.QUESTION
Collaborative identification and interpretation of practice problems
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It is essential that you read over the directions as these have key instructions and helpful hints to complete the required worksheet. I encourage you to read the directions first and then download your required worksheet located here, read over the practice base scenario and your grading rubric which is located underneath the practice base scenario. Be sure again that you're using your grading rubric to complete the required worksheet. Your instructor will use a grading rubric to evaluate each of the criteria you will be completing. Please be sure that you complete the assignment using that first column to ensure you capture all available points for that criteria. Before you begin completing the worksheet, you must be sure that you read over the assignment practice scenario. This scenario mimics something that could be experienced in clinical nursing practice. It includes you being assigned to a Nursing Evidence-based Committee, and as a committee member you are required to complete the PPE worksheet. After reading the assignment practice scenario, you are to select one of the key nursing independent practice issues from this list of familiar, quality, and safety clinical problems. Again, you are to choose only one problem area. There are several links in your directions for this assignment. The PPE worksheet is required, and you must complete the PPE worksheet that is available here. You can download from this link. Please make sure that you use the current worksheet for this session you are taking the course. You also have some helpful sources from the library located here. You also have your NR439 guide for writing PICOT questions and examples that you need to use to help you be successful in writing a PICOT question. If you are interested in practicing writing PICOT questions, please be sure that you visit your Week 2 lesson area and scroll down to the practice case studies designed to assist you with practicing, creating, and writing PICOT formatted clinical questions. Here is an example of a completed PPE worksheet. The following is an example only you will notice that I've chosen a problem that is not one of the practice problems, as this is an illustration only. You must use your grading rubric to ensure you're meeting all elements of the required assignment. I have chosen a clinical nursing problem of smoking, and you will notice that I have done some preliminary search of evidence on this problem. In doing so, I came across this study by Panpakdee, indicating a nursing model as an intervention that demonstrated an impact on reducing patient smoking. I have summarized why I believe this problem is important and supported with the evidence I located, and I summarized why I chose the problem. The next criteria is the clinical nursing PICOT question, and I used the NR439 guide for writing PICOT questions and examples to create my question. From that question, you can copy and paste the PICOT elements into the defined PICOT elements criteria. For the evidence retrieval process and summary, you need to complete the list of criteria. It includes using only the CCN library, and I located nursing evidence related to my problem, and I explained why I believe the evidence is nursing related and why I chose the evidence. I also provided a complete APA reference which includes the authors, the year, the title of the evidence, and the name of the resource that it came from. This study was completed within the last 10 years, and I also provided the permalink. Remember, the directions for providing a permalink are found in your guidelines located here. Next you will see I summarized the study by discussing what I learned and why I believe the Nursing Evidence-based Practice Committee should focus their next research project on this problem I chose. The next element is the evidence search terms, which requires you to select key terms you used when searching for evidence. You will see the terms that I used are indicated here. I want to encourage you to use the terms nursing interventions in your problem. Doing so will bring up evidence related to your subject. Here you will see an example of some studies and evidence that came up in the library when I use the word nursing interventions and smoking. Finally, you want to select four or more key evidence or strategies you used. I want to point out that I did provide the resources that I used in completing this assignment. This is not required but highly encouraged as we are learning, we need to support our thinking and discussions with evidence. The PPE worksheet assignment is worth a 175 points. I want to point out that you need to use scholarly writing, spelling, grammar, and complete sentences. Be sure you are using mostly your own words to answer the questions, and use in-text APA citations for any paraphrased sentences. You will find APA resources as well as writing assistance in your resource tab. Have fun completing this extremely valuable learning activity. This activity is a great way to help you support your knowledge on how to utilize research and evidence-based practice such as a BSN. As always, please contact your NR439 instructor with any questions. |
NR 439 PICOT Question Guide
The following contains PICOT question guides/templates to use to help write questions using all of the PICOT elements. Each template contains a guide that you can use to write a complete PICOT question, examples of PICOT elements, and illustrations[i]. Review some tips and hints below to think about for each of the PICOT elements that can help create a sound clinical nursing PICOT question:
P=Population of patients: Think about a group of patients you are interested in studying—identify the group by age ranges, diagnosis/disease of interest, history or length of time with the diagnosis/disease of interest, location, unit, or setting, gender type (if applicable), race (if applicable), or other identifiable characteristics such as Medicare, Medicaid, immobile, ventilated, inpatient, outpatient, etc.
I=Intervention: Consider the nursing action or intervention you are thinking that would make a difference? From your search for evidence, what is the evidence indicating that nurses can do to help improve the problem or issue you have chosen?
C=Comparison: Think about comparing to the intervention of interest or the alternative such as routine/standard care. If no comparison, state not implementing the intervention or no comparison group.
O=Outcome: Reflect upon what would be the measurable, relatable indicator that would demonstrate the intervention is making a difference or not? What would be the needed outcome that you could observe/check/measure? For example, “the pain is okay” would not be a measurable outcome. Rates pain level less than 3 on pain scale would be measurable.
T=Timeframe: For this element, reflect on how long it would take to implement your study by collecting data or the time needed to observe to see if any changes occurred or will occur. Think about 1 month, 3 months, 6 months etc... Use a timeframe that is realistic.
Template A
Among/In _________________________ (P), does______________________ (I) (**decrease/increase/impact/influence/affect/reduce/improve**) _____________________ (O) compared to ______________________________ (C) over ______________________________(T)?
(**choose one term**)
Example:
Among 65+ and older diabetic immobile adults in long-term care (P), does a bedside oral care kit and checklist protocol (I) compared to routine oral care without a bedside oral care kit (C) affect the number of times oral care is completed (O) over 3 months (T)?
P=Population of patients: 65+ and older diabetic immobile adults in long-term care
I=Intervention: bedside oral care kit and a checklist protocol
C=Comparison: routine oral care without a bedside oral care kit
O=Outcome: number of times (frequency) oral care is completed
T=Timeframe: 3 months
Template B
Among/In _________________________ (P), would______________________(I) (**decrease/increase/impact/influence /affect/reduce/improve **)_____________________ (O) compared to ______________________________ (C) over ______________________________(T)?
(**choose one term**)
Example:
In male ICU patients who are 65+ and older diagnosed with COPD (P), would the confusion assessment screening tool (CAST) (I) impact the number of early identification of delirium (O) compared to no screening tool (C) over 6 months (T)?
P=Population of patients: Inpatient male ICU patients 65+ and older diagnosed with COPD
I=Intervention: confusion assessment screening tool (CAST)
C=Comparison: routine care/no screening tool
O=Outcome: number of early identification of delirium
T=Timeframe: 6 months
Template C
Among/In _________________________ (P), will ______________________ (I) (**decrease/increase/impact/influence/affect/reduce/improve **)_____________________ (O) compared to ______________________________ (C) over ______________________________ (T)?
(**choose one term**)
Example:
Among Hispanic pregnant women between 36-40 weeks (P), will completing a lactation course (I) increase the number of breastfeeding initiations by or within 6 hours of delivery (O) compared to no lactation course (C) over 6 months?
P=Population of patients: Hispanic pregnant women between 36-40 weeks
I=Intervention: lactation course completed
C=Comparison: no lactation course
O=Outcome: number of breastfeeding initiations within 6 hours of delivery
T=Timeframe: 6 months
Template D
Among/In _________________________ (P), what is the effect of ______________________ (I) on ____________________ (O) compared to ___________________________ (C) over ______________ (T)?
Example:
In pediatric non-Hispanic Black males ages 8-18 years old with a 5 year history of type 1 diabetes (P), what is the effect of the Glucose Buddy Diabetes Tracker app (I) on maintaining HbA1C levels <7% (O) compared to the mySugar Diabetes Tracker Log app (C) over 6 months (T)?
P=Population of patients: pediatric non-Hispanic Black males ages 8-18 years old with 5 year history of type 1 diabetes
I=Intervention: Glucose Buddy Diabetes Tracker app
C=Comparison: mySugar Diabetes Tracker Log app
O=Outcome: HbA1C levels <7%
T=Timeframe: 6 months
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| Subject | Nursing | Pages | 10 | Style | APA |
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Answer
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Problem/PICOT/Evidence Search (PPE) Worksheet |
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Criteria |
Clinical Priority Issue: reducing nurse fatigue and stress among nurses through 8 hourly shifts rather than 12 hourly shifts. Rationale: Long shifts is associated with nurse fatigue and stress may increase the risk of medication errors or increase nurse turnover rates. |
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Clinical Nursing Practice Problem
Select and identify ONLY one quality or safety clinical priority area from the assignment guidelines practice scenario. Summarize why you believe the nursing practice problem/issue is the most important. Summarize your rationale (why) for choosing the problem.
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Clinical Nursing PICOT Question
Using the NR439 Guide for Writing PICOT Questions and Examples located in the assignment guidelines, write out your PICOT question. Include the PICOT letters in your question.
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PICOT Question: Among the nurses (P), does eight (8) hourly shifts (I) compared with 12-hourly shifts (C) help to reduce the level of fatigue and stress among nurses (O) within a period of six (6) months.
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Define PICOT Elements
Define each of the PICOT elements from your question above.
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P- (patient population/patients of interest): Nurses
I- (Intervention): 8-hourly shifts
C- (Comparison): 12-hourly rounding
O- (Measurable outcome): Levels of nurse self-reported fatigue and stress.
T- (Time frame in months): Six months. |
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Evidence Retrieval Process and Summary
Using only the Chamberlain College of Nursing library: (1) Locate evidence that is relevant to your chosen nursing practice problem. Explain how you believe the evidence is relevant to your chosen nursing practice problem. (2) Explain why you chose the evidence (3) Provides a complete APA reference to the evidence (must include authors, year, title of the evidence, title of the resource) (4) Evidence must be published within the last 10 years (5) Provides the permalink
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Article Battle, C., & Temblett, P. (2018). 12-hourly nursing shifts in critical care: A service evaluation. Journal of the Intensive Care Society, 19(3), 214-218. https://journals.sagepub.com/doi/pdf/10.1177/1751143717748094
Relevance The article compares 12-hour and 8-hour shifts on nurse and patient care outcomes. The outcomes that were studied included staff sickness rates, number of personal injuries, clinical incidences, burn-out, and staff training.
Justification: Battle and Temblett (2018) compared with 8-hourly shift, 12-hourly shift on the staff as well as patient outcomes; therefore, the article can inform the PICOT question above. The authors are of the view that 12-hourly shifts have become increasingly popular in hospital settings; thus, it is important to understand the impacts has on nurses as well to patients at the reception end of care and services (Battle & Temblett, 2018).
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Implications of the Evidence Summarize what you learned from the evidence. Summarize why you believe the nursing evidence-based practice committee should focus their next research project on the nursing practice problem. |
In Battle and Temblett’s (2018), 150 nurses participated in the study throughout a two-year study period. The study indicated that there is no statistically significant difference between 8-hourly and 12-hourly shift in terms of outcomes such as staff training, sickness rates, personal injuries, and clinical incidences (Battle & Temblett, 2018). There is need to review other similar studies to compared if there is significant difference in terms of outcomes in terms of 8-hour shift and a 12-hour shift. |
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Evidence Search Terms Identify 4 (or more) relevant searchable terms you used for your search for evidence.
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Evidence Search Terms - 8-hour versus 12-hour shift AND nurse fatigue - 8-hour versus 12-hour shift AND nurse stress - 8-hour AND 12-hour shift in nursing - 8-hour versus 12-hour shift AND nursing staff outcomes.
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Evidence Search Strategies
Select 4 (or more) relevant search strategies you used to narrow/limit your search for evidence. |
____ Full text ____ Boolean Operators/Phrase ____ Selected publication dates within last 10 years ____ Academic or scholarly (Peer Reviewed) journals ____ Selected key terms from PICOT question |
References
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