nursing research

My Instructor’s advice

As I was reviewing discussion posts from last week, I noticed that some of you are struggling with identifying the components of your PICOT question. You can find detailed information in your Melnyk & Fineout-Overholt (2019) textbook, pages 34-52, I will summarize below the steps that you can take to develop your question. Some of you have already worked through this process either through this structure process or worked it out in other ways.

1. Background questions

1. You will identify a problem that you see in your nursing practice. Perhaps you are seeing new nurses leave after 6 months. Maybe you are seeing patient satisfaction scores dip or patients have expressed that they feel they are not being listened to. Another issue you may have seen is that CLABSI rates in your unit are higher than they should be.

2. To start off with, you will ask background questions, usually the answers to these type of questions can be answered in a textbook or a Google search.

3. Example 1: What is the best approach to nurse retention?

4. Example 2: How does a clinical decision support system (CDSS) help clinicians provide best care?

5. Example 3: What are better ways to avoid CLABSI

2. Foreground questions

1. Once you have explored your background questions and found some answers, you will formulate some foreground questions and do some research in the library to find research related to you topic.

2. Example 1: In newly graduated licensed nurses, how does a nurse residency program compared with traditional precepted orientation affect retention rates after 1 year?

3. Example 2: In acute care clinicians, how does an electronic health record (EHR) with a CDSS compared with an EHR without a CDSS affect a clinician's adheranceto clinical pathway choices, documentation or care, and completions of documentation within his or her given shift?

4. Example 3: In critical care patients, what is the effect of using alcohol-impregnated disinfection caps compared to current practice of standard cleaning protocol, which involves scrubbing the catheter hub with an alcohol disinfectant wipe prior to accessing the lines on rates of CLABSI?

3. Once you have explored reviewing articles related to you your foreground questions.

1. Develop a PICOT question and find higher level articles that help you answer the question.

4. After finding supporting evidence, which should reveal a nursing practice that is evidence based.

1. In answer to you PICOT question what is the nursing practice that your would recommend

1. this could be a change in practice or that the current practice is appropriate

I look forward to reviewing your power points this week.

Another question has been about how identify levels of evidence.

· First to identify the type of article refer to this previously posted document  Category of articles.docx  

· As far as identifying levels of evidence, I would first mention that there are many versions of what is included in the levels. For example, you textbook uses a  Levels of evidence from Melynk and Fineout-Overholt, 2019.docx    , the library uses another version https://academicguides.waldenu.edu/library/healthevidence/evidencepyramid (the library link will provide more guidance on identifying the level), but this course uses the Johns Hopkins version as copied below and attached here  Level of evidence.docx   . Which ever version you use, be sure to cite the source. When you do your next matrix you will use the Johns Hopkins version, so I would suggest you go ahead and start using it. 

Evidence Levels:

 

•             Level I

Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis

 

•             Level II

Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis

 

•             Level III

Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis

•             Level IV

Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence

•             Level V

Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence