NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

Sample Answer for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS Included After Question

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. 

RESOURCES 

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.  

WEEKLY RESOURCES 

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 you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course. 
  • Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available. 
  • Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research. 

The Assignment (Evidence-Based Project) 

Part 2: 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 relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article. 
  • 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. 

BY DAY 7 OF WEEK 5 

Submit Part 2 of your Evidence-Based Project. 

SUBMISSION INFORMATION 

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  1. Then, click on Start Assignment near the top of the page. 
  1. Next, click on Upload File and select Submit Assignment for review. 

A Sample Answer For the Assignment: NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

Title: NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

Introduction

  • This presentation will discuss:
  • A clinical issue of interest- CLABSI
  • Developing my PICOT question
  • Research Databases used
  • Peer-reviewed articles
  • Strengths of Systematic Reviews

The following presentation will discuss a clinical issue of interest that I have identified. I will describe how I developed my PICOT question. In addition, I will state the databases I used to conduct my search for the peer-reviewed articles and list the articles used.  Besides, I will describe the level of evidence for each article and explain the strengths of using systematic reviews for clinical research.

 

Clinical Issue of Interest

 

  • Clinical issue- Central line bloodstream infection
  • A lab-confirmed bloodstream infection
  • It affects patients with central line catheters
  • CDC estimate about 41,000 CLABSI annually
  • Contributes to: prolonged hospital stays
  • High patient care costs & mortality
  • Prevention: Aseptic techniques, surveillance, & management

 

Central line bloodstream infection (CLABSI) is my chosen clinical issue of interest. It is a laboratory-confirmed

NURS 6052 EVIDENCE-BASED PROJECT, PART 2 ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS
NURS 6052 EVIDENCE-BASED PROJECT, PART 2 ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

bloodstream infection not associated with an infection at another site, which occurs within 48 hours of a central line placement (Bell & O’Grady, 2017). CLABSI affects hospitalized patients with central line catheters. It occurs when microorganisms enter a patient’s central line and then into their bloodstream.

CLASI is an issue of interest since the CDC estimates that about 41,000 bloodstream infections are caused by contaminated central lines in U.S. hospitals annually (Bell & O’Grady, 2017). Besides, it contributed to prolonged hospital stays and increased patient care costs and mortality. Nevertheless, most CLABSI cases can be prevented through appropriate aseptic techniques, surveillance, and management interventions (Bell & O’Grady, 2017). The CDC and Infectious Diseases Society of America (IDSA) have developed CLABSI prevention guidelines during central line insertion and maintenance.

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PICO

In hospitalized patients with central lines, does daily chlorhexidine baths compared with daily bath with regular soap and water decrease the incidence of CLABSI infections during the hospital stay?

 

Developing the PICO Question

  • Identified population of interest- patients with central line
  • Researched for an EBI from peer-reviewed articles
  • Intervention- use of daily chlorhexidine baths
  • Comparison intervention- bath with regular soap and water
  • Indentified outcome- decreasing CLABSI infections

 

Research Databases

I used several research databases to search peer-reviewed articles on interventions effective in addressing CLABSI among hospitalized patients. The databases include:

PubMed, MEDLINE, Cochrane Library, and CINAHL Plus.

Peer-Reviewed Articles

Musuuza, J. S., Guru, P. K., O’Horo, J. C., Bongiorno, C. M., Korobkin, M. A., Gangnon, R. E., & Safdar, N. (2019). The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis. BMC infectious diseases19(1), 1-10. https://doi.org/10.1186/s12879-019-4002-7

Reyes, D. C. V., Bloomer, M., & Morphet, J. (2017). Prevention of central venous line-associated bloodstream infections in adult intensive care units: a systematic review. Intensive and Critical Care Nursing43, 12-22. https://doi.org/10.1016/j.iccn.2017.05.006

Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., … & Granger, B. B. (2021). Results of the Chlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line-associated bloodstream infections Study (Changing Baths): a stepped wedge cluster randomized trial. Implementation Science, 16(1), 1-16.  https://doi.org/10.1186/s13012-021-01112-4

Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M. R., Schüpbach, R., Falk, C., … & Schreiber, P. W. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007

Levels of Evidence

  • Musuuza et al. (2019)- Level I evidence
  • Reyes et al. (2017)- Level I evidence
  • Reynolds et al. (2021)- Level II evidence
  • Scheier et al. (2021)- Level III evidence

 

Musuuza et al. (2019) is a level I evidence article. It employs a systematic review and meta-analysis of randomized controlled trials, cluster-randomized trials, and quasi-experimental studies.

Reyes et al. (2017) is a level I evidence. It conducted a systematic review of Randomized controlled trials and observational studies.

Reynolds et al. (2021) is a level II evidence article since it uses evidence from a stepped wedge cluster randomized trial.

Scheier et al. (2021) is a level III evidence article since it uses evidence obtained from well-designed controlled trials but without randomization.

 

Strengths of Using Systematic Reviews for Clinical Research

  • Minimizes bias- reliable & accurate conclusions
  • Information is easier for the reader to understand
  • Produce reliable estimates on interventions’ impact
  • Disclose where knowledge is lacking
  • Save time for research discoveries & implementation
  • Increase generalizability & consistency of outcomes

Systematic reviews concentrate on a specific clinical question and carry out an extensive literature search to discover studies with sound methodology (Møller et al., 2018).

Advantages of using systematic reviews in clinical research include:

  1. The method employed to find and select the studies minimizes bias and thus highly likely to lead to reliable and accurate conclusions (Møller et al., 2018).
  2. Systematic reviews sum up findings from multiple studies, making the information easier for the reader to understand.
  3. They abide by a strict scientific design founded on explicit, pre-specified, and reproducible methods. Consequently, they produce reliable estimates about the impact of interventions to make defensible conclusions (Møller et al., 2018).
  4. They disclose where knowledge is lacking, which guides future clinical research.
  5. They save time used in research discoveries and implementation (Møller et al., 2018).
  6. Systematic reviews also increase the generalizability and consistency of outcomes.

References

Bell, T., & O’Grady, N. P. (2017). Prevention of Central Line-Associated Bloodstream Infections. Infectious disease clinics of North America31(3), 551–559. https://doi.org/10.1016/j.idc.2017.05.007

Møller, M. H., Ioannidis, J. P., & Darmon, M. (2018). Are systematic reviews and meta-analyses still useful research? We are not sure. Intensive Care Medicine44(4), 518-520. https://doi.org/10.1007/s00134-017-5039-y