NURS 6052 Assignment Levels of Clinical Inquiry

NURS 6052 Assignment Levels of Clinical Inquiry

NURS 6052 Assignment Levels of Clinical Inquiry

This presentation will discuss my selected clinical issue of interest and describe how I developed a PICOT question focused on the clinical issue of interest. I will include the four research databases used to conduct the search for the peer-reviewed articles and the citations for the articles.  Besides, I will describe the level of evidence of each peer-reviewed article. Lastly, I will discuss the strengths of using systematic reviews for clinical research.

The clinical issue of interest is cognitive decline in mild-moderate Alzheimer’s disease (AD). AD is a neurocognitive disorder characterized by progressive deterioration of cognitive function (Berg-Weger & Stewart, 2017). The decline in cognitive function results in cognitive deficits, evidenced by short-term memory, language dysfunction, poor judgment, impaired reasoning, difficulty managing complex tasks, and visuospatial dysfunction (Berg-Weger & Stewart, 2017). Pharmacological therapies available for AD helps only to slow or reverse the progression of AD but do not reverse the effects of cognitive decline. Besides, therapies previously proposed for AD have produced mostly disappointing outcomes (Berg-Weger & Stewart, 2017).  Therefore, there is a major need to identify non-pharmacological approaches to improve cognitive function in the early stages of the disease before the symptoms progress.

I developed a PICOT question centered on cognitive function in AD by first identifying a population of interest. In this case, the population of interest was patients with mild to moderate AD.

The second step was to identify an intervention that would help address the issue of cognitive decline in AD. The identified intervention was cognitive training combined with drug therapy. The intervention will be compared to drug therapy alone. The next step entailed identifying a measurable outcome that will be used to determine the effectiveness of the proposed intervention. The desired outcome after cognitive training is improved cognitive function. Lastly, I set up a time frame that will be used to evaluate the intervention. The time frame for this case is six months.

The PICOT question for the clinical issue is:

In patients with mild to moderate AD (P), does cognitive training combined with drug therapy (I) compared to drug therapy alone (C) improve cognitive function (O) in six months (T)?

The research databases used to search peer-reviewed articles on non-pharmacological interventions that can improve cognitive functioning in patients with mild-moderate AD include APA PsycInfo, BioMedCentral, CINAHL Plus, and Cochrane Database of Systematic Reviews.

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: NURS 6052 Assignment Levels of Clinical Inquiry

Week 5 Assignment

Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

Develop a PICO(T) question to address the clinical issue of interest for the Assignment.

Use the key words from the PICO(T) question you developed and search at least four different databases in the Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level related to your research question.

Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

Identify and briefly describe your chosen clinical issue of interest.

Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

Provide APA citations of the four peer-reviewed articles you selected.

Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

From a practice viewpoint, clinical issues represent the care aspects prioritized when performing clinical interventions. They are primarily the everyday events in health care delivery that adversely affect health outcomes. Clinical issues often inform research problems. In this case, they are the basis for evidence-based application in health practice where nurses and other care providers integrate scientific evidence with clinical expertise and patient preference to enhance health outcomes. This presentation describes the clinical issue of interest, PICOT development, and the databases used to conduct the search process. It also identifies the research databases used, APA citations for the peer-reviewed articles used, and levels of evidence. The last part is a detailed analysis of the strengths of systematic reviews as the highly recommended evidence type for clinical research.

To provide optimal patient care, nurses should always be in the right physical and mental health state. Unfortunately, clinical issues hamper nurses’ ability to provide quality and satisfactory care. Workplace incivility in nursing is among the common clinical issues profoundly affecting health outcomes. Typical among nurses, workplace incivility involves rude and disrespectful actions towards colleagues. Incivility shows disregard for others’ feelings and needs, often intending to harm or hurt them. The effects of incivility are far-reaching since it is positively correlated with anxiety and job burnout besides lowering nurses’ self-esteem (Shi et al., 2018). Other effects necessitating evidence-based interventions include the affected nurses negatively perceiving the nursing profession (Alshehry et al., 2019) and being highly vulnerable to medical errors (Abdollahzadeh et al., 2017). The outcomes are detrimental to the quality of patient care.

The PICOT approach is highly recommended in health practice when developing interventions for clinical problems. When creating the PICOT question, the problem or population in question is first identified. It should be vivid too. The issue of interest is workplace incivility among nurses. The other central components include the intervention and comparison. The intervention suggested to reduce workplace incivility is policy interventions and awareness programs compared to no intervention. From a practice viewpoint, the intervention should lead to a specific objective: reducing workplace incivility to promote a healthy working environment. The time frame defines the time it will take for an intervention to realize the desired outcome. In this case, six months.

To make informed decision about a clinical issue, nurses and other health care providers should search for evidence from the leading research databases. Since workplace incivility is a nursing issue, the search was limited to nursing research databases. As a reliable source of scholarly and peer-reviewed sources, CINAHL Plus with Full Text provides access to literature related to nursing and allied health. JAMAevidence has many nursing and health care articles. Trip Pro is largely a search engine that enables a nurse to access research evidence relevant to clinical practice. Systematic reviews and practice guidelines can be accessed via Trip Pro. Google Scholar facilitates search for peer-reviewed articles.

The full citations of the above articles have been provided in the reference list. As indicated, the articles focus on different research areas related to workplace incivility. The broadened focus enhances understanding of the topic to justify why evidenced-based interventions are necessary. The article by Kile et al. (2019) examined the effectiveness of education and cognitive rehearsal in managing workplace incivility. Both interventions enhance awareness of workplace incivility. Abdollahzadeh et al. (2017) examined how to prevent workplace incivility from a nurses’ perspective. Armstrong (2018) primarily focused on nursing workplace incivility prevention. The last article by Shi et al. (2018) examined the link between workplace incivility and job burnout.

Nurses should use the highest level of evidence to guide decision-making in health practice. Systematic reviews provide high-level evidence since they comprehensively search for evidence from multiple credible sources. Besides the high quality of evidence, systematic reviews narrowly focus on a clinical question. By synthesizing available evidence of a particular topic, systematic reviews help nurses and other health care providers to make more informed decisions regarding practice issues. Most systematic reviews identify research biases and flaws in the synthesized literature and propose areas that require further research based on the research gaps. As a result, they inform decision-making and guide future research.

This presentation primarily focused on workplace incivility as the clinical issue of interest. It deserves maximum attention due to its adverse impacts, including reducing nurses’ self-esteem, contributing to burnout and anxiety, and increasing the chances of nurses committing medication errors. Nursing and health care research should always be informed by the highest evidence level possible. As a result, systematic reviews are highly encouraged due to their high level of evidence and in-depth analysis of a clinical problem. Their use enhances understanding of a clinical problem and ensures that the evidence used to guide interventions is relevant to the reviewed issue.

References

›Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966

›Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106

›Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709

›Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.