Part 1 PICO question For nurses working in the emergency...

Question Part 1 PICO question For nurses working in the emergency… Part 1PICO questionFor nurses working in the emergency department, how does continuous education on CAUTI prevention bundle improve practices compared with the absence of education programs and maintaining current practice reduces the rate of CAUTI?For this PICO question choose any combination of qualitative, quantitative, systematic review, and/or practice guideline resources for a total of two different resources. Collect what you believe to be the most relevant resources by using an effective combination of search terms, search parameters, and a systematic search process. In order to demonstrate competence, you must collect evidence from reputable sources, including health science databases, databases maintained by nonprofit international organizations for health practitioners, and databases supported by professional specialty organizations in the health field. Refer to this article for ways to assess databases, information about conducting effective searches, and names of some of the databases that are relevant to evidence-based nursing practice.[So, where to start? The answer obviously depends on the topic, how much time you have to devote to the search, and whether you are doing it as an individual or as part of a group developing an e-b protocol. Search strategy also depends to a great extent on the type of evidence you are looking for. There are places to look specifically for evidence-based clinical practice guidelines (EbCPGs) or for systematic reviews (SRs), but there are also resources that can be used to identify all three types of research evidence, i.e., EbCPGs, SRs, and individual study reports.Also, searching from the point of care on a handheld device will be different than an extensive search for an e-b project. This chapter describes what is available from a health center or academic library. Point-of-care searching on handhelds will be addressed in Chapter 19.For reasons stated earlier, most often it is best to start by looking for EbCPGs and SRs. You can search for both in a health science citation database or by going to the databases of organizations that indexes just EbCPGs or SRs. Let’s start with the health science databases.Health Science DatabasesFirst the basics: A database is a collection of a specified type of data that is organized for storage, accessibility, and retrieval. The specific type of data of interest to evidence-based nursing is bibliographic information about journal articles (and other resources) in the health sciences. Three of the most widely used by nurses are described below.PubMed/MEDLINEThe most accessible database listing healthcare-related publications is PubMed. It is the online version of MEDLINE and is available at http://www.ncbi.nlm.nih.gov/pubmed/. Even simple searches using keywords are aided by pop-up suggestions. A PubMed search produces a list of relevant article citations, often with abstracts, and sometimes with links for accessing the article (see the screen shot that follows).Reproduced from PubMed, National Center for Biotechnology Information, U.S. National Library of Medicine.The PubMed search engine is quite powerful and has numerous features to help you get to the topic and evidence type of interest. Filters are available to help narrow your search by date, journal type, or languageto name just a few. Using the filter Article type, Customize you can limit your search to “practice guideline” and/or “systematic review.” Beware, however, that not all the guidelines retrieved are evidence-based and not all the systematic reviews meet the definition.Like with all the health science databases, it takes a bit of trial and error and practice to get good at using PubMed, but for those who rely on the Internet for doing their searching, the time would be well spent. To get you up to speed, the site provides a quick-start guide and tutorials.For readers who have access to a health science library, you can access MEDLINE via the library’s subscription. Most libraries have subscriptions to many journals, and often you can download the article right from the search engine the library uses. If a library doesn’t have a subscription to a particular journal, it can usually obtain the article you are interested in via other means.Cumulative Index to Nursing and Allied Health LiteratureThe Cumulative Index to Nursing and Allied Health Literature, better known as CINAHL, is an index of articles in nursing and allied health journals and other resources that are not included in MEDLINE, although there is considerable overlap between the two databases. CINAHL is available only by subscription, but all academic healthcare libraries and many hospital libraries have a subscription for use by students, their staff, and in many cases, by members of the public. Many articles are available in full text. Like PubMed, you can do a simple search using keywords and combine them with AND or OR. You can then limit your search by article type, date of publications, or age of the population of interestto name a few of the limits possible. Again, tutorials are provided, and most librarians will assist you in learning to navigate it.PsycINFOThis database is centered on the interdisciplinary literature in psychology and the behavioral and social sciences. Many health science libraries subscribe to it, and it is searchable in many of the same ways that CINAHL is. A fact sheet about it is available at http://www.apa.org/pubs/databases/psycinfo/psycinfo-printable-fact-sheet.pdf.Nonprofit, International OrganizationsThere also are quite a few independent international organizations that produce or maintain databases of EbCPGs and SRs. The following is a sampling of these organizations.Registered Nurses Association of OntarioThis organization produces high-quality guidelines on a wide variety of topics. It uses an explicit and transparent production process and has to date published and updated over 50 best practice guidelines, quite a few of which are available in languages other than English. Its guidelines are available free at its website, http://rnao.ca/bpg. It also offers condensed guidelines for mobile devices and implementation tool kits.National Guideline ClearinghouseThe National Guideline Clearinghouse maintains an indexed database of clinical practice guidelines produced by a wide variety of organizations. The guidelines, which must meet inclusion criteria, are presented in a standardized format. Its index can be searched by disease/condition, by treatment/intervention, or by health service sector (e.g., profession, geographic area, or by the organization producing the guideline). National Guideline Clearinghouse guidelines are available free at http://www.guideline.gov/index.aspx.U.S. National Preventive Services Task ForceThis agency systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. It offers an app to search for USPSTF recommendations by specific patient characteristics, including age, gender, and selected behavioral risk factors. Its website is http://epss.ahrq.gov/PDA/index.jsp.Joanna Briggs InstituteThe Joanna Briggs Institute is an international organization based in Australia with collaborating centers in over 40 countries. Its undertakings in the areas of developing and supporting the synthesis, transfer, and utilization of evidence is quite broad, but it does maintain a database of systematic reviews and implementation reports it and its international collaborating centers have produced. Most Joanna Briggs Institute resources are available only by subscription through a library; check to see if the library you use has a subscription. The Joanna Briggs Institute website is at http://joannabriggs.org/.Cochrane CollaborationAlso an international organization, the Cochrane Collaboration promotes evidence-informed health decision-making by producing high-quality systematic reviews. The Cochrane Database of Systematic Reviews includes reviews produced by the Cochrane Collaboration and its partner groups. As of this writing, its SRs become free for all readers 12 months after publication via open access; however, it is working to make them open access immediately. Its open access guidelines are available at http://www.cochrane.org/search/site.Professional Specialty OrganizationsMany professional specialty organizations produce and make available EbCPGs and SRs. Some organizations publish their guidelines in a book that can be purchased; others make them free to members, and others make their guidelines free online. The rigor of guideline development across the many producers varies. The list is long but here are a few that make guidelines available free online:}After you have selected the two resources related to your PICO question, complete the performance task assessment using the following prompts:Resource Appraisal: Complete the corresponding appraisal worksheet for each of the resources selected. This will guide you to not only find credible and reliable resources but also synthesize the information. Note: That there are different appraisal worksheets for the different types of articles, so be sure that you choose the worksheet that corresponds to the resource you select.EP4003_Assessment_QualitativeAppraisalGuideEP4003_Assessment_QuantitativeAppraisalGuideEP4003_Assessment_SystematicReviewAppraisalGuideEP4003_Assessment_PracticeGuidelineReviewAppraisalGuidePart 2A summary of each article or resource and describe how each one relates to your PICO question.Identify the level of evidence in each article and describe the relative strengths and applicability of the study to your PICO question by using the AACCN hierarchy of evidence.Synthesize the evidence from both articles into a statement that supports your PICO question.Describe any additional evidence that you think will be necessary to support your PICO question.Finally, describe any gaps in the literature related to the PICO question.Part 3Based on the literature search, appraisals, and synthesis, defend either by keeping your PICO question the same or making changes. If you will make changes to the PICO question, provide the new version. Health Science Science Nursing NURS 4100 Share QuestionEmailCopy link Comments (0)