Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Assignment: Evidence-Based Project, Part 2: 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 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.
https://journals.library.ualberta.ca/eblip/index.php/EBLIP/article/view/9741

https://oce-ovid-com.ezp.waldenulibrary.org/article/00000446-201003000-00028?sequence=0&clickthrough=y

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.

Jadiam Lopez

MSN, Walden University

NURS-6052C

Dr. Emily Keyes

09/04/2021

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Use this document to complete Part 2 of the Module 2 Assessment, Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry, and Part 2: Research Methodologies

Full citation of selected article

Article #1

Article #2

Article #3

Article #4

Kapucu, S., & ÖZden, G. (2017). Nursing Interventions to Prevent Ventilator-Associated Pneumonia in ICUs. Konuralp Tıp Dergisi. https://doi.org/10.18521/ktd.285554

Jam, R., Mesquida, J., Hernández, S., Sandalinas, I., Turégano, C., Carrillo, E., Delgado-Hito, P. (2018). Nursing workload and compliance with non-pharmacological measures to prevent ventilator-associated pneumonia: a multicentre study. Nursing in Critical Care, 23(6), 291–298. https://doi.org/10.1111/nicc.12380

Frota, M. L., Campanharo, C. R. V., Lopes, M. C. B. T., Piacezzi, L. H. V., Okuno, M. F. P., & Batista, R. E. A. (2019). Good practices for preventing ventilator-associated pneumonia in the emergency department. Revista Da Escola de Enfermagem Da USP, 53. https://doi.org/10.1590/s1980-220×2018010803460

Al-Rabeei, N., Al-jaradi, A., Al-Wesaby, S., & Alrubaiee, G. (2019). Nursing Practice for Prevention of Ventilator-Associated Pneumonia in ICUs at Public Hospitals in Sana’a, City-Yemen. Al-Razi University Journal of Medical Sciences, 3(2), 69–80.

Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest)

I chose this article because it outlines common nursing interventions to prevent ventilated-associated pneumonia in the ICU. The clinical issue of interest is ventilated-associated pneumonia (VAP) specifically the common and best interventions used by nurses to prevent the infection. The ethics related to the clinical issue is non-maleficence which requires medical professionals to do no harm and ensure a patient’s safety.

I chose this article because it describes the influence of the nurse’s workload in complying and embracing common practices that are designed to prevent ventilator-associated pneumonia. The study is related to the clinical issue since evidence-based guidelines do not guarantee compliance and acceptance of VAP prevention interventions. Nurses frequently fail to apply common practices due to inadequate training, excessive workload, and lack of clinical outcomes. Nurses are ethically required to select interventions that produce the best outcomes and improve patient safety.

I selected this article because it outlines best practices used by nurses to prevent VAP in the emergency department. All hospitals have guidelines and instructions that guide nurses during the prevention and treatment of VAP in different healthcare settings. The guidelines are considered to be the best practices since they facilitate decision-making and lead to the best outcomes. The article is related to the clinical issue since it evaluates the compliance of nurses to recommended interventions and suggests ways to improve care. Nurses are required to do no harm to patients and perform procedures that increase the quality of care.

I selected the article because it describes common nursing practices used in the ICU to prevent ventilator-associated pneumonia. The nursing interventions outlined in the research article are based on scientific knowledge and produce the best outcomes. The article is related to the clinical issue since it recognizes the role of nurses in preventing VAP and seeks to assess the effectiveness of common prevention practices. Nurses are vital in ensuring the highest standards of care in the ICU especially during the prevention of common infections.

Brief description of the aims of the research of each peer-reviewed article

The article aimed to investigate interventions used to prevent ventilated-associated pneumonia in the ICU among nurses in four Ankara university hospitals. The researchers sought to understand common practices used in the ICU to prevent VAP. The study described common primary practices embraced by nurses to prevent VAP and the reasons for non-adherence to recommended interventions.

The study aimed to find out the impact of the nurse’s workload on the prevention of VAP. The researchers also sought to evaluate nursing knowledge on various non-pharmacological measures used to prevent the infection. The study also describes the nurse’s attitudes to compliance with non-pharmacological measures. The impact of nurse’s workload was assessed in two adult intensive care units.

The study aimed to evaluate the nurse’s compliance to good practices designed to prevent VAP in a university hospital. Ventilated-associated pneumonia is frequently discovered in the ICU but mostly begins in the emergency room during intubation. The research study aimed to emphasize the importance of adopting good practices at the beginning of pre-hospital service and during the entire care process. The research was conducted in a Sao-Paulo University Hospital.

The research study aimed to describe common nursing practices used in Yemen public hospitals to prevent VAP. The researchers also identified factors associated with reduced knowledge among nurses and ineffective hospital practices. Public hospitals were chosen since they provide primary, secondary, and tertiary care to Yemen citizens. Prevention of VAP rewires the highest standard of care and interventions based on scientific evidence.

Brief description of the research methodology used Be sure to identify if the methodology used was qualitative , quantitative , or a mixed-methods approach. Be specific.

The article is a quantitative descriptive study. The researchers incorporated questionnaires to collect data from 290 ICU nurses. The questionnaires collected data on participant characteristics and common interventions used by the nurses. Data were analyzed using the statistical package for social sciences (SPSS). After analysis, data was presented through numbers and percentages describing common practices.

The researchers used a quantitative methodology to collect and analyze data. The article is a cross-sectional observational study. Observation and questionnaires were used to collect data. Nurses working in the ICU completed a knowledge questionnaire and compliance was assessed later through observation. The data collection tools measured nursing knowledge, overall workload, and compliance. Quantitative data were analyzed using the statistical package for social sciences. Data was presented through tables and graphs.

The article is a cross-sectional analytical study. The researchers adopted a quantitative approach during data collection and analysis. Data collection methods included observation of good practices used by nurses in the emergency room and patient hospital records. The researchers observed practices such as raising the patient’s head, reducing sedative infusion, and maintaining oral hygiene. Hospital records were observed for signs such as low white blood cells count, high temperature, and worsening radiology. Data were presented using tables.

The article is a descriptive cross-sectional study. A quantitative methodology was adopted by researchers to collect and analyze data. Data was collected for three months through observation. An observation checklist was used to carefully detect common practices used by Yemen nurses. After collection, quantitative data were analyzed using the statistical package for social sciences. Data were presented using tables and pie charts.

A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

The descriptive study was quick and easy to conduct. It provided an in-depth understanding of the clinical issue specifically the diverse nursing interventions used to prevent VAP in the ICU. However, the researchers do not describe ways through which reliability and validity were increased throughout the research process.

The strength of the cross-sectional observational research methodology is it provided a multifaceted approach that gives a broad view of the data. The study setting comprised of two ICUs with huge workloads making observation an effective method of data collection. Reliability and validity were increased through familiarizing the participants with the assessment and motivating respondents.

The strength of the cross-sectional analytical study is it was cheap and easy to conduct. The data on all selected variables was collected once thereby saving time. The methodology was effective since the researchers measured the prevalence of the factors that were identified during the literature review. Reliability and validity were ensured through the measurement of multiple outcomes of compliance to good practices.

The strength of the descriptive, cross-sectional study was the unique description of nursing experiences in the ICU. Observation is effective in describing individual experiences because it removes academic barriers and allows the researcher to observe ways through which other people experience events. The validity of the research collection tools was ensured through expert review. Reliability was guaranteed through the Cronbach’s Alpha tool.

General Notes/Comments

The results are biased and cannot be generalized since data were obtained from specific settings in a hospital. The researchers recommend that nurses should receive training and specific protocols should be observed during the prevention of VAP.

Since nurses were aware they were being observed, they may have changed their behaviors thereby altering the results. Non-compliance and skepticism of the interventions are not related to the level of knowledge or the nurse’s workload.

The best practices identified by the researchers include head elevation and oral hygiene. The findings are limited since the study was conducted in a single setting thereby the results cannot be generalized to other study sites.

The study discovered that nurses have a poor perception of VAP and limited knowledge of interventions to prevent the infection. Nurses should be effectively trained to help them critically assess the best and common practices to implement in the ICU and hospital emergency settings.

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