Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic ReviewsYour quest to purchase a new car begins with an identification of the factors important to you. As

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Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic ReviewsYour 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 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 3: Advanced Levels of Clinical Inquiry and Systematic ReviewsCreate 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.

Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic ReviewsYour quest to purchase a new car begins with an identification of the factors important to you. As
Running head: CRITICAL APPRAISAL 0 Critical Appraisal Lakme O’Connell Walden University Essentials of Evidence Based Practice NURS-6052 7/6/20 Critical Appraisal Evaluation Table Article 1 Article 2 Article 3 Article 4 Full APA citation Delgado, S. A. (2020). CE: Managing Pain in Critically Ill Adults: A Holistic Approach. AJN, American Journal of Nursing, 120(5), 34–42. https://doi.org/10.1097/01.naj.0000662808.81949.d6 Lin, S.-H., Liao, W.-C., Chen, M.-Y., & Fan, J.-Y. (2012). The impact of shift work on nurses’ job stress, sleep quality, and self-perceived health status. Journal of Nursing Management, 22(5), 604–612. https://doi.org/10.1111/jonm.12020 Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110(3), 58–61. https://doi.org/10.1097/01.naj.0000368959.11129.79 Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Searching for the Evidence. AJN, American Journal of Nursing, 110(5), 41–47. https://doi.org/10.1097/01.naj.0000372071.24134.7e Evidence level Level V Level I Level II Level I Conceptual framework The article discusses the difference between PADIS and PAD guidelines Long term shifts affect nurses concentration and quality of service delivered to patients No conceptual framework The article has no conceptual framework Design/Method The article is a quality improvement analysis It was a prospective cross-sectional study from August to September Analysis of various methods to assess evidence-based practice The study involved a continuation of a scientific case study form a previous article Sample/setting The study involves the analysis of PADIS and PAD guidelines discussing their differences The study involved 266 nurses from Chiayi County District Hospitals in Taiwan Assessing the application of evidence-based practice in nursing care A step by step method of searching for evidence for PICOT question Major variables studied The article discusses the use of opioids, analgosedation, and adjunctive analgesia according to the PADIS framework. Demographic variables, sleep quality measure and health status measure were determined Establishing PICOT questions for evidence-based research Applying different methodologies in searching for the right databases for evidence Measurement (primary statistics used) Patient population to benefit from analgosedation Optimal analgesics to incorporate in the protocols Independent T-test and ANOVA were all utilized in the study No measurements were applied in the study No measurements were given in the article Data analysis statistics (Actual numbers of determined by statistical tests) No data statistics were used. Hierarchical regression was applied for the analysis of the data Analysis of various case scenario in clinical cases Obtaining evidence from different databases using multiple techniques Findings and recommendations Response to pain by patient involves several phenomena related to other aspects of the illness. Hospitals should put in place more healthy shift work schedules to promote nurses’ clinical performance No findings were stated in the research study No study findings were identified. Appraisal (general worth of the study, risks associated with implementation and feasibility of the use of in practice) Through modification of the PADIS and PAD guidelines, nurses will be able to improve their care for critically ill patients. The study is reliable and can be applied by hospital management to improve nursing care and patient outcomes The study is not credible to be applied in nursing practice. The article provides insights into the methods of obtaining evidence for PICOT questions Key findings Agitation and delirium affect patients’ ability to report pain sensation. Amount of shift work affects nurses’ resulting in moderate sleep and job stress No findings were reported in the article No study findings were reported Outcomes With PADIS, there is a need for multiple strategies to address patients’ paint in different contexts Job stress was determined to be inversely proportional to sleep quality The article does not state outcomes from the study The study did not provide research outcomes. General comments The article is feasible and can be utilized by nurses in improving care for critically ill patients. The article is important for healthcare systems as there has been negligence on shift and schedules. The article helps formulate PICOT questions for various clinical cases. The research study highlights the techniques that can be used by nurses in searching for evidence during their clinical practice.
Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic ReviewsYour quest to purchase a new car begins with an identification of the factors important to you. As
Running Head: SEARCHING DATABASES 0 Searching Databases Name Institution Transformation of Clinical Inquiry into a Searchable Question in PICO (T) P- 73-year-old female in good health with normal cholesterol levels and no chronic diseases I – Lipitor C- Atorvastatin O- Slow the rate of memory loss. Searchable Question In aging females in good health with normal cholesterol levels and no chronic disease, will using atorvastatin help slow down memory loss? Strategies I might use to increase the Rigor and effectiveness of a Database Search on my PICO (T) Question To increase the precision and effectiveness of a database search for my PICO (T) question, I will use six specific strategies. They are, conceptualize my search, use suitable vocabulary, merge terms and ideas using the Boolean device, review my search strategy, explore more than one database, and acquire database search rules and idiosyncrasy (Stillwell et al., 2010a). By conceptualizing my search, I will first consider my patient, a 73-year-old female, in good health as an adult. Then the type of studies I would prefer to answer my PICO (T) question; in this case, I will prefer systematic review since I will use literature present in the databases (Stillwell et al., 2010a). I will then consider the range of years that I want to get data from, the language from which I want the literature that is English, and finally, the settings in which I want the data, for instance, I would like my PICO (T) to be in the hospital setting. Since each database has its distinctive terminology based on the topic subject of the database, therefore, I will use the right terminologies such as atorvastatin to determine the database I will use for my search (Melnyx et al., 2009). The common vocabulary that will determine that I will use a medical database is MeSH, which both PubMed and Medline use. After identifying the right vocabularies for my database search, I will then merge terms and ideas by utilizing the Boolean operators (Davies, 2011). For instance, I will use words like and, or, and not combine the keywords to enhance the probability of finding the appropriate data. I will then review my search strategy by looking at the research question once again, identify the key ideas, review my search terms, review the search fields I will use, and phrase search using Boolean operators (Stillwell et al., 2010b). The next strategy that I will follow to enhance practical and rigorous searches will be to explore more than one database with literature regarding medical research (Melynx, 2011). Using more than one medical database will give me a broader range of peer-reviewed literature that I can choose from the most relevant article addressing my question. The final strategy that I will use is to acquire the rules and idiosyncrasy that are necessary for the medical database (Stillwell et al., 2010a). This will help me know how to manage the information I will get from the database to become useful for my search activities. Knowing how to manage the database will make the information I add to it to be more accessible and integrated. It will allow me to become a strategic user of the data that I already have. References Davies, K. S. (2011). Formulating the evidence-based practice question: a review of the Frameworks. Evidence-Based Library and Information Practice, 6(2), 75-80. Melnyk, B. M., Fineout-Overholt, E., Stillwell, S., & Williamson, K. M. (2009). Igniting a spirit Of inquiry: An Essential foundation for evidence-based practice how nurses can build the knowledge and skills they need to implement ebp. American Journal of Nursing, 109(11), 49-52. Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & Healthcare: A Guide to best practice. Lippincott Williams & Wilkins. Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence- Based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79 Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence- Based Practice, step by step: searching for the evidence. AJN The American Journal of Nursing, 110(5), 41-47.

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