healthcare quality and patient outcomes. When EBP is developed, it is defined as the reliable use of current best evidence to make best decisions about patient care and outcome. Development in research including the evidence-based approach continues to change the relationship between research and practice. Evidenced-based practice initiates with a questioning of clinical practices. Nurses often encounter questions about current practice when delivering care to patients. For example, why do patients come to hospitals when colorectal cancer has aggressively progressed? How do patients prevent colorectal cancer? How can a colorectal cancer screening rate be increased? How can healthcare providers promote colorectal cancer screening and help reduce disparities in colorectal cancer screening? The issue of how to prevent colorectal cancer by screening education could help reduce disparities in colorectal cancer screening in the community. Colorectal cancer is the second leading cause of cancer-related death and is the third most widespread cancer in both men and women and in the United States (Centers for Disease Control and Prevention [CDC], 2017). The rationale of this research within the evidence-based practice is providing an education for both patients and providers, guiding them regarding a colorectal cancer screening through navigator system. It increases colorectal cancer screening to ensure patients living longer, healthier, and supporting the early detection of cancer to lead to higher survival rate and quality of life. This project also examines the importance of nurse navigator system with PICOT question, discusses a review of the collected literature, and proposes practice REFINEMENT OF NURSING ISSUE 3 changes from examining the findings that could help increase colorectal cancer screening in the community The anatomy of good research based on good question. The PICOT format provides a practice-based research frame for the clinician which helps to formulate and explore important research question. So, what is PICOT? P (population)- refers to sample of the chosen subjects, I (Intervention)- refers to treatment or intervention that will implemented to the subjects, C (comparison)- refers to O (outcomes)- represents the result that will measure outcomes of your intervention and T(time)- Time describes the duration of the study (Echhevarria & Walker, 2014). Picot question help to formulate nursing question in a format based on evidence-based practice. It helps the researchers to eliminate unnecessary or unappropriated assumption in the research because some research takes a long time to achieve desired observations. My PICOT format related to my EBP nursing research: Population – children under 5 years of old Intervention – vaccination against childhood disease Comparison – no Vaccination Outcome Critique of Systematic Research Review Amanda Slepicka Chamberlain College of Nursing Advanced Research Methods: Evidenced-Based Practice NR 505 Dr. Bridgette Johnson June 4 th , 2017 CRITIQUE OF SYSTEMATIC RESEARCH REVIEW 2 Critique of Systematic Research Review This paper critically analyzes the Systematic Research Review conducted by Freitas, Dias, Chaves, Ferreira, Ribeiro, Guerra and Mendonca (2015). The topic for review is how postural drainage and its different positions can be used in young children up to six years suffering from cystic fibrosis with regard of risks of gastroesophageal reflux. Despite the low number of studies reviewed, the structure, presentation of this Systematic Research Review, quality of studies’ critique and authors’ conclusions are highly credible. Cystic fibrosis lung disease is characterized by depleted air way sur- CRITIQUE OF SYSTEMATIC RESEARCH REVIEW 3 face liquid volume and thickened mucus, which results in im- paired mucus clearance Cystic fibrosis lung disease is characterized by depleted air way sur- face liquid volume and thickened mucus, which results in im- CRITIQUE OF SYSTEMATIC RESEARCH REVIEW 4 paired mucus clearance Cystic fibrosis lung disease is characterized by depleted air way sur- face liquid volume and thickened mucus, which results in im- paired mucus clearance Cystic fibrosis lung disease is CRITIQUE OF SYSTEMATIC RESEARCH REVIEW 5 characterized by depleted air way sur- face liquid volume and thickened mucus, which results in im- paired mucus clearance Cystic fibrosis lung disease is characterized by depleted air way sur- CRITIQUE OF SYSTEMATIC RESEARCH REVIEW 6 face liquid volume and thickened mucus, which results in im- paired mucus clearance Relevance of the Nursing Research Problem Freitas et al. (2015) state that during the last decades “cystic fibrosis has been increasingly diagnosed in populations from places such as Latin America and the Middle East” (p.3) besides the traditionally affected populations of white Caucasian descent. The authors draw attention on two particular ways of postural drainage usage among children up to six years diagnosed with cystic fibrosis – head-down tilt versus no head-down tilt with different angles

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