HCA 699 What strategies will you use in your new role in health care to review and critique literature pertinent to your practice?

HCA 699 What strategies will you use in your new role in health care to review and critique literature pertinent to your practice?

HCA 699 What strategies will you use in your new role in health care to review and critique literature pertinent to your practice?

As a health care worker, strategies to review and critique literature pertinent to my practice will be important. Observations in the field may lead to discovering an issue or problem. Understanding that the answer requires external information will likely require the skills of searching for credible evidence. The best and most efficient approach to conducting a literature search is through the use of a PICOT question (Melnyck & Fineout-Overholt, 2019). This strategy can guide the search by targeting keywords and ensuring the population, intervention, and outcomes are accounted for. An example of this scenario in health care may include an elective joint replacement patient providing feedback to the surgeon after discharge that he felt unprepared for his return home and that he could not remember all of the instructions provided at discharge due to his postoperative mental state. Working with the hospital’s orthopedic director, a PICOT question is developed: In elective total joint replacement patients (P), would a mandatory preoperative education class (I) improve patient satisfaction and other recovery outcomes within the first 30 days following surgery (T)? Using this question to conduct a literature search produces several systematic reviews and randomized control trials that support preoperative education for total join replacement impacts outcomes after surgery including increased patient satisfaction, reduced 30-day readmissions, and improved rehabilitation goals. The director and surgeon create a new standard practice for all elective primary joint replacements coming through the hospital to attend an education class two weeks prior to surgery.

This hypothetical scenario explains how reviewing and critiquing literature can positively impact practices in health care. The skill of searching for best evidence may be time-consuming, so understanding the types of evidence available is also important. Melnyk & Fineout-Overholt (2019) recommend that clinicians utilize preappraised literature to quickly find reliable answers to the PICOT question. This type of literature appears to save time by providing reliable information when numerous studies are conducted on the topic of interest. Overall, utilizing the PICOT format and understanding the advantages of preappraised evidence are two strategies that will be pertinent to my practice in health care.

Reference

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidenced-based practice in nursing & healthcare: a guide to best practice. Wolters Kluwer. Retrieved from https://www.gcumedia.com/digital-resources/wolters-kluwer/2018/evidence-based-practice-in-nursing-and-healthcare_a-guide-to-best-practice_4e.php

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A great way of introducing your discussion. Indeed, before one can start to analyze the literature, an observation needs to occur so as to identify the issue that may be affecting a facility or clinical setting. The identification will then precede the utilization of PICOT, which is the most significant method that is used to analyze an issue. The PICOT is important as it will guide the research of articles using population that will be affected as well as the offered interventions (Melnyk & Fineout-Overholt, 2019). For instance, in the PICOT that you have used, the population would be those undergoing total hip joint replacement while the intervention is the mandatory preoperative education. During the critique and review of relevant articles, the terms will be used in combination as the keywords. The list of the articles that will be yielded will then be reviewed based on whether they meet the threshold that will be set based on certain worksheet guidelines. In most cases, peer-reviewed systematic and randomized control trials are preferred. Moreover, the applicability of the articles to the clinical setting will also be determined after the analysis of the chosen articles’ recommendations and results.

References

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidenced-based practice in nursing & healthcare: a guide to best practice. Wolters Kluwer. Retrieved from https://www.gcumedia.com/digital-resources/wolters-kluwer/2018/evidence-based-practice-in-nursing-and-healthcare_a-guide-to-best-practice_4e.php

 

Re: Topic 2 DQ 1

Healthcare organizations need to be organized and equipped with staff and technology to meet the needs of the

HCA 699 What strategies will you use in your new role in health care to review and critique literature pertinent to your practice
HCA 699 What strategies will you use in your new role in health care to review and critique literature pertinent to your practice

clinicians and patients. Often, clinicians will be presented with patient issues they are not familiar with or need additional information in order to make a diagnosis. In most cases, the clinician will not have a lot of time for research to answer the patient questions. It is imperative healthcare organizations have a strategic process and best practice for clinicians to follow expeditiously to meet patient needs. The following are some strategies to include in a best practice (Melnyk & Fineout-Overholt, 2019):

  • Development of the PICOT question will assist the clinician in narrowing the focus on research to be reviewed
  • Determine the sources of evidence which may include critically appraised topics
  • Using internal evidence such as the electronic health record (EHR), and external evidence from point-of-care resources that integrate with the EHR
  • Dependent on the issue, the clinician will review evidence from systematic reviews, practice guidelines, topic summaries and article synopses
  • Determine which database or combination of databases will have the right evidence
  • The database search strategy will begin with the P(problem, patient or population) and the I (intervention/indicator)
  • Assess the evidence from the research

Example PICOT:

In depressed adolescents (P) what is the effect of cognitive behavioral therapy combined with Prozac (I) compared with Prozac alone (C) in reducing depressive symptoms (O) within the first year of diagnosis (T)?

The research will begin by identifying keywords to use in databases such as PsycINFO, PubMed or MEDLINE, using the keywords Prozac and adolescents. In this case, to minimize the search results using both words in the search engine will yield only relative studies and articles. In addition to searching for Prozac and adolescents, a search for relevant information on different behavioral therapies for depression will also need to be done (Melnyk & Fineout-Overholt, 2019).

Once the research for evidence from the appropriate databases is completed, critical appraisal is performed. It is important the clinician is able to distinguish between appraised information and other information that does not have evidence-based practice behind it. From this appraisal, the clinician will have gathered enough evidence to institute a practice change in serving depressive adolescents or will use the information found to develop an internal trial per se, and work with the adolescent on the best treatment options, monitor and adjust over time, and record outcomes from each method change for future best practice (Melnyk & Fineout-Overholt, 2019).

As a healthcare administrator, it is important to ensure staff and clinicians have the availability of libraries and databases for use in searching information that is needed. In addition to that, development of a manual with instructions on how to search data to maximize time and effort. Training is key, therefore it will be key to develop a training program for the administrative staff so they will be better equipped to help the clinicians with searching data. Changing the protocols and best practices will be done as needed to maintain the most up to date information.

Reference:

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: a guide to best practice (4th ed.). Philadelphia: Wolters Kluwer.

Thank you for a very informed post on review and critique of literature necessary for your area of practice. The process of undertaking the above should start by identifying the area than requires interventions in the facility. The identification will then precede the creation of a PICOT question whose principal purpose entails narrowing down the pertinent articles for the issue in question (Zomorodi, 2018). The population and intervention measures contained in a PICOT can be used as keywords to search for articles from various databases. The yielded articles will then be analyzed on the basis of whether they meet certain criterion that would be outlined in qualitative and quantitative research guidelines. The level of the articles in terms of their usefulness to the research issue will also impact the choices that a researcher will make. Therefore, a combination of methodologies is fundamental to reviewing and critiquing literature materials.

References

Zomorodi, M. (2018). Applying evidence-based practice through an unfolding critique to achieve quality and safety education for nurses competencies. Nurse educator, 43(3), 116.