**THIS IS A POWERPOINT SLIDE ASSIGNMENT!**
**The four peer-reviewed articles mentioned in the Directions are attached in a Word document/PowerPoint in files**
**PLEASE FOLLOW THE RUBRIC ATTACHED IN FILES***
The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
To Prepare:
- Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
- Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
- Consider the best method of disseminating the results of your presentation to an audience.
The Assignment: (Evidence-Based Project)
Part 4: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:
- Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
- Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
- Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
- Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
- Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
- Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
- Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
- Add a lessons learned section that includes the following:
- A summary of the critical appraisal of the peer-reviewed articles you previously submitted
- An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)
Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 3A: Critical Appraisal of Research
Full APA formatted citation of the selected article. |
Article #1 |
Article #2 |
Article #3 |
Article #4 |
Cho, H., & Steege, L. M. (2021). Nurse fatigue and nurse, patient safety, and organizational outcomes: A systematic review. Western Journal of Nursing Research, 43(12), 1157-1168. |
Montgomery, A. P., Patrician, P. A., & Azuero, A. (2022). Nurse burnout syndrome and work environment impact patient safety grade. Journal of Nursing Care Quality, 37(1), 87-93. |
Al Ma'mari, Q., Sharour, L. A., & Al Omari, O. (2020). Fatigue, burnout, work environment, workload, and perceived patient safety culture among critical care nurses. British Journal of Nursing, 29(1), 28-34. |
Swamy, L., Mohr, D., Blok, A., Anderson, E., Charns, M., Wiener, R. S., & Rinne, S. (2020). Impact of workplace climate on burnout among critical care nurses in the Veterans Health Administration. American Journal of Critical Care, 29(5), 380-389. |
|
Evidence Level * (I, II, or III)
|
III |
III |
III |
III |
Conceptual Framework Describe the theoretical basis for the study ( If there is not one mentioned in the article, say that here).** |
N/A |
N/A |
N/A |
N/A |
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). |
The present meta-analysis includes only quantitative studies conducted from January 2000 to July 2020 only. Given the topic of focus, only the quantitative studies with relevance to nurse fatigue and its effects on the nurse, patient safety as well as organizational consequences were considered. |
The study design used in this research study is the cross-sectional descriptive survey design. Self-completed cross-sectional questionnaires were obtained from 928 registered nurses employed in AL AC hospitals. |
Cross-sectional and prediction design. Self-developed cross-sectional survey conducted on 270 critical care nurses in Oman. Used descriptive statistics as well as inferential statistics. |
This study applied a cross-sectional survey design and targeted 2,352 employed nurses in 94 organizations. Self-administered anonymous questionnaires were used, and data was collected in the year 2017. |
Sample/Setting The number and characteristics of patients, attrition rate, etc. |
The kind of studies that were included in this review involved different samples and different scenarios. |
928 respondents in this study were nurses coming from 19 acute care hospitals in the state of Alabama. |
Concerning 270 critical care nurses from two of the public hospitals in Oman. |
2,352 critical care nurses from 94 Organizations in the group of Veterans Health Administration. |
Major Variables Studied List and define dependent and independent variables |
Independent variables: nurse fatigue. Dependent variables: the health of the nursing personnel, the health of the patients, the security of the patients, and the general performance of the health facility. |
Independent variables: Again, nurse burnout and the work environment they experience are identified mostly by students. Dependent variables: patient safety grade is the numerical rating assigned to the patient safety of an organization. |
Independent variables: employee fatigue, burnout, workload, and work environment. Dependent variables: The findings highlight the %each and every one of the hospitals' overall picture of the perceived patient safety culture. |
Independent variables: workplace climate. Dependent variables: burnout. |
Measurement Identify primary statistics used to answer clinical questions ( You need to list the actual tests done). |
Secondary analysis of quantitative data /Analysis of quantitative findings. |
CBI, Descriptive statistics, Inferential statistics. |
Survey research, correlation analysis, and regression analysis. |
Exploratory study, cross-sectional. Findings either Data analysis is statistical or Qualitative. |
Data Analysis Statistical or Qualitative findings ( You need to enter the actual numbers determined by the statistical tests or qualitative data). |
The various outcomes are analyzed into three main groupings, namely: Nurses’ outcomes, outcomes generated by nurses about patients, and Organizational outcomes. |
Moderate to strong associations were found between the burnout rate, the index of the work environment, and the patient safety grades. |
The correlations between the study variables are, Fatigue, Burnout, Workload, and Perceived Patient Safety Culture. |
As it will be identified, the climate being witnessed at the workplace has a direct influence on burnout levels of critical care nurses. Findings and Recommendations |
Findings and Recommendations General findings and recommendations of the research |
Fatigue harms the nurse, the patient, and the organization in various aspects of performance. How the findings may be of use for more examination & intercession. |
People’s burnout level and work environment quality directly influence patient safety. Organizational strategies are crucial. |
Fatigue, burnout, workload as well as work environment have a direct impact on the perception of the patient safety culture. Recommendations for targeted interventions. |
The organizational environment also has a critical influence on the burnout of the nurses. Structural interventions are necessary. |
Appraisal and Study Quality Describe the general worth of this research to practice. What are the strengths and limitations of the study? What are the risks associated with the implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice? |
Complements existing literature by discussing the general effects of nurse fatigue. Strengths: the framework of a significant number of reviewed research. Limitations: This aspect may be attributed to variations in the study designs chosen by the authors of the surveys. |
Large subject sample and reliable measuring tools. Strengths: robust statistical analysis. Limitations: As it is mentioned that the current study used a cross-sectional design, this type of research design restricts causality. |
Most research studies and surveys have a large sample size and achieve a high response rate. Strengths: detailed analysis. Limitations: self-reported data. |
Therefore, this study has a large sample size and multilevel analysis. Strengths: addresses organizational factors. Limitations: cross-sectional design. |
Key findings
|
Various studies demonstrate the costly effects of shift work and employee fatigue on the nurse and the patient. |
Directions for the future of nurse burnout and work environment quality patient safety. |
Employment burnout, employment fatigue, and the employment workload are some of the determinants of perceived patient safety culture. |
Thus, there is a positive correlation between the workplace climate and the critical care nurses’ burnout level. |
Outcomes
|
Another implication evident in the study focuses on the need for interventions that are aimed at reducing the level of nurse fatigue. |
The a need to upgrade the workplace to minimize burnout and increase safety for the patients. |
Lack of workload and burnout engagement related to the intervention's effectiveness as per the patient safety perception. |
System-level changes that can be implemented in the workplace include the following with a view to preventing burnout. |
General Notes/Comments |
Stresses that more attention should be paid to the problem and research on the subject of nurse fatigue. |
Emphasizes the organizational action plan in the prevention of burnout. |
Identifies existing obstacles to the formation of the desired patient safety culture in the workplace. |
Implied that interventions should be aimed at structures more so than people. |
References
Al Ma'mari, Q., Sharour, L. A., & Al Omari, O. (2020). Fatigue, burnout, work environment, workload, and perceived patient safety culture among critical care nurses. British Journal of Nursing, 29(1), 28-34.
Cho, H., & Steege, L. M. (2021). Nurse fatigue and nurse, patient safety, and organizational outcomes: A systematic review. Western Journal of Nursing Research, 43(12), 1157-1168.
Montgomery, A. P., Patrician, P. A., & Azuero, A. (2022). Nurse burnout syndrome and work environment impact patient safety grade. Journal of Nursing Care Quality, 37(1), 87-93.
Swamy, L., Mohr, D., Blok, A., Anderson, E., Charns, M., Wiener, R. S., & Rinne, S. (2020). Impact of workplace climate on burnout among critical care nurses in the Veterans Health Administration. American Journal of Critical Care, 29(5), 380-389.
Critical Appraisal Tool Worksheet Template
© 2023 Walden University, LLC 2
,
Chronic Pain in the Elderly Patient Population
Tiara Sank
Dr, Usama Saleh
Essentials of Evidence-Based Practice
Walden University Date
introduction
Clinical Issue: Chronic pain in the elderly patient population: Treatment and management strategies.
Symptoms: Chronic pain, ability to move limited, course of mind negatively affected.
Current Practices: Medications, physical therapy, and psychological support are typical measures.
Challenges: Drug-interaction between drugs, compliance to therapeutic regimen.
Objective: What is currently known about efficient management and how can it be utilized?
2
Development of the pico(t) question
PICO(T) Framework: PICO: The mnemonic for identifying the four elements of a final study question is PICO, for Population, Intervention, Comparison, Outcome, Time.
Population: They include patients with chronic pain and those who are elderly.
Intervention: In this study, a multimodal approach of managing pain was used to encompass both physical and medical aspects.
Comparison: Standard pharmacological treatment.
Outcome: Diminished facets of the pain scale, enhanced well being status.
Time Frame: Table 2: Based on the survey of over a period of 6 months.
3
Pico(t) question:
‘What is the difference in pain levels and quality of life 6 months after elderly chronic pain patients had adopted a multimodal pain management approach as compared to adopting standard pharmacological treatment?’
4
databases
Database 1: PubMed
Focus: Biomedical literature.
Database 2: Cochrane Library
Focus: in identified systematic reviews and meta-analyses.
Database 3: CINAHL
Focus: Nursing and allied health literature are used as sources to get perspective on the knowledge deficit.
Database 4: Evidence appraisal and synthesizing will be done using the Joanna Briggs Institute (JBI)
5
Peer-reviewed articles
Article 1
Kechichian, A., Lafrance, S., Matifat, E., Dube, F., Lussier, D., Benhaim, P., … & Desmeules, F. (2022). Multimodal interventions including rehabilitation exercise for older adults with chronic musculoskeletal pain: a systematic review and meta-analyses of randomized controlled trials. Journal of Geriatric Physical Therapy, 45(1), 34-49.
Article 2
Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: an update on burden, best practices, and new advances. The Lancet, 397(10289), 2082-2097.
Article 3
Yong, R. J., Mullins, P. M., & Bhattacharyya, N. (2022). Prevalence of chronic pain among adults in the United States. Pain, 163(2), e328-e332.
Article 4
Bao, Z., & Landers, M. (2022). Non‐pharmacological interventions for pain management in patients with dementia: A mixed‐methods systematic review. Journal of Clinical Nursing, 31(7-8), 1030-1040.
6
Levels of evidence in selected articles
Article 1: Level I
•Strengths: Publication level assessment aims at examining the body of evidence and its relevance to the clinical question of interest, hence the focus was done on the randomized controlled trials.
Article 2: Level I
•Strengths: Basically, using more than one therapy comparison with high number of sample subjects, enhanced research method.
Article 3: Level II
•Strengths: Cohort studies with plentiful data of high quality, duration of the follow-up data.
Article 4: Level I
•Strengths: Option of unpredictable approach, versatility in applying the intervention strategies.
Advantages of Systematic Reviews: High relevance, methodological rigor, integration of other research reports.
Examples: Having continued education clinical practice guidelines lead to better decisions.
Strengths of using systematic reviews for clinical research
Comprehensive Evidence: Then sum up available information from a number of studies.
Reduces Bias: This approach limits bias that might be associated with carrying out research on specific studies.
Generalizability: Key Research Strength: Extends the generalizability of the results to other groups of people.
Informs Practice: Fully substantiates standards being utilized in the clinical field.
Efficiency: Reduces time spent in attempting to analyze large data sets through giving a summary of the research done.
Decision-Making: Affords well-based clinical decisions to light the professionals.
references
Bao, Z., & Landers, M. (2022). Non‐pharmacological interventions for pain management in patients with dementia: A mixed‐methods systematic review. Journal of Clinical Nursing, 31(7-8), 1030-1040.
Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: an update on burden, best practices, and new advances. The Lancet, 397(10289), 2082-2097.
Kechichian, A., Lafrance, S., Matifat, E., Dube, F., Lussier, D., Benhaim, P., … & Desmeules, F. (2022). Multimodal interventions including rehabilitation exercise for older adults with chronic musculoskeletal pain: a systematic review and meta-analyses of randomized controlled trials. Journal of Geriatric Physical Therapy, 45(1), 34-49.
Yong, R. J., Mullins, P. M., & Bhattacharyya, N. (2022). Prevalence of chronic pain among adults in the United States. Pain, 163(2), e328-e332.