NR-505 Advanced Research Method: Evidenced Based Practice
Research Summaries (graded)
Read the box above about Mr. Lowell and his facility. As an advanced practice nurse, you need to help the staff understand the differences between various translation documents. Therefore, in this discussion, compare and contrast two of these five types of research summaries: meta-analysis, meta-synthesis, systematic research reviews, clinical practice guidelines, and care protocols. What are the differences in their purposes, audiences, and authors?
Reference
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best practice (3rd ed.). Retrieved from http://bookshelf.vitalsource.com
•Chapter 9: Implementing Evidence in Clinical Settings
•Chapter 10: The Role of Outcomes and Quality Improvement in Enhancing and Evaluating Practice Changes
•Chapter 13: Models to Guide Implementation and Sustainability of Evidence-Based Practice
•Chapter 14: Creating a Vision and Motivating a Change to Evidence-Based Practice in Individuals, Teams, and Organizations
•Chapter 17: ARCC Evidence-Based Practice Mentors: The Key to Sustaining Evidence-Based Practice
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice (2nd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott, Williams, & Wilkins.
Pearson, A. (2010). The Joanna Briggs Institute model of evidence-based health care as a framework for implementing evidence (2010). In Rycroft-Malone, J. & Bucknall, T. (Eds.), Models and frameworks for implementing evidence-based practice: Linking evidence to action (pp. 185–206). Malden, MA: Wiley-Blackwell.
Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.
Health and safety issues in Ironridge community
The primary health and protection issues in the Ironridge community include; the presence of a burger restaurant near an open- constructed place with an open ground fire pit and the trash that is on fire near the sidewalk. There are also some health issues like; trash surrounds an open tented bed that is that, and a rodent was walking across the street. The presence of rodents on the walkway is a sign of unhealthy environment for human habitation. There is also a man sitting in front of a trash can on fire. Three trash bags are sitting on the sidewalk that is near a car with no tires on fire.
The homeless individual lying on a bench and an open Biohazard with a red sign are not healthy for this person. Biohazards cause health problems human beings. A biohazard is a risk to human health or the environment arising from vital work. Microorganisms have mainly caused the main biological work that usually the origin of biohazard
Health and safety issues in Summerville community
The security issues that I identified in the Summerville community were a loose K-9 dog and a government dog without an owner or leash. Such dogs can cause harm to humans. These may be through biting which causes injuries to victims. The dogs can bite the two women outside a store near both dogs and cause damage. Rodents walking in the middle of the road is a sign of dirty environment. Dirty environment causes health problems in humans inhabiting the area. The presence of a bike underneath the car at a residential home in this community shows how children have exposed to ill-health factors, kids riding the bike without helmet.
Mr. Lowell, the nursing executive at St. Louis Hospital in Summerville, hears about your consultant work for the cities of Ironridge and Summerville, and he asks you to help him evaluate the hospital’s evidence-based practice program and recommend an EBP model. He strengthened the staff education department a few years ago with a new MSN-prepared director who could use a consultant to get the evidence-based practice program off of the ground.
Recall that systematic reviews and meta-analyses of randomized controlled trials (RCTs) are considered the best evidence when clinicians search for information on a clinical problem. Meta-analyses are reviews of literature related to a particular intervention, culminating in the calculation of the effect size of an intervention. The effect size is a measure of how well an intervention works based on the results of several studies.
Systematic reviews of research (SRRs) are either summaries of the research on an intervention or summaries of what is known about a phenomenon. A rigorous process is used to identify appropriate studies based on criteria developed by the researcher. The results of studies are synthesized, but no statistics are calculated.
Meta-syntheses are systematic reviews of qualitative studies, often resulting in theoretical propositions that can later be tested in practice. Meta-analyses, SRRs, RCTs, and even meta-syntheses are used to develop clinical practice guidelines (CPGs). Clinical practice guidelines are translated into care protocols, care maps, procedure manuals, and algorithms that are then implemented within institutions (see Figure 1). The developers of CPGs consider all of the studies related to a clinical problem.
Clinical Practice Guidelines
Clinical practice guidelines, or CPGs, are documents developed by multidisciplinary committees or professional organizations to provide guidance for clinicians about treatments supported by research. These committees examine all levels of research and typically include an analysis of the levels of evidence in their guidelines. Meta-analyses and systematic reviews of research based on RCTs are especially valued because they are considered the most credible research, but other types of studies are also included.
CPGs are available online on several websites. Here are a few.
•The Cochrane Collaboration is an international effort established in 1993 to provide CPGs or reviews related to healthcare research. Accessing the Cochrane Collaboration is possible through many libraries.
•The National Guideline Clearinghouse, which is maintained by the United States Agency for Healthcare Research and Quality (AHRQ), has provided guidelines since 1992. Guidelines are submitted by professional organizations, governmental committees, and clinicians.
•The Veterans Administration (VA)/Department of Defense Clinical Practice Guidelines website provides guidelines developed by VA and military clinicians.
Clinical practice guidelines are also compiled or collected by professional organizations, many federal agencies, and organizations dedicated to evidence-based practice, such as the Joanna Briggs Institute in Australia. More than one guideline, therefore, may be available for any clinical problem.
Learning to read and critique CPGs is important. The following criteria are useful for critiquing CPGs.
•Scope and purpose—Why was this guideline or best practice document developed?
•Stakeholders—Who has developed this CPG? Was the CPG developed for physicians, nurses, other health professionals, or a multidisciplinary team?
•Rigor of evidence—What were the criteria for inclusion or exclusion of articles in the CPG? Were the levels of evidence for the articles in the CPG described? Were the articles recently published?
•Recommendations and expected consequences—What is the intended audience for the CPG? Is the CPG appropriate and practical for nursing practice or multidisciplinary practice?
•Practicality and application—How will this practice summary be applied?
The following activity asks you to match the CPG criteria with additional questions that may be asked when critiquing them.
In advanced practice, within a nursing-practice committee, or as part of a multidisciplinary team, nurses use CPGs to design protocols of care, care maps, algorithms, procedure manuals, or other documents that translate the research in the CPG into practical bedside plans of care. Nursing specialty organizations, such as the American Association of Critical-Care Nurses, also provide care protocols for their members.
Page or paragraph numbers must be included with quotes per APA. See APA re how to format references and in-text citations i.e. capitalization issues and use of the ampersand versus the word (“and”).
Including at least one in-text citation and matching reference.
Check for grammar and spellings