Evidence-based Practice in Nursing & Healthcare.

Evidence-based Practice in Nursing & Healthcare.

 

Double spaced. Note: To access this Learning Resources 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.Evidence-based Practice in Nursing & Healthcare.

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• 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 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.-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 Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/healthevidence/types#s-lg-box-1520654 Required Media Laureate Education (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD: Author. Discussion: Searching Databases When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems. The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format. In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently.Evidence-based Practice in Nursing & Healthcare. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question. To Prepare: • Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources. • Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. By Day 3 of Week 4 Post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Then, describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.Evidence-based Practice in Nursing & Healthcare.

The PICO methodology is used to find research evidence in support of a change to evidence-based practice or EBP (best practice) using clinical inquiry (Melnyk & Fineout-Overholt, 2019). This is an example of such a PICO inquiry.

Table 1: PICO statement elements

P Patient population Patients with obesity and hypertension
I Intervention (program) A nurse-led bundled approach of education, exercise, diet, and atorvastatin
C Comparison Atorvastatin alone
O Outcome Reduction in the rate of myocardial infarction

 

PICO question: In patients with obesity and hypertension (P), does a nurse-led bundled approach of education, exercise, diet, and atorvastatin (I) compared to atorvastatin alone (C) lead to a reduction in the rate of myocardial infarction (O)?Evidence-based Practice in Nursing & Healthcare.

Search Terms, Two Databases, and Search Results

The two databases that were used to search for peer-reviewed research articles on this PICO question were PubMed and CINAHL (Walden University Library, n.d.-a). To make the search specific and focused, the search terms “nurse education”, “atorvastatin”, “myocardial infarction”, and “prevention” were used. Without using any Boolean operators or filters, the original search only yielded three results. After adding the search terms “nurse education”, “atorvastatin”, “myocardial infarction”, and “prevention” combined using the Boolean operators “OR” and “AND” the results were an impressive 670 articles (Walden University Library, n.d.-b).Evidence-based Practice in Nursing & Healthcare.

The strategies that could be used to make the search more effective and rigorous include filtering the search by publication date, by type of articles, or by presentation (abstract or full text). In this case, applying the randomized controlled trial (RCT) filter yielded 179 results. This was after combining the terms using the Boolean operators in the following manner: “nurse education OR atorvastatin AND myocardial infarction AND prevention”.Evidence-based Practice in Nursing & Healthcare.