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Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment

Course Project: Part 3—Translating Evidence Into Practice

 

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

 

(Link for part 1 – https://www.homeworkmarket.com/content/nurs-5052nurs-6052-essentials-evidence-based-practice-course-project-part-1-grading-rubic-an)

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(Link for part 2 – https://www.homeworkmarket.com/content/nurs-5052nurs-6052-essentials-evidence-based-practice-course-project-part-2-grading-rubic-an)

 

Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field. Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment

 

To prepare:

 

Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?

With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.

Explore possible consequences of failing to adopt the evidence-based practice that you identified.

Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

 

To complete:

 

In a 3- to 4-page paper:

 

Restate your PICOT question and its significance to nursing practice.

Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.

Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.

Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

 

This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course. Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment

Note: In addition, include a 1-page summary of your project.

You will combine Parts 1, 2, and 3 of your Course Project (assigned in Weeks 2, 4, and 8 respectively) into one cohesive and cogent paper.

 

For this final iteration, you will need to:

Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

 

 

Please follow the belo link for Templates:

 

http://academicguides.waldenu.edu/writingcenter/templates

 

Required Readings

 

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 12, “Sampling in Quantitative Research”

This chapter introduces key concepts concerning sampling in quantitative research. This includes such concepts as a description of populations, different types of sampling and their uses, and how to determine a manageable, yet sufficient number to be included in a sample. The chapter also includes suggestions for implementing a sampling plan.

 

Chapter 13, “Data Collection in Quantitative Research”

Once a sampling design is complete, the next step is to collect the data, and this is the focus of Chapter 13. The chapter describes how to develop a data collection plan, and provides information about the different types of instruments that can be used, such as structured observation and biophysiologic measures. Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment

 

Chapter 22, “Sampling in Qualitative Research”

The focus of this chapter is on the sampling process in qualitative research. The chapter describes the different types of sampling and when they are commonly used. Sampling techniques in the three main qualitative traditions (ethnography, phenomenological studies and grounded theory studies) are highlighted.

 

Chapter 23, “Data Collection in Qualitative Research”

This chapter examines the process of data collection in qualitative research as well as key issues surrounding data collection. This includes such methods as self-reporting, surveys, interviews, and personal journal keeping. The chapter also highlights important considerations when utilizing unstructured observations to gather data and how to record field notes. Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment

Keough, V. A., & Tanabe, P. (2011). Survey research: An effective design for conducting nursing research. Journal of Nursing Regulation, 1(4), 37–44. Copyright 2011 by Elsevier Science & Technology Journals. Used with permission of Elsevier  Science & Technology Journals via the Copyright Clearance Center.

 

This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.

Walden University. (n.d.a.). Paper templates. Retrieved July 23, 2012, from 
http://writingcenter.waldenu.edu/57.htm

 

This resource provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.

Media

Laureate Education (Producer). (2012b). Data collection. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 4 minutes.

 

Dr. Kristen Mauk discusses how she collected data for her DNP project in this video. She describes the details of her pre- and post-tests used to track nurses’ knowledge in a rehabilitation unit.

 

Optional Resources

Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. (2009). Evidence-based practice challenge: teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journal of Nursing Education, 48(4), 186–195.

 

This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.

Horsley, T., Hyde, C., Santesso, N., Parkes, J., Milne, R., & Stewart, R. (2011). Teaching critical appraisal skills in healthcare settings. Cochrane Database of Systematic Reviews (Online), 11, Art. No.: CD001270.

Melnyk, B., Fineout-Overholt, E., & Mays, M. (2009). The evidence-based practice beliefs and implementation scales: Psychometric properties of two new instruments. Worldviews on Evidence-Based Nursing, 6(1), 49.

Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing. Philadelphia, PA: F.A. David Company.

Chapter 9, “Evaluation of Research Instruments and Experimental Conditions”

 

NURS 5052/NURS 6052: Essentials of Evidence-Based Practice

Course Project Overview

Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.

For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the course project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.

Before you begin, review this document, which contains information about all three parts of the Course Project.

Note: 
This Course Project will serve as the 
Portfolio Assignment
 for the course. In addition to submitting portions of this Project in Weeks 2 and 5, you will turn in all three deliverables in 
Week 10
.

Course Project: Part 1–Identifying a Researchable Problem

One of the most challenging aspects of EBP is to actually identify the answerable question. —Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase the likelihood of obtaining meaningful results.

In this first component of the course project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the weekly Learning Resources to design your questions.

To prepare:

· Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for Week 2. Focus on the PICOT model for guiding the development of research questions. Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment.

· Review the section beginning on page of the course text, 75 titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.

· Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.

· Generate at least 5 questions that relate to the issue that you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.

· Formulate a preliminary PICOT question—one that is answerable—based on your analysis. What are the PICOT variables (patient/population, intervention/issue, comparison, and outcome) for this question? 
Note:
 Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

· Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

To complete:

Write a 3- to 4-page paper that includes the following:

· A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice

· The 5 questions that you have generated, and a description of how you analyzed them for feasibility

· Your preliminary PICOT question and a description of each PICOT variable relevant to your question

· At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections

Part 1 of the Course Project is due by 
Day 7
 of 
Week 2
. It will also be a component of your 
Portfolio Assignment
 for this course, which is due by 
Day 7
 of 
Week 10
.

Reference:
 Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. 
Evidence Based Library and Information Practice, 6
(2), 75–80. Retrieved from 
https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

Course Project: Part 2—Literature Review

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question that you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

To prepare:

· Review the information in Chapter 5 of the course text
,
focusing on the steps for conducting a literature review and for compiling your findings. Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment.

· Using the question that you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.

· Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the 
Literature Review Summary Table Template
 located in this week’s Learning Resources.

· Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

To complete:

Develop a 2- to 3-page literature review that includes the following:

· A synthesis of what the studies reveal about the current state of knowledge on the question that you developed

· Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.

· Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry

· Your literature review summary table with all references formatted in correct APA style

Note:
 Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

Part 2 of the Course Project is due by 
Day 7
 of 
Week
 
5. 
It will also be a component in your portfolio assignment in this course, which is due by 
Day 7
 of Week 10.

Course Project Part 3 – Translating Evidence Into Practice

Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

To prepare:

· Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?

· With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.

· Explore possible consequences of failing to adopt the evidence-based practice that you identified.

· Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

To complete:

In a 3- to 4-page paper:

· Restate your PICOT question and its significance to nursing practice.

· Summarize the findings from the articles that you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.

· Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.

· Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

Part 3 of the Course Project is due by 
Day 7
 of 
Week
 
10
.
 
It should be combined with the other two components of the Course Project and turned in as your 
Portfolio Assignment
 for this course. 
Note:
 In addition, include a 1-page summary of your project.

For this final iteration you will need to:

· Submit your paper to Grammarly and Turnitin through the Walden Writing Center. Based on the Grammarly and Turnitin reports, revise your paper as necessary.

· 
Reminder:
 The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The 
School of Nursing Sample Paper
 provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

Note:
 The Course Project will be your 
Portfolio Assignment 
for this course.

 

Critique Template for a Qualitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by 
Day 7
 of
 Week 7
)

Date:       FORMTEXT

Your name:       FORMTEXT

Article reference (in APA style):       FORMTEXT

URL:       FORMTEXT

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study.

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

· Are the research findings appropriate to my practice setting and situation?

· What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?

· How might a proposed change in practice trigger changes in other aspects of practice?

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed-methods research study of your choice.

If the article is unavailable in a full-text version through the Walden University Library, you must 
e-mail the article as a PDF or Word attachment to your Instructor.

QUALITATIVE RESEARCH CRITIQUE

1. 
Research Issue and Purpose

What is the research question or issue of the referenced study? What is its purpose? (Sometimes ONLY the purpose is stated clearly and the question must be inferred from the introductory discussion of the purpose.) Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment.

 

2. 
Researcher Pre-understandings

Does the article include a discussion of the researcher’s pre-understandings? What does the article disclose about the researcher’s professional and personal perspectives on the research problem?

 

3. 
Literature Review

What is the quality of the literature review? Is the literature review current, relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.)

 

4. 
Theoretical or Conceptual Framework

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many “nursing” research studies draw on a “borrowed” framework, e.g., stress, medical pathology, etc.)

 

5. 
Participants

Who were the participants? Is the setting or study group adequately described? Is the setting appropriate for the research question? What type of sampling strategy was used? Was it appropriate? Was the sample size adequate? Did the researcher stipulate that information redundancy was achieved?

 

6. 
Protection of Human Research Participants

What steps were taken to protect human research subjects?

 

7. 
Research Design

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

 

8. 
Data Collection/Generation Methods

What methods were used for data collection/generation?
 
Was triangulation used?

 

9. 
Credibility

Were the generated data credible? Explain your reasons.

 

10. 
Data Analysis

What methods were used for data analysis? What evidence was provided that the researcher’s analysis was accurate and replicable?

 

11. 
Findings

What were the findings?

 

12. 
Discussion of Findings

Was the discussion of findings related to the framework? Were those the expected findings? Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described
?

 

13. 
Limitations

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

 

14. 
Implications

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don’t confirm their expectations as they interpret the meaning of their study findings.) Translating Evidence Into Practice – NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Assignment,

 

15. 
Recommendations

Does the author offer legitimate recommendations for further research? Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers’ recommendations seem to come from “left field” rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

 

16. 
Research Utilization in Your Practice

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

NURS 6052 Week 5 Discussion: Week 5 Discussion

Introduction

For the Week 5 discussion in NURS 6052, you are asked to find two quantitative research studies that address one issue chosen from a list of issues. This guide will teach you how to find a quantitative research article on a specific topic in a nursing database. Specifically, this guide will discuss how to:

pick relevant keywords
 for your topic and combine them with Boolean operators

identify and combine
 search words to find 
quantitative studies
in the CINAHL Plus with Full Text database NURS 6052 Week 5 Discussion: Week 5 Discussion.

evaluate 
the articles that you find to determine if they actually used the desired research method

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Pick keywords

Searching the Library databases is not the same as doing a Google search. Here are some key differences: NURS 6052 Week 5 Discussion: Week 5 Discussion.

The databases search for 
exactly
 what you enter in the search boxes.

If you enter a whole sentence, you’ll probably get no results.

If you misspell or mistype a word, you’ll probably get no results.

By default, the databases only search for what you enter in the search boxes in the article’s title, citation, abstract, and subject headings. NURS 6052 Week 5 Discussion: Week 5 Discussion,

This can help you get more 
relevant 
results. NURS 6052 Week 5 Discussion: Week 5 Discussion.

If your topic is obscure, or not mentioned in these fields, you may get no results.

To effectively search the Library databases we suggest:

Breaking apart 
your topic into the component parts

For example, if your topic is anxiety in children the main parts are: 
Anxiety
 and 
Children
. NURS 6052 Week 5 Discussion: Week 5 Discussion

Combining 
these main parts with the Boolean Operators, AND, OR, and NOT

AND tells the database to search for both terms in an article:

Anxiety 
AND
 Children

OR tells the database to search for either term, which is especially useful for synonyms:

Children 
OR 
Kids

NOT tells the database to exclude any results that have that term:

Anxiety 
NOT 
Depression

To learn more about finding articles on your topic in the databases, please see our guide:

To learn more about Boolean Operators, please see our guide:

Guide: Keyword Searching: Boolean

Quantitative studies

Quantitative studies
 use numbers and statistics to test their hypotheses.

Some keywords associated with quantitative research studies include:

Clinical trial

Correlational

Data

Laboratory experiment

Meta analysis

Randomized controlled trial NURS 6052 Week 5 Discussion: Week 5 Discussion

Regression

Statistically significant

Survey

 

Since not all quantitative research studies have the word quantitative in the title or abstract, it helps to link together the names of different types of quantitative research studies in your search. Here is an example of a search for 
quantitative research articles
 on 
anxiety in children
 in the 
CINAHL Plus with Full Text database
:

1.
 On the 
Library homepage
, go to the 
Subject Resources 
box.

2.
 Click on 
Select a subject
 and choose: 
Nursing
.

3. 
Scroll down until you see a section called Nursing articles, journals & books.

4. 
Click on 
Nursing databases
 and then click on the link for 
CINAHL Plus with Full Text
 to access the database.

Note:
If you have not already logged in to the Library databases, you will be prompted to log in with your myWalden Portal user name and password. NURS 6052 Week 5 Discussion: Week 5 Discussion

5.
 Once you are in the database, go to the 
first search box
 and enter:

quantitative OR trial OR meta analysis

6. 
In the 
second search box,
 enter your topic:

anxiety

7.
 In the 
third search box,
 enter the rest of your topic, if necessary:

children

Here is what your search boxes should look like: NURS 6052 Week 5 Discussion: Week 5 Discussion

 

8.
 To limit your results to only 
peer-reviewed
 articles, go below the search boxes and click in the box under 
Scholarly (Peer Reviewed) Journals
.

Click here to see this image in context
.

 

9
.
 Then click on the 
Search 
button to run your search.

10. 
As you are looking through your results, you can refer to the 
Evaluate your results section
 to make sure the article you pick is indeed a quantitative research study.

 

If you don’t find what you need in the CINAHL Plus with Full Text database, you can use the same search strategy in our other nursing and health databases: NURS 6052 Week 5 Discussion: Week 5 Discussion

MEDLINE with Full Text

ProQuest Nursing & Allied Health Source

Quiz on quantitative research

Which of the following keywords will 
not
help you find quantitative studies in the Library databases? NURS 6052 Week 5 Discussion: Week 5 Discussion

a.
 Meta analysis

b.
 Data

c.
 Interview

d.
 Trial

 

Quiz answer

Evaluate your results

Unfortunately, just because you entered keywords associated with the research type you are trying to find, that doesn’t guarantee that all of your results will be the desired research type. Once you have your list of results, reflect on the keywords associated with your desired research method. With those keywords in mind, here are a few places you can look to check that you’ve truly found what you wanted:

 

Title:
 Sometimes the research methodology will be stated in the title of the article. For example:

“Considerations for the provision of psychosocial services for families following paediatric burn injury: NURS 6052 Week 5 Discussion: Week 5 Discussion,A quantitative study.”

“Clown intervention to reduce preoperative anxiety in children and parents: A randomized controlled trial.” NURS 6052 Week 5 Discussion: Week 5 Discussion

 

Abstract:
 If the title does not specify what type of research methodology was used, the next place to look is the abstract. The abstract gives you a short summary of the article and will generally include the research methodology.

Here is how you can access an article’s abstract:

1. 
From the list of results, click on the 
title 
of the article.

2.
 Scroll down until you see the 
Abstract 
field.

Note: 
not all articles have an abstract. If the one you picked does not, you’ll need to look at the full text of the article.

 

Article
: If neither the title nor the abstract makes it clear what type of research methodology was used, you’ll need to go to the full text of the article. The sections where you are most likely to find out what type of research methodology was used are  NURS 6052 Week 5 Discussion: Week 5 Discussion the
Introduction
, 
Methodology/Method
, and 
Design
.

Note: 
These sections may have slightly different headings, but will generally be near the beginning of the article. NURS 6052 Week 5 Discussion: Week 5 Discussion

 

To learn more about 
evaluating
 your results, please see our guide:

More information

Best Practices in Quantitative Methods

Provides best practices for conducting quantitative research in the 21st Century.

Health Science Research: A Handbook of Quantitative Methods

This handbook goes over how to conduct quantitative research in the health sciences.

Evidence-Based Practice Research

Quiz answer

Quantitative Quiz Answer:

c
. Interviews

Interviews are a type of qualitative research. Meta analyses, data, and trials are all good keywords for finding quantitative research. NURS 6052 Week 5 Discussion: Week 5 Discussion NURS 6052 Week 5 Discussion: Week 5 Discussion

NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review

Week 5 Project: Literature Review

There are numerous reasons that literature reviews are conducted. Many research problems are because of personal interest and is significant or beneficial in daily life (Polit & Beck, 2012, p. 84). This paper will provide a probable explanation of inconsistencies and contradictions of the literature. The question is, does limited separation between mother and newborn have a positive effect on their attachment, compared to newborns staying in the nursery, as evidence by staff and patient perception and the decreased number of babies in the nursery with the implementation of the Baby-Friendly Hospital Initiative (BFHI). The initiative enables and encourages breastfeeding and bonding of mothers with their infants while recognizing hospitals and birthing centers for offering the best care and improving exclusive breastfeeding rates (Baby-Friendly USA, n.d.). NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review.

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Literature Review

The first article evaluated:
Breastfeeding promotion for infants in neonatal units: a systematic review
(Renfrew et al., 2010).  The instances of breastfeeding are low internationally in neonatal units. “The study evaluated the effectiveness of clinical, public health and health promotion interventions that may promote or inhibit breastfeeding feeding for infants admitted to neonatal units” (Renfrew et al., 2010, para. 1). The study was a systemic review that had a narrative synthesis. The intention was to use controlled studies to intervene causing infants admitted to neonatal units to be fed breast milk. NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review. In short-term outcomes only forty-eight studies were identified for single interventions in stable infants (Renfrew et al., para 3). Several interventions were identified in conclusion to the study including kangarooing using skin-to-skin, milk expression, support, training of the staff, and the UNICEF Baby-Friendly accreditation (Renfrew et al., 2010). In the study, there were certain gaps in evidence for outcomes, cost, and maternal health. More policy should be in place for infant feedings in neonatal units so many people are still unclear on how it effects them. The second article:
Barriers, Facilitators, and Recommendations Related to Implementing the Baby-Friendly Initiative (BFI): An Integrative Review
(Semenic & Childerhose, 2012). In the study, the goal was to research the international and peer-reviewed literature on the design and barriers related to the Baby-Friendly Initiative. The researchers used thirteen databases search the topic (Semenic & Childerhose, 2012). For the results of the search, there were forty-five articles from sixteen countries that met the criteria to be in the review. They used Cooper’s five stages of integrative research review for the analysis of the data (Semenic & Childerhose, 2012). In conclusion to the study, there were many obstacles identified along with solutions for the implementation of the Baby-Friendly Initiative. NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review. The priority issues identified were endorsements of policy makers for administration and government, hospital staff training, the influence of formula marketing, and union of community and hospital health services. To help promote the implementation of BFI in hospitals, strategies such as context-focused research and framing BFI as a multilevel, and sophisticated evidence-based change process should be used as a guide (Semenic & Childerhose, 2012). There were limitations to the study due to limited articles that are published in English so findings may not be interchangeable with other populations and health systems. There were also few studies on BFI in the community and specialty settings. NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review.

The third article:
Compliance with the Baby-Friendly Hospital Initiative and impact on breastfeeding rates
(Hawkins, Stern, Baum, & Gillman, 2014).  The objective of the study was to research how compliant hospitals are with the Baby-Friendly Hospital Initiative and to evaluate maternal education level with the initiation and duration of breastfeeding. In the study was 915 moms were from BFHI accredited, and 1099 moms were from non-accredited facilities in Maine (Hawkins, Stern, Baum, & Gillman, 2014).  NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review. The questionnaire reported that mothers stated seven of the ten essential practices for BFHI were done. A self-report for breastfeeding initiation carried out by all participants for exclusive breastfeeding or any breastfeeding of four weeks or more. Mothers that reported experiencing practicing breastfeeding. Mothers’ reported getting formula gift packs. BFHI increase instances of mothers’ with lower education initiating breastfeeding. Mothers’ with higher education did not have increased breastfeeding rates (Hawkins et al., 2014). There is not optimal compliance in the BFHI accredited facilities. More compliance would result in reduced socio-economic disparities and higher rates of breastfeeding. I believe for this study to be beneficial to change practice there needs to be a bigger group of those surveyed NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review.

The fourth article:
Early contact and breastfeeding in a baby friendly hospital
(D’Artibale & Bercini, 2013). The study was conducted to analyze factors that involved Baby-Friendly Hospitals and the experience of breastfeeding women and early contact with their baby. The University Hospital of Maringa is where the research was conducted with there being 16 participants who shortly after birth were able to establish contact and breastfeed with their baby(D’Artibale & Bercini, 2013). Data collect from November 2011- January 2012 through interviews, notes, and nonparticipating systematic observation (D’Artibale & Bercini, 2013). The initiation of breastfeeding shortly after birth feelings were favorable in the promotion of mother and baby bonding. Caesarean delivery and routine care were priorities, which was the obstacle of the study. It will be necessary to go beyond the technical approach for the initiative to move forward.

The fifth article:
Staff Perceptions and Experiences of Implementing the Baby Friendly Initiative in Neonatal Intensive Care Units in Australia
(Taylor, Sheehan, Gribble, & Dykes, 2011). “This study examined the implementation of the Baby-Friendly Hospital Initiative (BFHI) in the neonatal intensive care unit (NICU) and to understand perceptions and experiences of the staff”(Taylor, Sheehan, Gribble, & Dykes, 2011). Participants were from the Australian metropolitan area. There were 20 neonatal nurses, 18 midwives and a focus group of 8 BFHI hospital coordinators that were interviewed from four maternity hospitals, two were NICU (Taylor, Sheehan, Gribble, & Dykes, 2011). The study resulted in participants that had mistaken beliefs of how BFHI is applied in the NICU. Many of the concerns for BFHI were because of additional work, differences of NICUs and maternity units. Clearer guidelines are crucial for the achievement of the BFHI program NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review.

Summary

There were no significant inconsistencies and contradictions in the literature that I found. There were many articles found in aid of my preliminary conclusion of answering the PICO(T) question; does limited separation between mother and newborn have a positive effect on their attachment, compared to infants staying in the nursery, as evidence by staff and patient perception and the decreased number of babies in the nursery with the implementation of the Baby-Friendly Hospital Initiative (BFHI).  In the studies found there were definite conclusions for the implementation of the Baby-Friendly Hospital Initiative and, there were also studies that needed further research. NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review.

References

Baby-Friendly USA. (n.d.). Baby-Friendly Hospital Initiative. Retrieved October 1, 2016, from http://www.babyfriendlyusa.org/about-us/baby-friendly-hospital-initiative

D’Artibale, E. F., & Bercini, L. O. (2013). Early contact and breastfeeding in a baby friendly hospital.
Online Brazilian Journal of Nursing
,
12
, 587-589. Retrieved from http://web.b.ebscohost.com.ezp.waldenulibrary.org/ehost/detail/detail?vid=11&sid=1a8d728b-418d-4401-b0b8-16ab8231a79c%40sessionmgr106&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=104112269&db=rzh

Hawkins, S. S., Stern, A. D., Baum, C. F., & Gillman, M. W. (2014). Compliance with the Baby-Friendly Hospital Initiative and impact on breastfeeding rates.
Archives Of Disease In Childhood — Fetal & Neonatal Edition
,
99
(2), F138-43. http://dx.doi.org/10.1136/archdischild-2013-304842

Polit, D. F., & Beck, C. T. (2012).
Nursing research: generating and assessing evidence for nursing
(9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Renfrew, M. J., Dyson, L., McCormick, F., Misso, K., Stenhouse, E., King, S. E., & Williams, A. F. (2010). Breastfeeding promotion for infants in neonatal units: a systematic review.
Child: care, health and development
,
36
(2), 165-178. http://dx.doi.org/10.1111/j.1365-2214.2009.01018.x

Semenic, S., & Childerhose, J. E. (2012, March 21). Barriers, facilitators, and recommendations related to implementing the Baby-Friendly Initiative (BFI): an integrative review.
Journal of Human Lactation
,
20
(10), 1-18. http://dx.doi.org/10.1177/0890334412445195

Taylor, C., Sheehan, A., Gribble, K. D., & Dykes, F. (2011, January). Staff perceptions and experiences of implementing the Baby Friendly Initiative in neonatal intensive care units in Australia.
Journal of Obstetric Gynecologic & Neonatal Nursing
,
40
(1), 25-34. http://dx.doi.org/0.1111/j.1552-6909.2010.01204.x NURS 6052, Section 7, Essentials of Evidence-Based Practice – Week 5 Project: Literature Review

Critiquing Qualitative and Quantitative Research Studies Example Paper
.

Critiquing Qualitative and Quantitative

Walden University

Nursing 6052C, Section 3, Essentials of Evidence-Based Practice

Critiquing Qualitative and Quantitative

           
 Qualitative and quantitative are the most popular types of studies. Each type serves a purpose in very different ways when proposing the resulting data. The purpose of this paper is to compare and contrast qualitative study to quantitative study by enhancing knowledge and the purpose of each.

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Qualitative Versus Quantitative

           
 Qualitative studies described as statistical data that can be observed rather than measured (Keenan, 2015). Subjective data that can only be seen and expressed by the participants and how daily live is affected is the basis for qualitative studies (Park & Park, 2016). It is important to know how life experiences are expressed in research data (Kopf, Hsu, Shows, & Albinsson, 2016). Although the data cannot be measured in usual standards with numbers, the results are no less significant to research. Most qualitative studies involve interviewing the participants to gather data. The questions are grouped into categories, to sum up the collective answers. Critiquing Qualitative and Quantitative Research Studies Example Paper.

Quantitative studies set up a hypothesis and compare the data in statistical numbers (Keenan, 2015).  Beginning with a hypothesis, the researchers are looking for a data set that proves the hypothesis. The how and why are not considered, but looking for outcomes that can be measured numerically (Kopf, Hsu, Shows, & Albinsson, 2016). With quantitative research, the findings can be graphed to give a visual representation of the final data.

Advantages and Disadvantages of Qualitative and Quantitative

           
 Qualitative studies give researchers the ability to expand the results to include the life experiences of the participants; the downside is when compiling the results there could be a different answer from each participant. Critiquing Qualitative and Quantitative Research Studies Example Paper. For a researcher, this could be overwhelming data to group into subcategories. The advantage of using qualitative studies is using open-ended questions give the participants the feeling of expressing their feelings and being heard rather than just being a statistic. Study groups are generally small with interview question sets and extended study time (Park & Park, 2016).

Quantitative studies result in numbers that can be measured; not all data are measurable in numbers depending on the hypothesis to be answered (Laureate Education, Inc. (Executive Producer), (2012b). Measuring one’s experience in numbers can be difficult. Quantitative studies are more related to large participant groups with little to no interactions with researchers (Kopf, Hsu, Shows, & Albinsson, 2016). These type studies generally consist of chart review or offering a lengthy survey to participants. Critiquing Qualitative and Quantitative Research Studies Example Paper. Quantitative studies can be more impersonal and are strictly about the numbers.

Qualitative a Real Science or Not

           
 Qualitative studies is described as pseudoscience. Life experiences cannot be measured in the sense of normal datasets (Laureate Education, Inc. (Executive Producer), (2012a). It is difficult to measure what makes a participant happy or sad, but a blood pressure or temperature is strictly number measured. Qualitative research is no less important when discussing the medical or behavioral care to be given to patients Critiquing Qualitative and Quantitative Research Studies Example Paper.

Summary

           
 Qualitative and quantitative studies are both successful in their respective presentations. Researchers must choose how they intend to present the resulting data, should it be statistically or based on life experiences (? Both studies can be extremely helpful when looking at the data, the presentation of data is offered in the results in a different manner.

 

References

Keenan, M. (2015). Research methods. 
Salem Press Encyclopedia
,

Kopf, D. A., Hsu, M. K., Shows, G. D., & Albinsson, P. A. (2016). Quantitative versus Qualitative Research Methods. 
Society For Marketing Advances Proceedings
, 470.

Laureate Education, Inc. (Executive Producer). (2012a).
Qualitative and mixed methods research designs
. Baltimore, MD: Author. Critiquing Qualitative and Quantitative Research Studies Example Paper.

Laureate Education, Inc. (Executive Producer). (2012b).
Quantitative research for evidence-based practice
. Baltimore, MD: Author.

Maciukiewicz, M., Pawlak, J., Kapelski, P., Łabędzka, M., Skibinska, M., Zaremba, D., & … Hauser, J. (2016). Can psychological, social and demographical factors predict clinical characteristics symptomatology of bipolar affective disorder and schizophrenia?.
Psychiatric Quarterly
,
87
(3), 501-513. doi:10.1007/s11126-015-9405-z

Park, J., & Park, M. (2016). Qualitative versus Quantitative Research Methods: Discovery or Justification?. 
Journal Of Marketing Thought
, 
3
(1), 1-7. doi:10.15577/jmt.2016.03.01.1

Polit, D. F., & Beck, C. T. (2017).
Nursing research: Generating and assessing evidence for nursing practice
(10th ed.). Philadelphia, PA: Wolters Kluwer. Critiquing Qualitative and Quantitative Research Studies Example Paper.

van Langen, W. J., Beentjes, T. A., van Gaal, B. G., der Sanden, M. N., & Goossens, P. J. (2016). How the illness management and recovery program enhanced recovery of persons with schizophrenia and other psychotic disorders: A qualitative study.
Archives of Psychiatric Nursing
,
30
(5), 552-557. doi:10.1016/j.apnu.2016.04.005

 

 

Critique Template for a Qualitative Study

 

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date:
January 14, 2018

Your name:
Keli Walker

Article reference (in APA style):

van Langen, W. J., Beentjes, T. A., van Gaal, B. G., der Sanden, M. N., & Goossens, P. J. (2016). How the illness management and recovery program enhanced recovery of persons with schizophrenia and other psychotic disorders: A qualitative study.
Archives of Psychiatric Nursing
,
30
(5), 552-557. doi:10.1016/j.apnu.2016.04.005 Critiquing Qualitative and Quantitative Research Studies Example Paper

 

URL:
     
     

 

 

 

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study.

 

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

 

Are the research findings appropriate to my practice setting and situation?

What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?

How might a proposed change in practice trigger changes in other aspects of practice?

Critiquing Qualitative and Quantitative Research Studies Example Paper

 

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed-methods research study of your choice.

 

If the article is unavailable in a full-text version through the Walden University Library, you must
e-mail the article as a PDF or Word attachment to your Instructor.

 

 

QUALITATIVE RESEARCH CRITIQUE

 

 

Research Issue and Purpose

 

What is the research question or issue of the referenced study? What is its purpose? (Sometimes ONLY the purpose is stated clearly and the question must be inferred from the introductory discussion of the purpose.)

 

The researchers are looking, in the patient’s perspective, at how an Illness Management and Recovery programs (IMR) assists with the recovery process for those patients diagnosed with schizophrenia. Critiquing Qualitative and Quantitative Research Studies Example Paper.

 

 

Researcher Pre-understandings

 

Does the article include a discussion of the researcher’s pre-understandings? What does the article disclose about the researcher’s professional and personal perspectives on the research problem?

 

All the researchers participating in the study are professionals in the field of mental health.

 

 

Literature Review

 

What is the quality of the literature review? Is the literature review current, relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.) Critiquing Qualitative and Quantitative Research Studies Example Paper.

 

A literature review is not set aside, but is incorporated into the introduction of the study. All references are appropriate and add strength to the study.

 

 

Theoretical or Conceptual Framework

 

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many “nursing” research studies draw on a “borrowed” framework, e.g., stress, medical pathology, etc.)

 

There is no theoretical or conceptual framework specifically stated.

 

 

Participants

 

Who were the participants? Is the setting or study group adequately described? Is the setting appropriate for the research question? What type of sampling strategy was used? Was it appropriate? Was the sample size adequate? Did the researcher stipulate that information redundancy was achieved?

 

The participants recruited included four women and four men having a diagnosis of schizophrenia or another psychotic disorder, patients in an outpatient facility in the Netherlands, who completed one of three IMR programs offered. All participants, except one, completed the program and offered insightful, promising statements of self-management of stressors that could potentially lead to a relapse in declining mental condition. Because this was the initial study of the IMR program, the sample size was appropriate, and information was redundant which was the hopeful outcome that the programs would be successful. Critiquing Qualitative and Quantitative Research Studies Example Paper.

 

 

Protection of Human Research Participants

 

What steps were taken to protect human research subjects?

 

Because there were no medical treatments offered in this study, there was no ethical approval needed. This study was strictly interview based with voluntary participation.

 

 

 

Research Design

 

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

 

The descriptive phenomenological design used for this study specifically concentrates on the lived experiences and how IMR contributes to the daily lives of the participants.

 

 

Data Collection/Generation Methods

 

What methods were used for data collection/generation?

Was triangulation used? 

 

Open interviews were conducted to collect the data reported. By using open-ended interview questions, the participants are allowed to voice their specific answers.

 

 

Credibility

 

Were the generated data credible? Explain your reasons.

 

The data collected can be labeled as credible based on the extensive attention to logging data during the study and additional qualitative research education for the authors. Critiquing Qualitative and Quantitative Research Studies Example Paper.

 

 

Data Analysis

 

What methods were used for data analysis? What evidence was provided that the researcher’s analysis was accurate and replicable?

 

Colaizzi’s data analysis method was used, as per the steps listed in Polit and Beck (2017), to compile the final results:

1)Read all protocols to acquire a feeling for them.

2) Review each protocol and extract significant statements

3) Spell out the meaning of each significant statement

4) Organize the formulated meanings into clusters of themes

5) Integrate results into an exhaustive description of the phenomenon under study

6) Formulate an exhaustive description of the phenomenon under study in as
u
nequivocal a statement of identification as possible

7) Ask participants about the findings thus far as a final validation step

 

 

Findings

 

What were the findings?

 

The findings were as predicted, IMR is a productive program that assists patients in learned behavior to manage stressors to prevent or reduce relapse in mental conditions.

 

 

Discussion of Findings

 

Was the discussion of findings related to the framework? Were those the expected findings?  Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described
?

 

Because this is the first descriptive phenomenological study, there are no comparisons available. Findings were discovered along the way after compiling interviews.

 

 

Limitations

 

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

 

Limitations were discussed in detail:

Only two trainers were available for the IMR program. The results could be reflecting the trainer’s ability to teach rather than the program itself

There may be bias because the selection process for potential participants were submitted by the trainers.

Limited participants and only those whom had completed the course were included. If those who had not completed the program may have different outlooks on the program, offering possible negative views.

 

 

Implications

 

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don’t confirm their expectations as they interpret the meaning of their study findings.)

 

The findings should be promoted during the program and all staff that are working with patients should be aware of the study findings to reinforce the learning.

 

 

Recommendations

 

Does the author offer legitimate recommendations for further research?  Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers’ recommendations seem to come from “left field” rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

 

No recommendations were noted other than the implications.

 

Research Utilization in Your Practice

 

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

 

The program studied would be very appropriate for the facility if outpatient services were offered. At this time there are no plans to offer outpatient mental services with the exception of referrals to other providers.

 

 

Critique Template for a Quantitative Study

 

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date:
January 14, 2018

Your name:
Keli Walker

Article reference (in APA style):

Maciukiewicz, M., Pawlak, J., Kapelski, P., Łabędzka, M., Skibinska, M., Zaremba, D., & … Hauser, J. (2016). Can psychological, social and demographical factors predict clinical characteristics symptomatology of bipolar affective disorder and schizophrenia?.
Psychiatric Quarterly
,
87
(3), 501-513. doi:10.1007/s11126-015-9405-z

 

URL:
     
     

 

 

 

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study.

 

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

 

Are the research findings appropriate to my practice setting and situation?

What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?

How might a proposed change in practice trigger changes in other aspects of practice?

 

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed methods research study of your choice.

 

If the article is unavailable in a full-text version through the Walden University Library, you must
e-mail the article as a PDF or Word attachment to your Instructor.

 

 

QUANTITATIVE RESEARCH CRITIQUE

 

Research Problem and Purpose

 

What are the problem and purpose of the referenced study? (Sometimes ONLY the purpose is stated clearly and the problem must be inferred from the introductory discussion of the purpose.)

 

To determine if clinical and demographical characteristics are predictors of symptom dimensions.

 

Hypotheses and Research Questions

 

What are the hypotheses (or research questions/objectives) of the study? (Sometimes the hypotheses or study questions are listed in the Results section, rather than preceding the report of the methodology used. Occasionally, there will be no mention of hypotheses, but anytime there are inferential statistics used, the reader can recognize what the hypotheses are from looking at the results of statistical analysis.)

 

The study is looking at social and demographical factors and how they affect the clinical characteristics with relation to the patient outcome.

 

 

Literature Review

 

What is the quality of the literature review? Is the literature review current? Relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.)

 

The literature review is incorporated into the background of the study. All resources are appropriate and within the limits of the study.

 

 

 

Theoretical or Conceptual Framework

 

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many “nursing” research studies draw on a “borrowed” framework, e.g., stress, medical pathology, etc.)

 

No theoretical or conceptual framework was mentioned.

 

 

Population

 

What population was sampled? How was the population sampled? Describe the method and criteria. How many subjects were in the sample?

 

Sample size consists of 892 patients diagnosed with bipolar disorder (443) and schizophrenia (449) of those patients 476 female and 396 male. All participants were inpatient in a region of Poland.

 

 

Protection of Human Research Participants

 

What steps were taken to protect human research subjects?

 

Written consent was obtained from the patient before acceptance into the study.

 

 

Research Design

 

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

 

No design was specifically stated.

 

 

Instruments and Strategies for Measurement

 

What instruments and/or other measurement strategies were used in data collection? Was information provided regarding the reliability and validity of the measurement instruments? If so, describe it.

 

Categories to sort demographic and clinical data with subsets within main categories offered a bigger picture rather than lumping data into generic categories.

 

Data Collection

 

What procedures were used for data collection?

 

Most data collected was from chart reviews, but in some instances, interview questions were needed to answer questions related to familial burdens.

 

Data Analysis

 

What methods of data analysis were used? Were they appropriate to the design and hypotheses?

 

Poisson regression models were used in the study.

 

 

 

Interpretation of Results

 

What results were obtained from data analysis? Is sufficient information given to interpret the results of data analysis?

 

It was proven that social factors do have effects on clinical outcomes. Social stressors can negatively affect mental status, and the possibility of regression is true.

 

 

Discussion of Findings

 

Was the discussion of findings related to the framework? Were those the expected findings?  Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described
?

 

The discussion of finding does address previous studies, and findings was similar to those studies. It should also be noted that this study also addresses the familial burdens of those diagnosed with bipolar disorders and schizophrenia.

 

 

 

 

Limitations

 

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

 

Limitations were not addressed in the article.

 

 

Implications

 

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don’t confirm their hypotheses as they interpret the meaning of their study findings.)

 

There were no implications discussed in the study.

 

 

 

Recommendations

 

Does the author offer legitimate recommendations for further research? Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers’ recommendations seem to come from “left field” rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

 

Recommendations were not discussed

 

 

Research Utilization in Your Practice

 

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

 

The study offers insight into the stressors that affect those diagnosed with bipolar and schizophrenia. It is important to keep these stressors in mind when working with these types of patients.

 

 

 

 

 

Walden University M.S. in Nursing

Formative Evaluation Criteria for Applications and Formal Papers

 

Categories and Criteria                                                                        

 

Points

QUALITY OF WORK SUBMITTED
– 35 Possible Points

1. The extent to which work meets the assigned criteria and
work reflects graduate level critical and analytic thinking                                                                                                            
(0-30 Points)

Assignment
exceeds
expectations. All topics are addressed with a minimum of 75% containing
exceptional
breadth and depth about
each
of the assignment topics.

25-30

Assignment meets expectations. All topics are addressed with a minimum of 50% containing
good
breadth and depth about
each
of the assignment topics.

20-24

Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.

16-19

Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.

 

0-15

2. Purpose of the paper is clear                                                                                      
(0-5 Points)

A clear and comprehensive purpose statement is provided which delineates all required criteria.

5

Purpose of the assignment is stated, yet is brief and not descriptive.

4

Purpose of the assignment is vague.

1-3

No purpose statement was provided.

0

ASSIMILATION AND SYNTHESIS OF IDEAS –
50 Possible Points

 
The extent to which the work reflects the student’s ability to-

1. Understand and interpret the assignment’s key concepts          
                                    (0-10 Points)

Demonstrates the ability to critically appraise and intellectually explore key concepts.

9-10

Demonstrates a clear understanding of key concepts.

8

Shows some degree of understanding of key concepts.

5-7

Shows a lack of understanding of key concepts, deviates from topics.

0-4

2. Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources
                                                                                             
(0-20 Points)

Demonstrates and applies
exceptional
support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view.

15-20

Integrates specific information from 1 credible outside resource and 3 to 4 course resources to support major points and point of view.

10-14

Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.

3-9

Includes and integrates specific information from 0 to 1 resource to support major points and point of view.

0-2

3. Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, and textbook) by comparing different points of view and highlighting similarities, differences, and connections.                                                           
(0-20 Points)

Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.

18-20

Summarizes information gleaned from sources to support major points, but does not synthesize.

16-17

Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.

14-15

Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.

0-13

WRITTEN EXPRESSION AND FORMATTING –
15 Possible Points

1. Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.
                                    (0-5 Points)

Paragraphs and sentences follow writing standards.

5

Paragraphs and sentences follow writing standards 80% of the time.

4

Paragraphs and sentences follow writing standards 70% of the time.

3

Paragraphs and sentences follow writing standards < 70% of the time. 0-2 2. English writing standards: Correct grammar, mechanics, and proper punctuation (0-5 Points) Uses correct grammar, spelling, and punctuation with no errors. 5 Contains a few (1-2) grammar, spelling, and punctuation errors. 4 Contains several (3-4) grammar, spelling, and punctuation errors. 3 Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. 0-2 3. The paper follows correct APA format for title page, headings, font, spacing,   margins, indentations, page numbers, running head, p arenthetical/in-text citations, and reference list                (0-5 Points) Uses correct APA format with no errors. 5 Contains a few (1-2) APA format errors. 4 Contains several (3-4) APA format errors. 3 Contains many (≥ 5) APA format errors. 0-2 Total Points for Assignment: Please copy and paste this rubric table at the end of all Application Assignments in order for your assignment to be graded. Guidance for Application Assignments : Application Assignments require a title page, introduction, body of the paper, conclusion, and reference page. The title page needs to follows APA style and includes a title, student name, course number and section, and date. An abstract is not required. APA style headings are to be used appropriately to separate and organize sections of the paper. The use of direct quotes is discouraged and should only be used when the source material uses language that is particularly striking or notable. The introduction should provide an overview of the topic, the purpose of the paper, and topics that will be addressed. The body of the paper needs to address all required topics. The conclusion ought to provide closure for the reader, synthesize the content, and tie everything together to help clarify the main points of the paper. The reference page should include all references cited in the assignment in correct APA format.. Some course assignments may require the use of more than 2 credible outside resources. In these cases, the minimum outside sources specified in the instructions for the assignment will be applied in the grading of these course assignments. Credible sources include scholarly peer-reviewed journal articles, evidence based resources, and professional (.org), educational (.edu), and government websites (.gov). Commercial websites (.com) are not considered credible sources. Please note: When selecting articles for course assignments, you are advised (unless you are referencing seminal information) to focus on work published within the past five years. Late Policies : Assignments submitted late without prior agreement of the Instructor, outside of an emergency absence, or in violation of agreements for late submission, will receive a grade reduction for the Assignment amounting to a 20% point loss.  After 5 days, the Assignment will not be graded. Students should be aware that late Assignments may not receive the same level of written feedback as do Assignments submitted on time. Critiquing Qualitative and Quantitative Research Studies Example Paper. Assignment Expectations Quantitative Critique completed appropriately- Qualitative or Mixed Methods Critique completed appropriately  Contrasted the types of information that you gained from examining the 2 different research approaches Critiquing Qualitative and Quantitative Research Studies Example Paper Described general advantages and disadvantages of the 2 research approaches. Used examples from articles Formulated a response to the claim that qualitative research is not real science. Highlighted general insights that both quantitative and qualitative studies can provide to researchers. Supported with references to learning resources other credible resources Critiquing Qualitative and Quantitative Research Studies Example Paper

PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients

Literature Research Review

Lisa Clemente

Walden University

 

Literature Research Review

Literature reviews are conducted for numerous reasons.  For the scholar, these reviews accentuate the integrity of the writer in his or her field. An in-depth review can govern how to make a significant addition to existing evidence. Researchers typically conduct research within the context of existing knowledge by undertaking a thorough literature review (Polit & Beck, 2017, p. 85). The purpose of this paper is to provide a synthesis of what the studies reveal about the current state of knowledge on the said PICOT question. This paper will also identify inconsistencies and contradictions in the review and offer possible explanations for such. The preliminary conclusion will provide evidence that either substantiates practice change or calls for

further research. PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients

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PICOT Question

What is the difference between the administration of t-PA and Heparin in patients diagnosed with stroke and success in the prevention of disabilities?

Population/Patient Problem: Stroke is diagnosed

Intervention: plan; testing computed axial tomography (CT) scan, physical examination, history and physical, laboratory studies, and neurology consult.

Comparison: thrombolytic (t-PA) vs. anticoagulant (heparin)

Outcome: prevention of disability

Time: when patient presents to the emergency department within 3 hours when last seen normal was within 2 hours.

Why develop a PICOT question? A crucial first step in evidence-based practice involves converting information needs into well-worded clinical questions that can be answered with research evidence (Polit & Beck, 2017, p. 31).  Evidence-based practice (EBP) is the integration of the best research evidence with clinical expertise and patient values (Twycross & Shorten, 2016). Formalizing a clinical question in particulars of the specific patient problem assists the researcher in finding clinically significant evidence in the literature PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients.

Literature Reviews: Finding and Critiquing Evidence

The aptitude to find research documents on a topic is an important skill that requires flexibility and patience.  A flexible approach to “data collection” and thinking creatively about ideas for new sources of information, is one way to conduct a qualitative study. An important

advantage of survey research is its flexibility (Keough & Tanabe, 2011, p. 37). Despite the method or approach used, primary and secondary questions will need to be addressed.  The systematic review of literature is a valuable resource for all nurses to influence policy decisions, and effectuate change. Several organizations that provide helpful guidelines for the conduct of systematic reviews of the literature, including the Cochrane Collaboration, the Johanna Briggs Institute, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, ProQuest, and PubMed. For nurses to assume a leadership role in synthesizing scientific evidence for evidence-based policy development and refinement, nursing education will need to assume a more active role in teaching systematic review methodology (Houde, 2009, p. 9). PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients. Using evidence hierarchies rank evidence sources according to the strength of the evidence they provide, and in most cases, randomized controlled trial’s (RCTs) are near the top of these hierarchies (Polit & Beck, 2017, p. 25). Filtered and unfiltered data searches using key search words were utilized. Key search words such as; stroke, thrombolysis, heparin, rehabilitation, brain, hypertension, and hemorrhage revealed a Boolean phrase: stroke AND thrombolysis AND heparin. This initial search generated 22 hits, 5 had relevance to the chosen topic.

Identified Studies

The first study evaluated:
Drug Treatment of Acute Ischemic Stroke
by Basal, Sangha, and Khatri, identified acute ischemic stroke (AIS) as the fourth leading cause of death and the leading cause of adult disability in the USA. The discussion of the medications related to ischemic stroke care in the context of overall treatment. Ischemic stroke, accounts for 85% of all strokes (American Heart Association, 2011). This study evaluated therapies regarding emergent management of hypertension as one modifiable risk factor. This study also stressed the importance of maintaining glycemic control. Identified barriers in the study emphasized the importance of preventative care.

The second study titled,
Treatment Discontinuation with New Oral Agents for Long-term Anticoagulation: Insights from a Meta-analysis of 18 Randomized Trials Including 101, 801

Patients.
The objective of this study was to systematically examine discontinuation rates with new US Food and Drug Administration-approved oral anticoagulants (NOACs). This is a randomized control study comparing NOACs to placebo or traditional therapy. Conducted by two authors, the conclusion was that drug discontinuations were not statistically significant from those with conventional drug therapies. PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients. Poor compliance to medication regimens by patients is the leading cause of treatment failure.

The third study titled,
Acute Stroke Reperfusion Therapy Trends in the Expanded Treatment Window Era,
hails from the American Heart Association/American Stroke Association (AHA/ASA). From the year 2007 to 2012, there were 182,235 AIS patients (median age, 72 years; 51.5% women) in the database at the time of analysis (AHA/ASA, 2011). There was a trend for increased use of IV rt-PA in the 0.3 hours and the 3-4.5 hours’ time window. The conclusion infers that widening the window for thrombolysis increases the likelihood of administration. The strength of this study rests in the significant number of patients and the multistate data from a variety of hospitals. One weakness includes outcomes assessment by clinical features rather than formal scales such as the modified Rankin scale (mRS) score. The NIHSS score was only recorded in 55.5% of patients in the cohort, which is a hindrance in the establishment of baseline disability.

The fourth study:
Barriers to the utilization of thrombolysis for acute ischemic stroke.
This study was published in the
Journal of Clinical Pharmacy & Therapeutics.
This is a systematic review regarding what is currently known about the use of thrombolytic. Several barriers to utilization were identified. Pre and post admissions barriers were identified. The major barrier is the late presentation to the emergency department, placing the patient outside the treatment window. Current utilization is suboptimal at <3%. The final study, Comments, Opinions, and Reviews, A Qualitative Study of Stroke, is a literature review of published articles. This is a qualitative study method with the aim of understanding social research on behavior. This was unstructured with focus group interviews and ethnographic observation. With these methods conceptual data is obtained. The key words in this study search were: stroke, cerebrovascular accident, and qualitative. Each paper was reviewed independently by two authors with experience in researching stroke. The findings of 113 papers with 18 excluded, left 95 papers in the study. The conclusion calls for further education of the general public as to stroke identification and recognition. Early detection is the key to initiation of appropriate treatment. PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients. Synthesis of What the Studies Reveal About the Current State of Knowledge The selected studies were conducted in acute care settings due to the nature of the acuity. All subjects included were patients that suffered a stroke. The primary purpose was to identify the current knowledge in using t-PA versus heparin, and the resulting disabilities. There is considerable debate as to what treatment is best practice. These medications carry significant risk, and the benefit to these risks are not often quickly identified. The inclusion criteria are designed to maximize the benefits while recognizing the risk factors. The recurring theme in this literature research is the essence and importance of time. Public education is one area where gains have been made but reinforcement of this teaching is required. The ‘Act FAST’ public education campaign was introduced to reduce the time to presentation in patients with stroke, and thereby increase the opportunity for thrombolysis and rapid initiation of secondary prevention (Harbison & Hossain, 2003). Inconsistencies and contraindications with explanations There were no major discrepancies identified, the explanation for this is a direct result of the problem stated. The majority of acute ischemic stroke patients do not receive thrombolytic therapy due to late arrival to emergency departments and currently there is a lack of acute interventions for them. Further clinical trials may lead to medical breakthroughs to limit the extent of damage PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients. Preliminary Conclusion Currently, best practice dictates the use of thrombolysis in acute ischemic stroke. The interdisciplinary team approach offers the best opportunity to initiate treatment swiftly and minimize or prevent disability. Continued research efforts will bring new treatments that offer hope where there otherwise may not be. PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients. Literature Review Research Summary Table               Citation Type of Study   Design Type   Framework/Theory Setting Key Concepts/Variables Findings Hierarchy of Evidence Level Bansal, S., Sangha, K., & Khatri, P. (2013). Drug Treatment of Acute Ischemic Stroke. American Journal of Cardiovascular Drugs , 13(1), 57-69 13p. doi:10.1007/s40256-013-007-6 Type of Study: Randomized Clinical Trial- European Cooperative Acute Stroke Study (ECASS) III and the large scale registry SITS-ISTR     Design Type: randomized controlled-experimental     Framework/Theory: Descriptive tabulations of data are presented and interpreted   Acute Care Facility Concepts: medication efficacy comparison     Independent Variable: Physical exam, testing, Blood Pressure, Temperature t-PA vs heparin     Dependent Variable: Time frame of presentation     Controlled Variable: Wilcoxon-Mann-Whitney Rank Test       Urgent anticoagulation for Acute ischemic stroke (AIS) has generally not shown benefits that exceed the hemorrhage risks in the acute setting. Urgent antiplatelet use for AIS has limited benefits and should only promptly be initiated if alteplase was not administered, or after 24hours if alteplase was administered. Level 1 Systematic review Chatterjee, S., Sardar, P., Girl, J.S., Ghosh, J., & Mukherjee, D. (2014). Treatment Discontinuations with New Oral Agents for Long-term Anticoagulation: Insights from a Meta-analysis of 18 Randomized Trials Including 101, 801 Patients. Mayo Clinic Proceedings, 89(7), 896-907 12p. doi: 10.1016/j.mayocp.2014.01.030   Type of Study: Meta-analysis RCT   Design Type: systematic examination open label, double blind     Framework/Theory Independent extraction of relevant data was performed by 2 authors: Acute PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patientscare facility Concepts: comparing New oral anticoagulants with conventional therapy         Independent Variable: choice of medication     Dependent Variable: outcome of treatment, +/- disability       Discontinued due to adverse events, consent withdrawal, and nonadherence. Level 1 Systematic review PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients George, M., Tsai, A., & Peacock, J. (2014). Acute Stroke Reperfusion Therapy Trends in the Expanded Treatment Era. ScienceDirect, 23, 2316-2321. http://dx.doi.org/10.1016/j.strokecerebrovasdis.2014.04.023   Type of Study: The study population included patients admitted with a diagnosis of acute ischemic stroke from 2007-2012, there were 182,235 AIS patients in the Paul Coverdell National Stroke Registry.       Design Type: European Cooperative Acute Stroke Study III Trial         Framework/Theory: Trends in rates of IV rt-PA versus IA therapy were examined.   Acute Care Facility in 6 states Georgia, Mass, Michigan, Minnesota, North Carolina, and Ohio Concepts: With an expanded treatment window of 4.5 hours, more stroke patients are eligible for treatment with t-PA. The expanded treatment window allows for increased treatment opportunities. It is a must to ascertain last seen normal     Independent Variable: Age, race, stroke scale     Dependent Variable: t-PA therapy, no t-PA therapy     Controlled Variable: Wilcoxon-Mann-Whitney Rank Test     Guideline recommendations on IV reperfusion after AIS in an expanded time window are slowly being adopted into community practice.  Future studies can examine further trends in IV and IA treatments for AIS now that recent studies have shown no superiority of IA therapies to traditional interventions. Level II prognosis study Krass, I., & Bajorek, B. (2012). Barriers to the utilization for thrombolysis for acute ischemic      stroke. Retrieved from web.b.ebscohost.com.ezp.waldenulibrary.org   Type of Study: Medline, Embase, International Pharmaceutical Abstracts and Google Scholar     Design Type: retrospective observational studies in clinical audits, RCT study     Framework/Theory: NINDS trial Systemic integrated multidisciplinary approach.   2 tiered search strategy Concept: Several barriers to the utilization of thrombolysis in stroke care have been identified in the literature and can be classified as preadmission barriers and post-admission barrier. Thrombolysis significantly decreases disability from AIS. As expected, thrombolysis is contraindicated in patients with a high risk of bleeding, including patients on therapeutic anticoagulation, recent gastrointestinal bleeding. Level II Therapy and etiology McKevitt, C., Redfern, J., Mold, F., & Wolfe, C. (2004). Qualitative Studies of Stroke a Systematic Review. Retrieved from stroke.ahajouranls.org/content/35/6/1499.full   Type of Study: Qualitative     Design Type: Literature Review of published articles identified by systematically searching online database using key words   Framework/Theory: European Stroke Initiative (EUSI) and recommendations for medical stroke management. Qualitative social science framework Acute Care Setting PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients Concepts: EUSI recommendations identify the increasing recognition of stroke as an acute emergency, and call for education of the general public to allow them to recognize symptoms more quickly and to seek urgent treatment.     Independent Variable: identification of last seen normal     Dependent Variable: efficacy of treatment on +/- of disability         Qualitative studies have addressed a wide range of issues related to the impact of stroke on individuals, and to the organization and delivery of care. Level II Meaning and process questions       References American Heart Association. Heart disease and stroke statistics-2011 update. Circulation. 2011;123: e18-209 http://dx.doi.org/10.1161/CIR.ob013e3182009701 Bansal, S., Sangha, K., & Khatri, P. (2013). Drug Treatment of Acute Ischemic Stroke. American Journal of Cardiovascular Drugs, 13(1), 57-69 13p. doi:10.1007/s40256-013-007-6 Chatterjee, S., Sardar, P., Girl, J.S., Ghosh, J., & Mukherjee, D. (2014). Treatment Discontinuations with New Oral Agents for Long-term Anticoagulation: Insights from a Meta-analysis of 18 Randomized Trials Including 101, 801 Patients. Mayo Clinic Proceedings, 89(7), 896-907 12p. doi: 10.1016/j.mayocp.2014.01.030 George, M., Tsai, A., & Peacock, J. (2014). Acute Stroke Reperfusion Therapy Trends in the Expanded Treatment Era. ScienceDirect , 23 , 2316-2321. PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patientshttp://dx.doi.org/10.1016/j.strokecerebrovasdis.2014.04.023 Harbison, J., & Hossain, O. (2003). Is the ’Act FAST’ stroke campaign working? Retrieved from sfxhosted.exilbrisgroup.com/waldenu? ID=pmid:25385853&&genre=article&atitle= Houde, S. (2009). The Systematic Review of the Literature: A Tool for Evidence-Based Policy. Journal of Gerontological Nursing , 35 . Retrieved from web.a.ebscohost.com.ezp.waldenulibrary.org Keough, V., & Tanabe, P. (2011). Survey Research: An Effective Design for Conducting Nursing Research. Journal of Nursing , 1 , 37. Retrieved from web.a.ebscohost.com.ezp.waldenulibrary.org Krass, I., & Bajorek, B. (2012). Barriers to the utilization for thrombolysis for acute ischemic      stroke. Retrieved from web.b.ebscohost.com.ezp.waldenulibrary.org McKevitt, C., Redfern, J., Mold, F., & Wolfe, C. (2004). Qualitative Studies of Stroke a Systematic Review. Retrieved from stroke.ahajouranls.org/content/35/6/1499.full PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients Polit, D., & Beck, C. (2017). Nursing Research Generating and Assessing Evidence for Nursing Practice (10th ed.). Philadelphia, PA: Wolters Kluwer. Twycross, A., & Shorten, A. (2016). Using observational research to obtain a picture of nursing practice. Evidence-Based Nursing , 19 , 66-67. http://dx.doi.org/10.1136/eb-2016-102393 PICOT question Literature Research Review Example Essay- t-PA and Heparin in stroke / diabetes patients

Week 10 Main Discussion Post

Weighing the Evidence

“The demand for health care practices that are evidence-based, standardized, consistent, and promote optimal outcomes within the constraints of limited resources is growing” (Katapodi & Northouse, 2011). When weighing the value of evidence, it is important to study the hierarchies that “grade the evidence for its reliability and generalizability to larger populations based on research design and sampling method” (Stichler, 2010). Hierarchies offer a structure for grading the strength of the existing evidence (Stichler, 2010). weighing the evidence in nursing research essay example papers.

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Citation

Keyt, H., Faverio, P., & Restrepo, M. I. (2014). Prevention of ventilator-associated pneumonia in the intensive care units: A review of the clinically relevant recent advancements.
The Indian Journal of Medical Research
, 814-821. Retrieved from http://web.b.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?sid=5f6f3c89-eb57-4ed5-af8a-e2084725cbda%40sessionmgr103&vid=1&hid=118

 

Article Summary

The authors of this study reviewed the literature about evidence-based ventilator-associated pneumonia (VAP) prevention measures. This literature was reviewed because “the pathophysiology, epidemiology, treatment and prevention of VAP have been extensively studied for decades, but a clear prevention strategy has not yet emerged” (Keyt, Faverio, & Restrepo, 2014). In their research, Keyt, Faverio, and Restrepo discovered that any patient placed on a mechanical ventilator was at risk of developing VAP. Several strategies were identified as prevention measures: non-invasive positive pressure ventilation (NPPV), sedation holidays, weaning trials, avoiding re-intubation, and early tracheostomy weighing the evidence in nursing research essay example papers.

Data and Analysis

           
The article is a case-control study. Three authors reviewed “interventions currently available that have a clinical impact with regards to a reduction in the incidence of VAP” (Keyt, Faverio, & Restrepo, 2014). The authors looked for research on how VAP occurs, VAP prevention: reducing the time at risk, VAP prevention: targeting endotracheal tube colonization and microaspiration, VAP prevention: infection control in the ICU, and VAP prevention: reducing colonization. After reading multiple articles with similar results, they concluded that a multidisciplinary strategy showed more enhanced patient outcomes than strictly focusing on prevention approaches directed towards the pathophysiologic mechanism of VAP. The multidisciplinary strategy includes non-invasive positive pressure ventilation (NPPV), sedation holidays, weaning trials, avoiding re-intubation, and early tracheostomy (Keyt, Faverio, & Restrepo, 2014).

The weaknesses noted from the study was the lack of information about how the study was performed, how many studies were read, how they specifically came to their conclusions, and how the authors chose the articles and eliminated pieces. weighing the evidence in nursing research essay example papers. There was no information given about what roles each researcher played and how they obtained their articles to review. However, they did suggest that future research that studies clinical outcomes as primary endpoints will hopefully develop more thorough prevention strategies.

Additional Study

Based on their research, I learned that the use of ventilator bundles was most beneficial to prevent VAP. The study did not specify what interventions were the best to include in the ventilator bundles but stated that multiple interventions were favorable. Additional research could be completed on which interventions should be paired together to make up a ventilator bundle.

weighing the evidence in nursing research essay example papers References

Katapodi, M. C., & Northouse, L. L. (2011). Comparative Effectiveness Research: Using Systematic Reviews and Meta-Analyses to Synthesize Empirical Evidence.
Research and Theory for Nursing Practice, 25
(3), 191-209.

Keyt, H., Faverio, P., & Restrepo, M. I. (2014). Prevention of ventilator-associated pneumonia in the intensive care units: A review of the clinically relevant recent advancements.
The Indian Journal of Medical Research
, 814-821. Retrieved from http://web.b.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?sid=5f6f3c89-eb57-4ed5-af8a-e2084725cbda%40sessionmgr103&vid=1&hid=118

Stichler, J. (2010). Evaluating the Evidence in Evidence-Based Design.
JONA: The Journal of Nursing Administration, 40
(9), 348-351.

 

6052 Discussion Week 10

Weighing the Evidence

Throughout this course, many lessons have been learned regarding the intricacies of research.  When conducting original research, we have learned there are many steps and decisions to be made before embarking upon any research project. weighing the evidence in nursing research essay example papers. One of the final steps of research is determining a meaningful conclusion and formulating explanations for the meaning of their data.  According to Polit and Beck (2017), research is the step-by-step inquiry that utilized an orderly and disciplined method to answer questions and to solve problems (Polit & Beck, 2017).

APA Citation

Ansari, S., & Szallasi, A. (2011). ‘Wrong blood in tube’: Solution for a persistent problem.

 

International Journal of Transfusion Medicine, 100
(1), 298-302.

 

Research Article and Statistical Analysis

Data can be synthesized by using a systematic review or meta-analysis (Katapodi & Northouse, 2011). The article reviewed: ‘
Wrong blood in tube’: solutions for a persistent problem
(Ansari & Szallasi, 2011). In this study, the objective was to determine the occurrence of WBITs at Monmouth Medical Center. The study aims to assess the effectiveness of safe methods enforced in 2006. The method used in this study was the collection of data from 2005 to 2009.  The researchers found that within a four-year period, 59,373 samples were collected and 0.04% of the significant errors were WBITs. It was recorded that 8 of the errors from the 0.04% were due to errors in typing results. weighing the evidence in nursing research essay example papers. The hospital mandated in 2006 that two witnesses (nurses) must check all blood sample collections. Implementing a two-verifier program has helped decrease the rate of WBITs from 11 in 2006 to 5 in 2007, but the WBITs have not been eradicated. It was concluded that WBITs is still the primary cause of wrong blood transfusion at Monmouth Medical Center. In the article by Ansari & Szallasi (2011) we see that after MMC adopted the two-verifier program, the rate of WBITs reduced from 11 to five which does not seem much but we see a decrease in situations that could have caused serious harm or be fatal to the patient.

An identified weakness in the study and recommendation is that the check-type method is not a foolproof method. The nurses and phlebotomist may beat the system by collecting both tubes at the same time from the wrong patient and also the check-type system cannot prevent silent WBITs weighing the evidence in nursing research essay example papers.

 

References

 

Ansari, S., & Szallasi, A. (2011). ‘Wrong blood in tube’: Solution for a persistent problem.

 

International Journal of Transfusion Medicine, 100
(1), 298-302.

 

Katapodi, M. C., & Northouse, L. L. (2011).  Comparative effectiveness research: Using

systematic reviews and meta-analyses to synthesize empirical evidence. 
Research and Theory for Nursing Practice: An International Journal, 25
(3), 191-209.  Retrieved from the Walden Library databases.

Polit, D. F., & Beck, C. T. (2017). 
Nursing research: Generating and assessing evidence for

nursing practice
(10
th
ed.).   Philadelphia, PA: Wolters Kluwer

 

Weighing the Evidence

Evidence-based practice has increasingly come to be valued in the provision of quality health care (Stichler, 2010).  However, one must recognize that “not all evidence is created equal” (Stichler, 2010).  After locating appropriate research articles, Stichler (2010) suggests that we must appraise the rigor of the research design, note the generalizability of the findings to other situations, and view the applicability of the research to your current situation.  weighing the evidence in nursing research essay example papers. The purpose of this discussion is to provide a summary of my selected research article, describe the data and statistics used, and explain how researchers reached their conclusion.  Additionally, I will propose one additional research study that could be done to further investigate the topic.

Citation:

Chen, Y., Chi, M., Chen, Y., Chan, Y., Chou, S., & Wang, F. (2013). Using a Criteria-Based Reminder to Reduce Use of Indwelling Urinary Catheters and Decrease Urinary Tract Infections.
American Journal of Critical Care
,
22
(2), 105-114. doi:10.4037/ajcc2013464.

Summary of Article

The article “Using a Criteria-Based Reminder to Reduce Use of Indwelling Urinary Catheters and Decrease Urinary Tract Infections” written by Chen, Chi, Chen, Chou, & Wang (2013) describes a randomized controlled trial (RCT) which was performed in 2 respiratory intensive care units (ICUs) in Taiwan.  A RCT is level 2 evidence according to Polit & Beck (2017).  The researchers desired to determine the effect of a criteria-based catheter reminder system on urinary catheter utilization and catheter-associated urinary tract infection (CAUTI).  The intervention included criteria for initial catheter use along with removal of the urinary catheter once the same criteria was no longer met.  Investigators would contact the physician to discuss catheter removal once criteria were no longer being met. The results showed that “utilization rate of indwelling urinary catheters was decreased by 22% in the intervention group” and that CAUTI incidence was reduced by 48% in the intervention group. (Chen, Chi, Chen, Chan, Chou, & Wang, 2013). weighing the evidence in nursing research essay example papers.

Description of the Data and Statistical Test Results

According to Chen, Chi, Chen, Chan, Chou, & Wang (2013), “data were analyzed by using IBM SPSS Statistics 17 software. Between-group differences were examined using the Chi-square or Fisher exact test and the categorical differences were presented in percentages and numerical forms (Chen, Chi, Chen, Chan, Chou, & Wang, 2013).  The experimental results data were analyzed by utilization of a t test or the Mann-Whitney test and were presented as means, standard deviations, medians, and ranges (Chen, Chi, Chen, Chan, Chou, & Wang, 2013).  The level of significance was set at .05 (Chen, Chi, Chen, Chan, Chou, & Wang, 2013).  The researchers also calculated relative risk and 95% confidence intervals (Chen, Chi, Chen, Chan, Chou, & Wang, 2013).  Additionally, all participant characteristic data and experimental result data were presented in charts within the research article (Chen, Chi, Chen, Chan, Chou, & Wang, 2013).

The Researchers’ Conclusions

The researchers’ conclusions were that CAUTI incidence decreased and urinary catheter utilization decreased significantly with use of a criteria-based reminder intervention.  Researchers used data to support their conclusions.  For CAUTI incidence reduction, researchers’ provided data for relative risk (0.47), 95% confidence interval (0.27-0.82), and level of significance (P=0.009).  For catheter utilization rate reduction, the provided data were: relative risk (0.78), 95% confidence interval (0.76-0.80), and level of significance (P<0.001).  According to Dingle (2011), if an outcome is 0.1% effective it is statistically significant and if an outcome is 20-30% or more effective it is clinically significant. weighing the evidence in nursing research essay example papers.  Based on the information which was provided and after calculation of the absolute risk for CAUTI incidence, it appears that the data presented is statistically significant, but not clinically significant as there was only a 13% decrease in CAUTI incidence in the intervention group.  The absolute risk for catheter utilization was not able to be determined because numbers were not given for the intervention and control groups. Additional Research Study Additional research could be conducted to see if the criteria-based reminder intervention is more effective with use of different patient populations and larger sample sizes.  This research used only ICU patients and testing the intervention in various inpatient hospital units at many different facilities will allow the results to become more generalizable to other populations.  A larger sample size will help to enhance the power of the conclusions (Polit & Beck, 2017). Conclusion As a health care provider, it is important to familiarize yourself with statistics so that appropriate evidence-based interventions can be identified through your research.  According to Dingle (2011), studies have found that experienced professionals do not understand the difference between statistical and clinical significance which is a major problem because these professionals are generally required to explain the significance of an intervention to their patients and their health outcomes.  As health care professionals, it is important to be able to weigh the evidence of research so that important findings can be applied to practice (Laureate Education, 2013). References Chen, Y., Chi, M., Chen, Y., Chan, Y., Chou, S., & Wang, F. (2013). Using a Criteria-Based Reminder to Reduce Use of Indwelling Urinary Catheters and Decrease Urinary Tract Infections. American Journal of Critical Care , 22 (2), 105-114. doi:10.4037/ajcc2013464. Dingle, P. (2011). Statin Statistics: Lies and Deception. Positive Health , 180 1-11. Retrieved from the Walden Library databases. weighing the evidence in nursing research essay example papers. Laureate Education (Producer). (2013). Weighing the Evidence . Baltimore, MD: Author. Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer. Stichler, Jaynelle. (2010). Evaluating the Evidence in Evidence-Based Design. The Journal of Nursing Administration , 40 (9), 348-351. doi:10.1097/NNA.0b013e3181ee42a7.     Week 10 Discussion Response Post 1 Shannon, Great post! I never thought about depression being a factor that comes after having a type 2 diabetes diagnosis.  I can see why it happens because of the lifestyle changes that need to be made and having to learn all about the disease and how to control it.  This would be difficult to comprehend for me if I wasn’t a nurse. There are so many people with type 2 diabetes now that I never really thought about how it would affect a person mentally.  The researchers indicated that self-care activities included medication taking, specific diet, foot care, glucose monitoring, and exercise.  These activities were not followed by all patients, but it was dependent on several factors including age, educational level, social support, complications, and education about diabetes (Kav, Yilmaz, Bulut, & Dogan, 2017).  This is another great example on how important diabetes education is for patients with new diagnoses. Because of the various risks for other diseases, such as heart disease and stroke, that comes with diabetes, I think it is imperative for us as nurses and nurse practitioners to stress the importance of keeping good glycemic control for our patients.  Active diabetes education should be used to achieve effective and long-term adherence to treatment in order to reduce incidence of complications (Luan et al., 2017).  Have you educated new diabetics on their condition before? My facility has a diabetic advanced practice nurse educator that goes around to all newly diagnosed patients and patients who have poor control of their diabetes.  She educates them regarding their insulin dosage, best times to check sugars, and about a1c levels. weighing the evidence in nursing research essay example papers. I think this is such a great resource to have for our patients and they always state how much more comfortable they feel with their diagnosis after she spends time with them! References Kav, S., Yilmaz, A. A., Bulut, Y., & Dogan, N. (2017). Self-efficacy, depression and self-care activities of people with type 2 diabetes in Turkey. Collegian, 24 (1), 27-35. doi:10.1016/j.colegn.2015.09.005 Luan, L. L., Yang, J., He, Y. F., Huang, Z. X., Liu, L., & Huang, Z. S. (2017). Biomedical Research, 28 (3), 1172-1177. Week 10 Discussion Response Post 2 Dai, Great post! I have chronic back pain and this article was interesting to me because I can see why people could become depressed because of it.  Back pain is very frustrating to live with and I feel like you never know when it is going to occur. weighing the evidence in nursing research essay example papers.  According to Lopez-Lopez et al. (2017), people with subacute lower back pain have a significant increase in depression regardless of gender.  Their study seems very limited as they did not test to see if people already have cases of depression or other mental illness as well.  I agree with you that one of the weaknesses of the study is not measuring the severity of the LBP related to depression.  What do you think would be a good way for them the researchers to measure this? According to Robertson, Kumbhare, Nolet, Srbely, and Newton (2017), people experiencing depression are 60% more likely to develop back pain in their lifetime versus non-depressed people.  It would be interesting to see if this could be attributable to lower levels of activity because of depression.  Do you think that there could be some level of somatic disorder with the lower back pain related to depression? References Lopez-Lopez, D., Vilar-Fernandez, J. M., Calco-Lobo, C., Losa-Iglesias, M. E., Rodriguez-Sanz, D., & Becerro-de-Dengoa-Vallejo, R. (2017). Evaluation of depression in subacute low back pain: A case control study. Pain Physician, 20(4), E499-E505. Robertson, D., Kumbhare, D., Nolet, P.. Srbely, J., & Newton, G. (2017). Assocations between low back pain and depression and somatization in a Canadian emerging adult population. Journal of the Canadian Chiropractic Association, 61 (2), 96-105. weighing the evidence in nursing research essay example papers.

Public Health Law Short Report Midterm Project

“A Public Health Law Short Report”

Title of Midterm Project: “A Public Health Law (Short Report)”:

You will pick a US public health law – a law at the federal, state, country or city level that is designed to protect the health of the public. You will do a literature search and write a report about the law and how it has impacted the health of the public.  Note that this is a “short” report – only 1,000 words Public Health Law Short Report Midterm Project.

 

The public health law must be from
one
of the following three topic areas:

1) Lead

2) Smoking

3) Immunization

 

Important tips on writing your midterm report:

Once you choose you main topic (lead, smoking or immunization), you should choose a law that addresses that topic that has been in effect at least for a few years. Search literature first to make sure that the law’s impact has been evaluated. For instance, “an evaluation study found that 5 years after the introduction of an anti-smoking law, smoking prevalence and incidence of asthma declined” Public Health Law Short Report Midterm Project.

 

Also, the law has to be very specific – for instance, “The Clean Indoor Air Act of NYS of 2003 (Public Health Law, Article 13-E)” instead of “Anti-smoking law in NYS”.

 

The content of your midterm report should cover the following points:

Background

Why was the law enacted?  Health, social, economic, and other contextual backgrounds

Description of the law

Explain the law:  What, When, Where, How and Who

Evidence of the law’s impact on health

Summarize evidence gathered from scientific studies and government reports that evaluated the law’s impact.

Brief concluding statement

Include your own assessments including critiques of the law (lessons learned), and any limitations to report.

 

Format Requirements:

Public Health Law Short Report Midterm Project Top of the first page: Title, your name, date of submission, and word count of the text*

Abstract: up to 200 words to summarize your report

Text: 1 inch margins, page numbered (lower right), single spaced, 12 point font.

Citation Style:  The JAMA style is preferred (see attached guide). Other established styles (APA, Chicago, etc.) are acceptable.

Bibliography/Citations: A minimum of 3 peer reviewed journal articles or credible government reports. All online materials should have URLs, and the date that you accessed them.

Appendix (optional): graphs, tables, and photos. Limit: one page total. They should supplement, but not duplicate, your writing. All materials need proper citations or disclosure of sources.

*Word count: 1,000 words maximum, excluding the title section, abstract, bibliography, and appendix. Public Health Law Short Report Midterm Project.

 

Submission:

You will submit your midterm report in a
Microsoft WORD document
 (uploading instructions are provided in the
MIDTERM PROJECT SUBMISSION
link below).

Due Date: Sunday 3/31 (11:59 PM at night)

 

Quality of report will be graded based on the following criteria:

Compliance with the format requirements

Quality of information (scientific value, accuracy)

Organization of materials (clarity and consistency)

Originality (of conclusion & interpretation)

Citations (minimum of 3 citations from peer reviewed journals or credible government reports)

This assignment 
will be reviewed for plagiarism using SafeAssign. Review the syllabus for the full policy on Academic Dishonesty and plagiarism.

 

Resource:  NYS Lead Laws

https://www.health.ny.gov/regulations/public_health_law/article_13/title_10/index.htm#prevention Public Health Law Short Report Midterm Project

Differential Diagnosis for Skin Conditions Essay Assignment Paper

Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Differential Diagnosis for Skin Conditions Essay Assignment Paper, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

To prepare:

Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Assignment.

Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?

Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected. Differential Diagnosis for Skin Conditions Essay Assignment Paper.

Consider which of the conditions is most likely to be the correct diagnosis, and why.

Download the SOAP Template found in this week’s Learning Resources.

ORDER A CUSTOM-WRITTEN PAPER NOW

To complete:

Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format, rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of
three to five
possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least 3 different references from current evidence based literature  Differential Diagnosis for Skin Conditions Essay Assignment Paper.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 1

 

Differential Diagnosis for Skin Conditions Essay Assignment Paper Learning Resources

Required Readings

Note:
To access this week’s required library resources, please click on the link to the Course Readings List, found in the
Course Materials
section of your Syllabus.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015).
Seidel’s guide to physical examination
(8th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 8, “Skin, Hair, and Nails” (pp. 114-165)

This chapter reviews the basic anatomy and physiology of skin, hair, and nails. The chapter also describes guidelines for proper skin, hair, and nails assessments. Differential Diagnosis for Skin Conditions Essay Assignment Paper.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016).
Advanced health assessment and clinical diagnosis in primary care
(5th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 28, “Rashes and Skin Lesions” (pp. 325-343)

This chapter explains the steps in an initial examination of someone with dermatological problems, including the type of information that needs to be gathered and assessed.

Note:
Download and use the Adult Examination Checklist and the Physical Exam Summary when you conduct your video assessment of the skin, hair, and nails Differential Diagnosis for Skin Conditions Essay Assignment Paper.

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for skin, hair, and nails. In
Mosby’s guide to physical examination
(7th ed.). St. Louis, MO: Elsevier Mosby.

 

This Adult Examination Checklist: Guide for Skin, Hair, and Nails was published as a companion to
Seidel’s guide to physical examination
(8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Skin, hair, and nails physical exam summary. In
Mosby’s guide to physical examination
(7th ed.). St. Louis, MO: Elsevier Mosby.

 

Differential Diagnosis for Skin Conditions Essay Assignment Paper This Skin, Hair, and Nails Physical Exam Summary was published as a companion to
Seidel’s guide to physical examination
(8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

Everyday Health, Inc. (2013).
Resources for dermatology and visual conditions
.

Retrieved from http://www.skinsight.com/info/for_professionals

 

This interactive website allows you to explore skin conditions according to age, gender, and area of the body.

Clothier, A. (2014). Assessing and managing skin tears in older people. Nurse Prescribing, 12(6), 278–282. Retrieved from http://www.nurseprescribing.com/

Retrieved from the Walden Library Databases.

Watkins, J. (2013a). Skin rashes, part 1: Skin structure and taking a dermatological history. Practice Nursing, 24(1), 30–33. doi:10.12968/pnur.2013.24.1.30

Retrieved from the Walden Library Databases. Differential Diagnosis for Skin Conditions Essay Assignment Paper.

Watkins, J. (2013b). Skin rashes, part 2: Distribution and different types of rashes. Practice Nursing, 24(3), 124–127. Retrieved from http://www.practicenursing.com/

Retrieved from the Walden Library Databases.

Watkins, J. (2013c). Skin rashes, part 3: localized rashes. Practice Nursing, 24(5), 235–241. doi:10.12968/pnur.2013.24.5.235

Retrieved from the Walden Library Databases.

Document:
Skin Conditions (Word document)

 

This document contains five images of different skin conditions. You will use this information in this week’s Discussion.

Document:
Comprehensive SOAP Exemplar (Word document)

Document:
Comprehensive SOAP Template (Word document)

Note:
To access the online resources included with the textbook, you need to complete the FREE online registration that is located at
https://evolve.elsevier.com/cs/product/9780323172660?role=student
.

To Register to View the Content

Go to
https://evolve.elsevier.com/cs/product/9780323172660?role=student

Enter the name of the textbook,
Seidel’s Guide to Physical Examination
(name of text without the edition number) in the Search textbox.

Complete the registration process.

To View the Content for this Textbook

Go to
https://evolve.elsevier.com/
.

Click on
Student Site
.

Type in your
Username
and
Password
.

Click on the
Login
button.

Click on the
plus sign icon
for Resources on the left side of the screen.

Click on the
name of the textbook
for this course.

Expand the
menu
on the left to locate all the chapters.

Navigate to the
desired content
(checklists, videos, animations, etc.).

Note:
Clicking on the URLs in the APA citations for the Resources from the textbook
will not
link directly to the desired online content. Use the online menu to navigate to the desired content.

Required Media

Online media for
Seidel’s Guide to Physical Examination

In addition to this week’s media, it is highly recommended that you access and view the online resources included with the course text,
Seidel’s Guide to Physical Examination
. Focus on the videos and animations in Chapter 8 that relate to the assessment of the skin, hair, and nails.

The following suturing tutorials provide instruction on the basic interrupted suture, as well as the vertical and horizontal mattress suturing techniques:

Tulane Center for Advanced Medical Simulation & Team Training. (2010, July 8).
Suturing technique.

Retrieved from https://www.youtube.com/watch?v=c-LDmCVtL0o

Mikheil. (2014, April 22).
Basic suturing: Simple, interrupted, vertical mattress, horizontal mattress
.

Retrieved from https://www.youtube.com/watch?v=MFP90aQvEVM

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014).
DeGowin’s diagnostic examination
(10th ed.). New York, NY: McGraw Hill Medical. Differential Diagnosis for Skin Conditions Essay Assignment Paper.

Chapter 6, “The Skin and Nails”

In this chapter, the authors provide guidelines and procedures to aid in the diagnosis of skin and nail disorders. The chapter supplies descriptions and pictures of common skin and nail conditions.

Ethicon, Inc. (n.d.a).
Absorbable synthetic suture material
. Retrieved from https://web.archive.org/web/20170215015223/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/absorbable_suture_chart.pdf

Ethicon, Inc. (2006).
Dermabond topical skin adhesive application technique
. Retrieved from https://web.archive.org/web/20150921174121/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/db_application_poster.pdf

Ethicon, Inc. (2001).
Ethicon needle sales types
. Retrieved from https://web.archive.org/web/20150921171922/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/needle_template.pdf

Ethicon, Inc. (n.d.b).
Ethicon sutures
. Retrieved from https://web.archive.org/web/20150921202525/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/suture_chart_ethicon.pdf

Ethicon, Inc. (2002).
How to care for your wound after it’s treated with Dermabond topical skin adhesive
. Retrieved from https://web.archive.org/web/20150926002534/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/db_wound_care.pdf

Ethicon, Inc. (2005).
Knot tying manual
. Retrieved from https://web.archive.org/web/20160915214422/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/knot_tying_manual.pdf

Ethicon, Inc. (n.d.c).
Wound closure manual
. Retrieved from https://web.archive.org/web/20170829043048/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/eth

Assignment 1: Differential Diagnosis for Skin Conditions

Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

To prepare:

Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Assignment.

Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?

Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected. Differential Diagnosis for Skin Conditions Essay Assignment Paper.

Consider which of the conditions is most likely to be the correct diagnosis, and why.

Download the SOAP Template found in this week’s Learning Resources.

To complete:

Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format, rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of
three to five
possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least 3 different references from current evidence based literature. Differential Diagnosis for Skin Conditions Essay Assignment Paper.

PCN 605 Case Study of Tina Essay Assignment

Case Study: Tina

PCN 605 Case Study of Tina

Tina is a 17-year-old Navajo female who is brought into a counselor’s office for symptoms of depression; her family has noticed that she is more withdrawn than usual and she is often observed crying and talking to herself. Through the intake interview, the counselor learns that Tina hears voices daily that command her to perform certain acts of hygiene (showering, combing her hair, etc.) PCN 605 Case Study of Tina Essay Assignment. She further reveals that she believes these voices to be the result of witchcraft that her boyfriend is using to control her. Tina also states that she has used methamphetamines heavily for the past several months. She and her mother ask the counselor to work with Tina for the depression, but claim that they wish to see a medicine man for hearing voices.

ORDER A PLAGIARISM-FREE PAPER HERE

Where does the counselor begin with this client? Tina is clearly demonstrating symptoms of psychoses, yet it is difficult to determine what has caused them. Is she experiencing a severe depressive episode with psychotic features? Have the voices been induced by excessive drug use? Alternatively, should the counselor take into account the cultural acceptance of witchcraft and let the medicine man exclusively treat Tina? This case study is but one example of the way different cultures deviate in concept of mental illness as it presents itself in the counselor’s office.

Viewing clients as devoid of their cultural backgrounds because notions of health and wellness differ greatly by who is defining them are unethical and unwise. In order to be as receptive as possible to a client’s position, counselors must constantly
 deconstruct and be aware of their own beliefs
 regarding psychopathology. This process of exploring a belief system has been given many names, one of which is 
social constructionism
 (Lemma, 2011).

Social constructionism is the concept that reality is formed and defined by the individual experience of it; the perceptions of any given society are constantly in flux as trends and knowledge shifts. PCN 605 Case Study of Tina Essay Assignment As such, the concept of psychology changes to meet the needs of each given culture. Ruder & Guterman (2007) state that “social constructionism is, itself, a social construction that is always changing and subject to reconstruction” (p. 387).

PCN 605 Case Study of Tina References

Rudes, J. & Guterman, J. (2007). The value of social constructionism for the counseling profession: A reply to Hansen. 
Journal of Counseling & Development,85
(4), 387-392

PCN 605 Case Study of Tina Paper Details

Review the diagnostic criteria on pages 99-100; 160-161; 561-562 of the DSM-5.

A counselor’s own perception of psychopathology is extremely important in the diagnostic process.

Using the case study of “Tina”, write a 500-750 word essay in which you examine your thought process about her presenting issues. Include the following in your paper:

Discuss the historic and cross-cultural perspectives of psychopathology that could potential impact the diagnosis and treatment of Tina.

After reviewing the several diagnoses that could pertain to Tina from the latest version of the DSM, what is your diagnostic impression?

Substantiate your diagnostic impression with appropriate criteria from the current version of the DSM. PCN 605 Case Study of Tina Essay Assignment.

Discuss how historic misconceptions of psychopathology could potentially impact the treatment of this client. As part of this discussion, you may include a diagnosis, any referrals that you would make, and a general course of treatment. At least five scholarly references in addition to the textbook in your paper.

Prepare this PCN 605 Case Study of Tina assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. PCN 605 Case Study of Tina Essay Assignment.

This PCN 605 Case Study of Tina assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this PCN 605 Case Study of Tina assignment to Turnitin. Refer to the directions in the Student Success Center. PCN 605 Case Study of Tina Essay Assignment.

DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment Paper

Competitive Markets and Market Power Paper 
Scenario:

You are the Chief Executive Officer of a large and complex integrated health delivery system (IHDS). The IHDS is a for-profit health system and is located in a major metropolitan area market. The metropolitan market is in high competition with similar large integrated health delivery systems, public and private, that compete directly with your IHDS. DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment Paper. Major characteristics of this market are booming economic activity, dynamic and diverse populations, labor market shortages, and a high uninsured population percentage (25% of the total population) which has been trending higher.

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Your IHDS operates multiple long-term acute care facilities and is affiliated with teaching hospitals, outpatient- and surgical centers, rehab and ancillary facilities, wellbeing- and urgent-care outlets, and multiple physician group practices (primary care and subspecialties clinics in different locations). You also have affiliation agreements with regional and national managed care plans and third-party payers. DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment Paper.

The recent healthcare reforms (Affordable Care Act, Accountable Care Organizations, shift from volume-based to value-based healthcare delivery systems, bundled payment system, etc.) have impacted the macro- and micro-level economic models and current competitive advantage position and outlook for the IHDS.

The Board of Directors has asked you to prepare an executive report about the economic impact of these trends and forces and to assess the economic outlook for your organization.

Write
, based on the scenario above, a 1,050- to 1,400-word executive report addressing the following:

Assess the economic assumptions of a competitive market model on IHDS and identify the evidence for and against the competitive model.

Evaluate the potential economic consequences of the applied community rating and experience rating on the IHDS. DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment Paper.

Compare and contrast alternative delivery arrangements for the IHDS in terms of their microeconomic efficiency.

Describe the determinants of market power for the IHDS and assess how it can use the market power to demonstrate superior economic efficiency and effectiveness.

Explain how market power can affect labor market outcomes for your organization.

Identify several alternative measures of the IHDS market competitiveness and economic evaluation.

Include 
at least 10 current peer-reviewed articles in your DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment paper.

Format
 your Competitive Markets and Market Power Paper assignment according to APA guidelines.

Submit 
to the DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment Paper files tab.

DHA 721 WEEK 8 Economic Impact of Managed Care Reform on the Healthcare Market Paper

The concept of managed care and the Health Maintenance Organization (HMO) has been evolving since the early 1970s and has significantly impacted the delivery of health and medical care in the United States.

Write
 a 1,050- to 1,400-word paper addressing the following:

Define managed care and briefly describe the different types of managed care models and key characteristics of an HMO.

Assess the economic impact of implementing managed care since the introduction of the 1973 HMO Act.

Explain how consumer and provider incentives work to achieve cost reduction, improved resource allocation, and return on investment (ROI) in a managed care environment.

Explain the economic impact of alternative provider payment methods on HMO performance.

Compare and contrast the effects of HMOs with the effects of fee-for-services on resources used and quality of care. DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment Paper.

Distinguish between employer and individual use of information on managed care health plan performance.

Discuss the rationale and potential implications and consequences of moving from a volume-based to value-based healthcare delivery system.

Include 
at least 10 current peer-reviewed articles in your paper.

Format
 your assignment according to APA guidelines.

Submit 
to the Assignment Files tab. DHA 721 WEEK 6 Competitive Markets and Market Power Essay assignment Paper.