Friday, June 28, 2013

Nursing


Evidence-Based Practice Project
Project description
Evidence-Based Practice Project Guidelines and Grading Criteria
Students are required to carefully formulate a researchable and answerable PICOT question arising from the clinical practice. This individual scholarly paper provides an opportunity for students to prepare a systematic plan to apply research finding in a clinical practice.
Directions: Students must follow specific requirements in this guideline to receive a full credit.
Assignment Submission: Submit the Final EBP paper with research articles in the pdf files to the drop box provided. Label each pdf file with the first author’s last name. Label the EBP project template file with your last name. Students must follow the EBP project guidelines to receive a full grade.
I. Introduction (10) (Estimated length: 1-2 paragraphs)
• Describe a specific clinical practice problem/situation that leads to PICOT question
• Describe significance of the clinical practice problem and the need for an EBP investigation by 1 or more of the following methods:
o Use of evidence to establish the prevalence/incidence of a specific clinical problem/situation
o Use of evidence to establish the risks associated with a specific clinical problem/situation
o Use of evidence to establish the potential impact of a specific clinical problem/situation on clients’ quality of life

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• Introduce the clinical question and sets the stage for the subsequent EBP inquiry
• A clinical question must be written clearly in a PICOT format including all five components, patient/population, intervention, comparison (if applicable), outcome, and time (5)
• Engage the reader
Evaluative Comments: __/10
II. EBP Investigation Process (25)
o Presentation of evidence investigation is objective, written in past tense, uses appropriate tentative language and active voice, and utilizes the following subheadings:
? Selection Criteria (5): (Estimated length: 1 paragraph)
? State the specific criteria you established and used for selection of “best evidence”
? Describe the selection criteria used and ensure they are appropriate for PICOT question
? Search Process (15): (Estimated length: 1 paragraph)
? Describe the search process in details that you followed in your comprehensive review of the literature relevant to selected topic. Provide rationales for the final selection of the studies included for the best evidence.
? Include details, such as the databases/evidence sources searched, the specific search/MeSH terms utilized in your search process, and the specific types of evidence targeted in your search process. Describe details of search results.

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? Selection of Best Evidence (5): (Estimated length: 1 paragraph)
? Identify the specific studies/publications, which you selected as “best evidence”. Refer your readers to the matrix in the Appendix A for a summary of each selected evidence document.
? Assure your readers that you selected all or a sufficient proportion of applicable best evidence, which met your pre-established selection criteria without bias.
? Discuss/explain the reasons behind any exclusions of located applicable evidence (as appropriate).
Evaluative Comments: __/25
III. Critical Appraisal of Collective Evidence (20): (Estimated length: 3-5 paragraphs)
? Use critique templates provided at the bottom of this guideline to evaluate each selected study. Be sure to use the appropriate template according to the type of the study design. Critique each selected article and keep it in Appendix B.
? Offer your critique of selected collective (not individual) evidence through the use of synthesis. Examples of aspects, which are typically critiqued, include the adequacy of sample sizes, appropriateness of methods for research question, bias demonstrated in inclusion/exclusion criteria, interventions, recency of research, and the level of significance of study results. For example: “All four of the studies implemented and intervention of vaccination with the HPV vaccine in young women and compared this to the placebo group…. Except for Smith et al’s study group (2009) which only included vaccination protection from type 16 and 18, the other studies included protection against type 6, 11, 16, and 18. Although the Smith et al’s study group (2009) investigation excluded protection in the vaccine from types 6 and 11, results showed cross protection from types 31, 33, and 45 which are also oncogenic.”

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? Evaluate the applicability of selected collective (not individual) evidence to clinical question/situation through the use of synthesis. Examples of aspects, which are typically evaluated, include the congruency/match between the selected evidence and clinical question in terms of PICO components—population, intervention, comparison, and outcome and the quality of the study. The purpose of this evaluation of applicability is to show the reader that application of the findings from the selected best evidence to your EBP clinical problem/situation is warranted/valid.
? Evaluate the sufficiency of selected collective (not individual) evidence to address the clinical problem/situation through the use of synthesis. Included in your evaluation of the sufficiency of collective evidence is your perception of the need (or lack of need) for further research.
Evaluative Comments: __/20
IV. Collective Results (20): (Estimated length: 2-3 paragraphs)
? Provide a summary of the collective results of the EBP investigation. Compare and contrast findings across collective studies including statistical findings and p-values or confidence interval. Draw conclusions from the collective results of the examined evidence through the use of synthesis. The following example illustrates a summary of results and conclusions drawn from the synthesis of collective results:
Two systematic review studies and a case control study, which compared large samples of cases with ovarian cancer with large control groups did not find a greater risk of ovarian cancer development in individuals who breastfed their infants for 6 to 12months (Klaus, Penington, & Sim, 2006; Leawood et al., 2004; Mena, et al., 2008). In contrast, Bar-Yam, Smith, and Young (2009) in a pooled analysis of 2 case control studies with a smaller sample size found a greater risk for the development of ovarian cancer among non-breastfeeding women. A greater risk for the development of ovarian cancer was noted among those who did not breastfeed (Bar-Yam, Smith, and Young (2009).


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V. Intervention Decision (10): (Estimated length: 1-2 paragraphs)
? Discuss the implications for practice that can be drawn from the results of your EBP inquiry. What specific “evidence-based” practice intervention(s) are supported (not supported) by your findings? Are there specific parameters that should be followed in the implementation of supported intervention(s)?
? If evidence did not support the intervention or insufficient evidence, research to generate new evidence may be needed. The implications should be discussed with respect to future research and recommendation for the next steps.
? Explore and select an EBP model to guide the implementation of the project. Briefly describe steps of the model.
? Explore how the values/preferences of “others” (patient, administrators, team members) may influence the implementation of the supported intervention (if applicable).
? Explore your ability to implement the “evidence-based” intervention in terms of the available resources within clinical settings.
Evaluative Comments: __/10
VI. Plan for Implementation and Evaluation of Intervention Decision or a brief research plan (if evidence of intervention was not supported) (10) (Estimated length: 1-2 paragraphs)
• Based on the above intervention decision and your chosen EBP model, outline a specific plan for the implementation of an “Evidence-based” intervention in clinical practice or brief research plan including:
o Design, setting and sample, description of the intervention, description of outcome measurement, procedure/protocol, data analysis, and time frame.
• Clearly


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