Evidence-Based Project Paper

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?

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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. Evidence-Based Project Paper

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. Evidence-Based Project Paper

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. Evidence-Based Project Paper

W552Assign.docx

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.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

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. Evidence-Based Project Paper

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.

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp

Walden University Library. (n.d.-f). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/boolean

Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/searching-basics

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, from https://academicanswers.waldenu.edu/faq/72670. Evidence-Based Project Paper

Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/healthevidence/types#s-lg-box-1520654

W552Rubric.docx

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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.

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.

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.

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.

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.

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.

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.

4 (4%) – 4 (4%)

Contains a few (one or two) grammar, spelling, and punctuation 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.

WK3Assgnguide.doc

Matrix Worksheet Template

Use this document to complete Part 2 of the Module 2 Assessment, Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies

Full *citation* of selected article	Article #1	Article #2	Article #3	Article #4
	Hessels, A. J., Paliwal, M., Weaver, S. H., Siddiqui, D., & Wurmser, T. A. (2019). Impact of patient safety culture on missed nursing care and adverse patient events. Journal of nursing care quality, 34(4), 287-294.	Fathi, A., Hajizadeh, M., Moradi, K., Zandian, H., Dezhkameh, M., Kazemzadeh, S., & Rezaei, S. (2017). Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting. Epidemiology and health, 39.	Griffiths, P., Ball, J., Bloor, K., Böhning, D., Briggs, J., Dall’Ora, C., … & Meredith, P. (2018). Nurse staffing levels missed vital signs and mortality in hospitals: retrospective longitudinal observational study. Health Services and Delivery Research, 6(38).	Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., … & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(1), 6-22.
*Why* you chose this article and/or *how it relates* to the clinical issue of interest (include a brief *explanation of the ethics* of research related to your clinical issue of interest)	I selected this article because it relates to my area of research which is the medical errors in nursing. The article describes the relationship that exists among patient safety culture, missed nursing care and adverse patient events.	I chose this article because it looks at my area of concern which are medical errors and how they can be prevented. The article is very thorough in looking at the prevalence and the type of medical errors and the barriers that exists in reporting medical errors	The major reason why I chose this article has elaborated on the relationship that exists between low staffing and adverse patient outcomes. This relates to my area of study explaining the significance of this article	I chose this article because it aimed at looking at the association of nurse staffing level with the patient outcomes which is related to the medical errors that is my main point of focus
Brief *description of the aims* of the research of each peer-reviewed article	This research is aimed at looking at the relationship that exists between nursing care and adverse events of care which can be prevented such as falls	This study was aimed at the prevalence of medical errors in clinical settings and how these errors can be minimized. Similarly, the article reported on the barriers that makes it hard reporting these issues.	In this study, the researchers at evaluating the impact of nurse staffing on the outcome of the patients. The nursing workloads at a unit level harm the patient’s outcome according to this article	The researchers of this article evaluated nurse sensitive patient outcomes basing on the ration on nurses to patients. It there looked at the connection between these two variables.
Brief description of the *research methodology* used Be sure to identify if the methodology used was *qualitative* , *quantitative* , or a *mixed-methods* approach. Be specific. Evidence-Based Project Paper	The researchers of this study opted to use qualitative methodology. This is where they conducted a cross sectional study that was aimed at determining the relationship that exists between the variables that were captured in this research.	The qualitative research methodology that was used enabled the researchers to be able to easily collect data using statistical methods. The data that was used in this case was primary data collected through questionnaires, which made the data valid. This study has clearly elaborated the medical errors that encountered in the clinical settings.	Evidence based practice uses best evidence in coming up with decisions concerning individual care of patients. It integrates individual clinic expertise with the best clinical evidence from systematic studies	In this study, A systematic review and meta-analysis of data were conducted by researchers in studying the association between the ratio of nurses to patients and their outcomes.
A brief description of the *strengths* of each of the research methodologies used, including *reliability* and *validity* of how the methodology was applied in each of the peer-reviewed articles you selected. Evidence-Based Project Paper	This method normally generates words rather than figures as data for study. This means that the aim is answering questions regarding ‘what’, ‘how ‘or ‘why’ of a phenomenon instead of ‘how many’ or ‘how much’. the data was naturally gathered in the settings of the contestants and data analysis was done by interpreting the meaning of data. Selecting the right method of research is very important for the overall success of the research. Regardless of the method used, the data collection technique must be suitable and capable of meeting the study objectives. The primary data through surveys that were conducted in this research shows that the data is valid and reliable.	The researchers of this article used a quantitative research method. The study used Convenience sampling and questionnaires method in collecting data. Sampling s very importantly since it helps in the identification of the population which satisfies the characteristics the study is trying to capture. The questionnaires were easy for respondents to give the required information and record the answer in a way that was easily interpreted	This study used quantitative research method making it reliable and valid. the nurse-patient ratio in a unit is used in comparing the relationship between the outcomes of patients and the staffing of nurses.	Meta-analysis is quantitative study that thoroughly evaluates earlier research studies, and it derives conclusions concerning that research. It can be used to identify the universal result like in this case scenario. We can say that this research is effective because it used objective formulas.
General Notes/Comments	This method also provides a more relaxed atmosphere in which a person is gathering information because individuals are much more at ease having a conversation about issues	This is a good choice of data collection as it involves a more manageable time commitment as compared to telephone surveys and focus groups. This is very useful when somebody wants to get detailed information about a certain issue	Workload parameters are one of the factors affecting the outcomes of the patients and the satisfaction of the nurses in their places of work. The more patients a nurse cares for, the higher the degree of dissatisfaction. When a nurse takes care of a few patients, the greater the job satisfaction of the RNs.	meta-analysis represents the first level of evidence the research was also very rigorous reflecting actual results clinicians

References

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., … & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(1), 6-22.

Fathi, A., Hajizadeh, M., Moradi, K., Zandian, H., Dezhkameh, M., Kazemzadeh, S., & Rezaei, S. (2017). Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting. Epidemiology and health, 39.

Griffiths, P., Ball, J., Bloor, K., Böhning, D., Briggs, J., Dall’Ora, C., … & Meredith, P. (2018). Nurse staffing levels, missed vital signs and mortality in hospitals: retrospective longitudinal observational study. Health Services and Delivery Research, 6(38).

Hessels, A. J., Paliwal, M., Weaver, S. H., Siddiqui, D., & Wurmser, T. A. (2019). Impact of patient safety culture on missed nursing care and adverse patient events. Journal of nursing care quality, 34(4), 287-294.

Matrix Worksheet Template