For this assignment, think about a clinical topic, problem or question that interests you and/or from your personal, professional, or clinical experiences. Come up with a paper approaching the problem/question using the five evidence-based practice guidelines discussed below. The problem/question will be related to nursing practice in some way. In other words, there needs to be nursing implications to addressing your question. Overall guidelines for each part of the project include:
***The Five Steps of Evidence Based Practice***
STEP ONE: Ask a clinical question which may interest you in PICO format. For example, are there pharmacologic interventions that have been effective in decreasing allergy symptoms in children? OR In children, what is the effect of pharmacologic interventions on allergy symptoms?
P= Population you are interested in (e.g., children under 5 years of age)
I= Intervention or interest (e.g., use of Singulair for allergies)
C= Comparison intervention or group (e.g., comparison of Singulair with control and another allergy medication)
O= Outcome (e.g., 20% decrease in allergy symptoms for experimental group as compared to control group).
Define your question using PICO. Your question should be used to help establish your search strategy. Submit the following information for your clinical question. First provide the following (use the below format):
Then write out your PICO question (IF relevant to your question, add “T” for time frame) Template for Asking PICOT Questions
INTERVENTION In ____________________
(P), how does ____________________
(I) compared to ____________________
(C) affect _____________________
(O) within ___________
(T)? DIAGNOSIS OR DIAGNOSTIC TEST
(P) are/is ____________________
(I) compared with _______________________
(C) more accurate in diagnosing _________________
(O)? PROGNOSIS/PREDICTION In ______________
(P), how does ___________________
(I) compared to _____________
(C) influence __________________
(O) over _______________
(T)? Short Definitions of Different Types of Questions: Intervention: Questions addressing the treatment of an illness or disability. Diagnosis: Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation. Prognosis/Prediction: Questions addressing the prediction of the course of a disease.
SAMPLE PICO QUESTIONS
Intervention: In African American female adolescents with hepatitis B
(P), how does acetaminophen
(I) compared to ibuprofen
(C) affect liver function
Diagnosis: In middle-aged males with suspected myocardial infarction
(P), are serial 12-lead ECGs
(I) compared to one initial 12-lead ECG
(C) more accurate in diagnosing an acute myocardial infarction
(O)? Prognosis/Prediction: For patients 65 years and older
(P), how does the use of an influenza vaccine
(I) compared to not received the vaccine
(C) influence the risk of developing pneumonia
(O) during flu season
(Copyright, Ellen Fineout-Overholt, 2006)
*Be sure you include “compared to” in your clinical question using PICO.
STEP TWO: Conduct a literature search. Be sure to include also systematic reviews (e.g., the Cochrane Database of Systematic Reviews) and evidence-based practice guidelines (www.guideline.gov) in your search strategy.
STEP THREE: Review and Critically Appraise the evidence. Describe the problem and purpose of each research study. Describe the research methods, including process of data collection, sampling, and data analysis, for each research study What were the results of the study? Summarize the major findings and conclusions of each research study Critique the strengths and weaknesses of the research methods. The expectation is that you also cite your textbook, when describing research methods or criteria for evaluating research. Are the results valid? To answer this question, you need to critique the studies for validity-based on your critical appraisal of the literature, are the results valid? Are the findings clinically relevant to patient(s) identified? Do you believe this will work in practice?
STEP FOUR: Integrate evidence to implement a decision.
STEP FIVE: Evaluate the outcome. Students will not be evaluating the outcome in this assignment. This occurs in clinical practice.