Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
NURS 6052 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? Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
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 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 examples.
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.
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.
Note: You will access this article from the Walden Library databases.
Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019.
Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019
Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019.
Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019.
Walden University Library. (n.d.-f). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved September 19, 2018.
Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September 19, 2018.
Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved September 6, 2019.
Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020.
Required Media
Laureate Education (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD: Author.
Advanced Levels of Clinical Inquiry and Systematic Reviews Example PPT Notes
Clinical Issue
My clinical issue of interest was pain assessment. Pain can be physical, emotional, or even sometimes spiritual. Unmanaged pain has long-term and short-term impacts on patient management and outcomes. Pain assessment approaches among children can differ from those used among adults. Younger pediatric patients may not express pain the same way adults do. Therefore, a clinician needs to use more effective and objective ways of assessing pediatric pain, especially among toddlers and preverbal children.
Two types of pain assessment are used among toddlers: behavioral and physiological methods of pain assessment. Physiological indicators include heart rate, oxygen saturation rates, blood pressure, respiratory patterns, and respiratory rates. Behavioral indicators include but are not limited to irritability, restlessness, aggressiveness, screaming, sobbing, and disturbance in sleep. Pain scales used among pediatrics most often use behavioral patterns to assess pain.
Clinical Question
My research question stated: among preverbal pediatric patients, does the use of pain scales more accurate in pain assessment compared with physiological indicators? My population in this clinical issue is preverbal pediatric patients, intervention is the use of pain scales, and comparison is the use of physiological indicators in pain assessment. The outcome of these interventions is the accuracy of pain assessment.
Search Databases
My databases were the Cumulative Index to Nursing and Allied Health Literature, Cochrane databases of systematic reviews, the American Psychological Association PsycINFO, and PubMed databases. These databases contain peer-reviewed journals of various types and books, among other literature sources.
Selected Articles #1 & 2
Both articles are Systematic reviews of randomized controlled trials and other studies. Therefore, their level of evidence is level I according to Melnyk & Fineout-Overholt (2022).
Selected Articles #3 & 4
Both articles are Systematic reviews of randomized controlled trials and other studies. Therefore, their level of evidence is level I according to Melnyk & Fineout-Overholt (2022)
Strengths of Using Systematic Reviews
Systematic reviews are considered sources of literature strongest evidence level. However, other methodologies also provide good evidence for healthcare decision-making. They have a narrow focus and thus a high level of evidence. They incorporate comprehensive and systematic evidence searches. Utilize relevant primary sources to provide more focused evidence. Their data synthesis is systematic, rigorous, systematic, and clear thus easily retrievable and usable. The findings have sufficient statistical power when many RCTs articles are used.
References
Ahn, E., & Kang, H. (2018). Introduction to systematic review and meta-analysis. Korean Journal of Anesthesiology, 71(2), 103–112. https://doi.org/10.4097/kjae.2018.71.2.103
Chan, A. Y., Ge, M., Harrop, E., Johnson, M., Oulton, K., Skene, S. S., Wong, I. C., Jamieson, L., Howard, R. F., & Liossi, C. (2022). Pain assessment tools in paediatric palliative care: A systematic review of psychometric properties and recommendations for clinical practice. Palliative Medicine, 36(1), 30–43. https://doi.org/10.1177/02692163211049309
Kang, H. (2021). Use, application, and interpretation of systematic reviews and meta-analyses. Korean Journal of Anesthesiology, 74(5), 369–370. https://doi.org/10.4097/kja.21374
Korving, H., Sterkenburg, P. S., Barakova, E. I., & Feijs, L. M. G. (2020). Physiological measures of acute and chronic pain within different subject groups: A systematic review. Journal de La Societe Canadienne Pour Le Traitement de La Douleur [Pain Research & Management], 2020, 1–10. https://doi.org/10.1155/2020/9249465
Letzkus, L., Fehlings, D., Ayala, L., Byrne, R., Gehred, A., Maitre, N. L., Noritz, G., Rosenberg, N. S., Tanner, K., Vargus-Adams, J., Winter, S., Lewandowski, D. J., & Novak, I. (2021). A systematic review of assessments and interventions for chronic pain in young children with or at high risk for cerebral palsy. Journal of Child Neurology, 36(9), 697–710. https://doi.org/10.1177/0883073821996916
Loeffen, E. A. H., Stinson, J. N., Birnie, K. A., van Dijk, M., Kulkarni, K., Rijsdijk, M., Font-Gonzalez, A., Dupuis, L. L., van Dalen, E. C., Mulder, R. L., Campbell, F., Tissing, W. J. E., van de Wetering, M. D., & Gibson, F. (2019). Measurement properties of instruments to assess pain in children and adolescents with cancer: a systematic review protocol. Systematic Reviews, 8(1), 33. https://doi.org/10.1186/s13643-019-0945-4
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer Health.
Sataloff, R. T., Bush, M. L., Chandra, R., Chepeha, D., Rotenberg, B., Fisher, E. W., Goldenberg, D., Hanna, E. Y., Kerschner, J. E., Kraus, D. H., Krouse, J. H., Li, D., Link, M., Lustig, L. R., Selesnick, S. H., Sindwani, R., Smith, R. J., Tysome, J., Weber, P. C., & Welling, D. B. (2021). Systematic and other reviews: criteria and complexities. Le Journal d’oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale [Journal of Otolaryngology – Head & Neck Surgery], 50(1), 41. https://doi.org/10.1186/s40463-021-00527-9
Subramaniam, S. D., Doss, B., Chanderasekar, L. D., Madhavan, A., & Rosary, A. M. (2018). Scope of physiological and behavioural pain assessment techniques in children – a review. Healthcare Technology Letters, 5(4), 124–129. https://doi.org/10.1049/htl.2017.0108
Rubric Detail
| Excellent | 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. | 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. |
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. |
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. |
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| 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. |
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. | 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. | 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. |
5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors. | 3.5 (3.5%) – 3.5 (3.5%)Contains several (three or four) grammar, spelling, and punctuation errors. | 0 (0%) – 3 (3%)Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | |||
| Total Points: 100 | ||||||
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