Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Week 1 -Assignment 2 Discussion

Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

Identify a problem or issue from within your specialty area that you feel needs to be improved upon. The Doctor of Nursing Practice site (http://www.doctorsofnursingpractice.org/resources/dnp-scholarly-projects/) provides many examples of these projects. The list below may help focus your thoughts.

Educational program

Evidence-based healthcare policy change

Evidence-based clinical issue or protocol for specific disease/condition

Discuss the relevance of the issue from your perspective (not the literature at this juncture) in relation to your selected advanced role option.

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What piqued your interest about this issue or problem?

How does it relate to your area of specialization?

What gave you the idea that evidence exists to support this change? See “note” below.

Provide a rationale as to why this will be an evidence-based project to improve outcomes and not generate new evidence (research). Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Please remember that the project will not be implemented during this course and no data will be collected. The outcome of this course is to complete a project proposal only.

Week 2 – Assignment 1 Discussion

Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

Briefly describe the problem or issue that you have decided to be the topic for your project proposal in order to orient your classmates and faculty

Indicate how it relates to your area of specialization

State your PICOT question. Indicate in parentheses after each segment, what part of PICOT the preceding words represent. For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T). Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Discuss which process model resonates with you and will help keep you focused during the project. Process models included in your text (Melnyk & Fineout-Overholt, 2011) are:

Clinical scholar model

Stetler model of evidence-based practice

Iowa model of evidence-based practice to promote quality care

Model for evidence-based practice change by Rosswurm and Larrabee

Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model

Provide feedback to your classmates that focuses on:

The use of correct PICOT format for the question to guide the literature search.

Does the question reflect a clinical research question or one appropriate for an evidence-based practice project?

Week 3 – Assignment 1 Discussion

In this discussion, you will share your search strategies that you have employed to find evidence for your study. For this discussion:

State your PICOT question. Did using the terms used in this question lead you to useful research studies?

What MESH terms have you tried? Did they help you find additional studies? Are you finding MESH terms useful to expand or delimit your search?

Are you finding relevant articles? If not, how did you modify your search to increase productivity?

Indicate which databases you used—those you found useful and those that were not.

What levels of evidence do the studies you are finding represent?

Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

Use the Search Tracker to keep track of search terms. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Using the appropriate Rapid Clinical Appraisal (RCA) Tools, appraise one or two articles and add the information to your Evaluation Table to receive feedback from faculty. At this juncture, your table is a work in progress. You will complete it in Week 4. The RCA Tools and Evaluation Table in Word for you to complete can be found in the Week 3 Overview section.

Week 4 – Assignment 1 Discussion

Discuss your experience completing the rapid critical appraisal process.

Was it really “rapid” or was it more of a laborious process?

Did reading the abstract help you make quick decisions about including or excluding the study?

What worked best for you in terms of the approach you decided to use to complete the appraisal and Evaluation Table? What didn’t work?

Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

Week 5 – Assignment 1 Discussion

This week the discussion focuses on creating a Synthesis Table(s) as a means to summarize and organize the body of evidence from the Evaluation Table. The Synthesis tables will be included in your formal proposal in the Appendix. In the body of the paper, you will describe the “keeper” studies in narrative format.

For this discussion, include the following:

Share your approach to synthesizing the evidence. What were the variables of interest you identified?

Learning to write in a scholarly fashion requires that you are able to succinctly summarize an article in a sentence or two and cite it appropriately using APA format. In this discussion, practice summarizing 2 articles you have identified from the Synthesis Table as pertinent to your proposal. Include the level of evidence, study design, and evidence of rigor. Use appropriate APA citation in text and references. Incorporate feedback from peers and faculty in your Dropbox assignment for this week.Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

In addition to research studies, patient preference and clinical expertise should also be considered. Discuss how you will incorporate these important perspectives into your project proposal.

Week 6 – Assignment 1 Discussion

For this week’s discussion, please address the following:

Briefly describe the clinical issue or problem for your project, the setting, and population of interest to orient classmates and faculty

Write your clinical question

Describe the intervention you plan to test

What type of study will you conduct? Will it be experimental? Quasi-experimental? Provide a rationale for your answer.

Provide feedback on the clinical questions of your colleagues

Week 7 – Assignment 1 Discussion

This discussion will focus on the measurement tools you will use to evaluate change from the intervention. The purpose of this discussion is to fine-tune your thinking about evaluation by receiving feedback from colleagues and faculty. Include in your discussion:

Write a brief description of your project that starts by stating your clinical question and succinctly explaining your planned intervention in order to orient everyone.

Will you need to develop your own evaluation tools or are valid and reliable tools available?

If you create your own tools, what are your thoughts on pilot testing them? How will you go about this? Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Will you gather baseline data? Will you use pre- and posttests? How will you measure change?

How will you identify the participants for your study? How does the sampling method chosen further define the type of study you will be doing?

How will you ensure confidentiality of study participants?

Week 8 – Assignment 1 Discussion

The discussion for this week will revolve around the analysis phase of your project. Include the following points in your discussion:

Begin with a brief description of your project that includes your clinical question, your planned intervention, the type of study you will conduct and how you plan to evaluate the outcomes. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

What type of statistical analysis will be done?

What is a reasonable timeline for your project?

What expenses should be considered? Include both obvious expenses, such as materials, as well as those that are hidden, such as time, which equates to part of your salary.

Will you need to consider a funding source for your project?

Week 9 – Assignment 1 Discussion

Although you will not implement your project during this course, it is important that you understand the various steps that are necessary to do so. As you begin to formulate your strategic plan for implementing your change project, discuss the following specific to your proposed project:

Who are the stakeholders? Please identify them by role or job within the organization, not by name. Can you identify any “champions” or people within your organization that you can convert to champions?

What potential barriers do you foresee and what strategies do you envision to prevent or overcome these barriers?

What change theory will you use to guide you?

Week 10 – Assignment 1 Discussion

For this discussion question, you are asked to review the student learning outcomes for this course and discuss how you met these outcomes. The intention here is to provide you an opportunity to “reflect” on the learning achieved during this term and how you successfully met these learning outcomes. If you do not feel you successfully met the objective, discuss your plans to successfully complete the objective in the future.

By the end of the course, the student should be able to:

Demonstrate synthesis of the knowledge and skills acquired in preceding graduate nursing core and specialty curriculum content. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Evaluate current health policy and legal and ethical considerations in addressing the health promotion and disease prevention of a target population.

Integrate this synthesis in the creation of a scholarly project of either an evidenced-based practice proposal or a research proposal that generates new nursing knowledge. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Disseminate significant components of the project through a written paper and oral presentation.