LEARNING ACTIVITY 4.3: SEARCHING THE LITERATURE FOR SUPPORTING EVIDENCE.

If you haven’t already done so, locate and read the library Nursing LibGuide titled Information Resources & Evidence Based Care in Nursing located at  http://libguides.fau.edu/c.php?g=325476&p=2182010  . This video was developed by FAU Librarian Kristy Padron and it assists you with use of the library databases.

Evidence-based nursing practice and quality improvement projects also follow a process with similar elements found in the research process

The articles must come from professional, peer-reviewed journals. The basic element for evidence is research. To make it easier to translate evidence in practice, researchers may summarize, synthesize/reanalyze research through publication of various types of evidence  systematic reviews, meta-syntheses, meta-analyses, and literature reviews . These cut down the time needed for lengthy literature searches as some of the work is already done. There are several journals dedicated to the study of evidence-based nursing and quality including: Worldviews on Evidence-Based Nursing, Journal of Nursing Care Quality, BMJ Quality and Safety, and Quality Management in Healthcare. Other journals may include specialty nursing journals such as Critical Care Nurse, Neonatal Network, and Med/Surg Nursing Journal.

Do not select a quality improvement project paper. This kind of article often includes background and reports the outcome of an implemented project in and agency.

Though not a part of this assignment, you need to also review the professional literature often published by professional associations and groups. For instance, the American Diabetes Association, etc. These types of publications are often standards and guidelines such as  clinical practice guidelines and consensus/position statements.

The learning activity is adapted using Grieves, N. (2016). Implementation of a Nursing Workload Tool to Reduce Nurse Burnout. Evidence-Based Practice Project Reports. Retrieved from  https://scholar.valpo.edu/ebpr/80/

NOTE THIS IS TO BE DONE BASED ON THE NURSING SITUATION PROVIDED HERE ONLY: AND WILL PREPARE YOU TO DO YOUR INDIVIDUAL SEARCHES WITH YOUR PICOT QUESTION BUT THIS ASSIGNMENT IS SOLELY RELATED TO THE WHAT IS PROVIDED FOR YOU IN THIS ARTICLE.

This assignment will require you to do the following in parts:

1.       Part 1-read through the nursing situation and  create a PICO(T) question  using the box provided and using the Nursing Situation Provided here.

2.        Provide a brief description of the highlighted databases  and why these would be appropriate to answer the PICOT question you identified from the nursing situation (1-2 sentences max for each database)

3.        Complete the Table  using your PICOT table ensuring to include the following:

a.       Use descriptors

b.       Identify each of the areas of the table including the descriptors and number of journal articles located in the various databases

4.        Include a citation using the Level of Evidence  Table-identify 1-2 articles that you located and how it fits the criteria outlined in the Levels of Evidence Hierarchy. Ensure to use APA -NOT A SUMMARY ONLY A CITATION AND WHY IT MEETS THE EVIDENCE TABLE CRITERIA (Use the Level of Evidence Table from your textbook on p. 92

5.        One paragraph about theory ( The general idea is to recognize and understand how does nursing theory impact EBP?

6.        One paragraph about what you learned

1.       NURSING SITUATION

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections,decreased patient satisfaction, decreased quality and safety of care, and increased mortality.

The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project,Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a presentation to Intensive Care Unit (ICU)/Pulmonary physicians on the correlation between workload, burnout, and other issues pertinent to MPCU such as current turnover rates and the inexperience of the nurses.  The project also included a dailyworkload tool for each patient in the progressive care unit for the first two months in order to gather reliable data for the submitted proposal to improve nurse: patient ratios. The last four weeks of the project consisted of identifying patients at risk for transfer to the ICU due to their medical instability and then calculating the Nursing Activities Score (NAS). The NAS is a validated ICU level nursing workload tool utilized forthis project.  If the patient reached an ICU level workload of 54 and was deemed ICU appropriate, the goal was to move patients due to their workload and acuity. If the patient could not be moved due to extraneousfactors such as lack of nursing staff in the ICU, then the pulmonary consult team, if appropriate, would consult. The Maslach Burnout Inventory (MBI) was utilized to measure burnout

1A

A.     DEVELOP A PICO(T) QUESTION USING THE ABOVE NURSING SITUAITON

Literature Search

With the problem of burnout and improper nursing workload for a MPCU in mind, a comprehensive literature search was undertaken in order to find the best evidence between nursing workload and burnout. Thefollowing sections describe how the sources were selected, how the evidence was examined, and how the evidence answered the clinical question.

B.      IDENTIFY SEARCH ENGINES AND KEY WORDS:

2.       Provide a brief description of the highlighted databases  and why these would be appropriate to answer the PICOT question you identified from the nursing situation (1-2 sentences max for each database)

  CINAHLPlus

  Medline (via PubMed or Ovid)

  PsycINFO

  Cochrane Database of Systematic Reviews

  JBI (Joanna Briggs Institute) EBP Database

  ProQuest Central

3.        Complete the Table  using your PICOT table ensuring to include the following:

a.       Use descriptors

b.       Identify each of the areas of the table including the descriptors and number of journal articles located in the various databasesIdentify the search terms and questions that you would use to search for articles in each of the databases outlined above. MAKE SURE TO INCLUDE THESE SPECIFIC TERMS AND KEY WORDS AS USED IN THE VARIOUS DATA BASES-make sure to follow the format whether with Boolean or MESH terminology depending on the database. Again, this has been what you have been learning throughout this learning module and chapter. Make sure to include all areas of the table.  Initially do a broad literature review in each of these from the PICO(T) question you identified. Moving from broad to more specific terms list the number of articles you identified in each of the various databases with the initial terms without limitations.

AFTER THE INITIAL SEARCH: Use the following criteria to narrow down your search. The inclusion and exclusion criteria

a.       Inclusion and Exclusion Criteria-Articles

         2000 to 2018 (use only these years)

         English Language

         Peer Reviewed

         Scholarly journals

         Research only in the U.S. This exclusion criterion was implemented due to concern that other countries’ hospital and healthcare systems would be too different to be directly applicable to the project and weaken the evidence.

                 Briefly review the articles by title (only if at a reasonable number)

         Articles were also excluded if their research did not appear to include any research on the link between staffing and nurse burnout.

RESEARCH TABLE (FRAMING THE EVIDENCE USING PICOT