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

Walden University NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS – Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

Whether one passes or fails an academic assignment such as the Walden University NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

The introduction for the Walden University NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

After the introduction, move into the main part of the NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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

Improving access to mental health is essential in dealing with the growing problem of mental health disorders. Millions of Americans with mental health do not get care services due to various reasons that include limited resources and associated stigma. More than half (56%) of individuals with mental health issues do not get treatment (CDC) Additionally, Mental Health America opines that over 27 million Americans with mental health never get treated (MHA, 2023). The prevalence of mental health illness among adults is high; ranging from 42.6% in Vermont to over 67% in Hawaii. As such, this presentation focuses on selected research articles based on the developed PICOT question on the issue. The presentation describes the level of evidence by the articles and significance of using systematic review articles.

The PICOT framework is a critical part of research process as researchers employ it to develop research questions and search for literature to answer the developed questions. The PICOT ensures that nursing researchers contextualize the identified health issue and develop evidence-based practice interventions. In this case, the issue is access to mental health services for millions of Americans. As such, the PICOT questions considers the population, intervention, comparison, outcomes and time required to implement the suggested solutions to such a problem.

Introduction 

The provision of safe, high quality and efficient care in nursing is important for the health and wellbeing of the patients. Often, nurses utilize practice interventions such as patient centeredness and evidence-based practices to ensure that the care needs of the patients are met. They also use the interventions to minimize the risk of occurrence of safety and quality issues in patient care. An example is the use of best practice interventions to ensure that the risk of medication errors in nursing practice is reduced. Despite the efforts adopted by nurses to ensure safety and quality, institutional and provider factors may still predispose patients to unintended safety and quality issues. For example, provider factors such as burnout due to the influence of institutional factors such as staff shortage may threaten the safety and quality of patient care. Therefore, this presentation examines the proposed intervention that can be used to reduce and prevent burnout among registered nurses. 

Selected Clinical Issue 

The selected clinical issue that relates to nursing practice is burnout among nurses. Burnout has been defined as the consequence of prolonged, persistent and chronic exposure of nurses to work-related stressors. The prolonged exposure to work stressors result in depersonalization, exhaustion, and reduced personal accomplishments. Nurses affected by burnout experience challenges in undertaking their clinical roles due to low levels of motivation and job satisfaction. Burnout among nurses has an adverse effect on the quality and safety of patient care (Ahola et al., 2017). For example, it increases the risk of medication errors by nurses due to lack of concentration in the care giving process. Burnout also causes low level of job satisfaction and motivation among the nurses. As a result, the rate of turnover among them increases significantly. In addition, the operational costs in healthcare organization rises due to the need for frequent hiring of new staffs to replace those who left the organization. Therefore, burnout among nurses should be addressed to ensure safety, quality and efficiency in healthcare organizations (Melnyk et al., 2020). ​

Development of PICOT

The developed question is: In acute care nurses, does the use of cognitive interventions result in the reduction of burnout levels when compared to no intervention, within eight month period?​

I developed the above PICOT question through a number of steps. The first one was performing a clinical inquiry of the common issues that affect quality and safety of patient care in healthcare settings. I also utilized knowledge from my clinical experience to identify issues in practice that can be addressed by adopting evidence-based interventions. This led to the identification of the clinical issue of burnout in nursing. The second step entailed the determination of the populations that the problem affect. This led to the identification of nurses as the most prone group of professionals to be affected by burnout. The other step was performing a literature search of the databases to determine practice interventions that can be used to address the issue. This stage led to the identification of cognitive therapies as the most effective intervention to address burnout in nursing. The next step was determining a way in which I could determine the effectiveness of the intervention. As a result, I considered a comparative intervention to be no use of any approach to address the issue of burnout among nurses. I then developed the outcomes to be achieved by the implementation of the intervention and the timeline of evaluating its effectiveness. 

Identified Articles 

The database search led to the above articles that explore the effectiveness of cognitive interventions in reducing and preventing burnout among nurses. 

Levels of Evidence 

The study by Ahola et al., (2017) provides level I evidence. The study was a systematic review of randomized controlled trials without meta-analysis. The study by Melnyk et al., (2020) provided level I evidence too. It was a systematic review of randomized controlled trials without meta-analysis. The study by Nayeri et al., (2021) provided level III evidence. It was a systematic review of a combination of quasi-experimental, randomized controlled trials, and non-experimental studies. It also lacked meta-analysis. The study  by Zhang et al., (2020) provided level II evidence. The study was a systematic review of quasi-experimental and randomized controlled trials with meta-analysis. 

Strengths of Using Systematic Reviews 

One of the strengths of using systematic reviews is the transparency in its processes. The processes of each of the phases of a systematic review are transparent, increasing the trust towards the obtained findings. Transparency also enables readers to determine the merits and demerits of the decisions that the authors made in synthesizing the data. The other benefit of using systematic reviews is that they provide comprehensive review of a topic. The use of multiple sources of data on a topic increases the relevance and implications of the data reported in a systematic review. The review of multiple studies also assists in the identification of gaps in research and practice. As a result, nurses can use the information from systematic reviews to inform their future research and practice. The last strength of systematic reviews is that it provides highly reliable results. The results have minimum bias due to the transparency in methods used. The focus on the results obtained in multiple studies also eliminates potential threats to validity and reliability of the obtained results.

Also Read:

EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

DEVELOPING A CULTURE OF EVIDENCE-BASED PRACTICE

DISCUSSION: PATIENT PREFERENCES AND DECISION MAKING

EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE

Conclusion 

• Burnout in nursing is a critical issue​
• Affects quality and safety of care​
• Increases operational costs in health​
• Cognitive interventions effective in addressing the problem

References

Ahola, K., Toppinen-Tanner, S., & Seppänen, J. (2017). Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. Burnout Research, 4, 1–11.​

Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. (2017). Burnout Research, 4, 1–11. https://doi.org/10.1016/j.burn.2017.02.001​

Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., Hoying, J., McRae, K., Ault, S., Spurlock, E., & Bird, S. B. (2020). Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review. American Journal of Health Promotion, 34(8), 929–941. https://doi.org/10.1177/0890117120920451​

Nayeri, N., Nukpezah, R., & Kiwanuka, F. (2021). Article no.AJRNH.71848 (1) Prof. Sharon Lawn, Flinders University, Australia. (2) Dr. Asmaa Fathi Moustafa Hamouda. Asian Nursing Research, 18–36.​

Zhang, X., Song, Y., Jiang, T., Ding, N., & Shi, T. (2020). Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses. Medicine, 99(26), e20992. https://doi.org/10.1097/MD.0000000000020992

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

Introduction 

Nurses play an important role in the promotion of the optimum health and wellbeing of their populations. They utilize evidence-based interventions to ensure the optimization of the care outcomes for their patients. The selected clinical issue of focus in my project is depression. Depression is a mental health problem with increasing prevalence globally and the USA too. It has severe health impacts that include loss of productivity, poor quality of life, increased care costs, and premature mortality. It is important for nurses and other healthcare providers to implement interventions that enhance depression management in the affected populations. As a result, my project proposes the use of telehealth interventions to improve depression symptoms among the affected populations. Telehealth is an effective approach that will enhance care outcomes that include safety, efficiency, and quality. 

Development of PICOT Question 

I developed the PICOT question by following a series of steps. The first step was identify the clinical issue of interest. I examined clinical issues with increasing rates and severe population impacts. The second step was identifying the population. The identified population is patients affected by depression. The third step was reviewing the existing literature to identify an effective and innovative intervention, which can be used to improve outcomes in the selected population. This step led to the identification of telehealth as the intervention. The other step was identifying a control or comparison which would provide a clear understanding of the effect of the intervention. The next step was developing measurable outcomes for the project and timeline. ​

Research Databases 

Four databases were searched for relevant literature on the use of telehealth in depression management. They included CINAHL, EMBASE, PubMed, and Cochrane. The search terms used included Telehealth, telehealth in depression, telehealth and depression outcomes, and effectiveness of telehealth in depression management. The selected articles must have been published over the last five years and written in English language. 

APA Citations 

• Scott, A. M., Clark, J., Greenwood, H., Krzyzaniak, N., Cardona, M., Peiris, R., Sims, R., & Glasziou, P. (2022). Telehealth v. face-to-face provision of care to patients with depression: A systematic review and meta-analysis. Psychological Medicine, 52(14), 2852–2860. https://doi.org/10.1017/S0033291722002331​
• Six, S. G., Byrne, K. A., Tibbett, T. P., & Pericot-Valverde, I. (2021). Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis. JMIR Mental Health, 8(11), e32199. https://doi.org/10.2196/32199​
• Tang, Y., Gierc, M., Lam, R. W., Liu, S., & Faulkner, G. (2022). The Effectiveness of Internet-Guided Self-help Interventions to Promote Physical Activity Among Individuals With Depression: Systematic Review. JMIR Mental Health, 9(12), e38049. https://doi.org/10.2196/38049​
• Zhao, L., Chen, J., Lan, L., Deng, N., Liao, Y., Yue, L., Chen, I., Wen, S. W., & Xie, R. (2021). Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis. JMIR MHealth and UHealth, 9(10), e32544. https://doi.org/10.2196/32544

Levels of Evidence 

The selected studies had different levels of evidence. The study by Six et al., (2021) had level 5 evidence while the rest have level 1 evidence. Six et al., (2022) provides level 5 evidence since it is a systematic review of descriptive and qualitative studies while the rest of the studies have level 1 evidence since they are systematic and meta-analyses of randomized controlled trials and quasi experimental studies. 

Strengths of Using Systematic Review for Clinical Research 

The use of systematic reviews for clinical research is associated with some strengths. One of them is the specificity nature of the results in systematic reviews. Researchers adopt comprehensive methods of data collection and analysis, which increases the relevance and applicability of findings in clinical settings. The other strength is the reliability and accuracy of results. The review of different studies such as randomized controlled trials produce highly accurate and reliable results, which can be translated into clinical practice. Systematic reviews are also comprehensive and exhaustive. They analyze topics in healthcare in great detail, which helps healthcare providers to identify potential bias in findings and their application to practice. The adopted methods in systematic reviews can also be replicated in nursing practice. Therefore, the results contained in systematic reviews have immense impact on nursing practice. 

Conclusion 

• The selected clinical issue is depression​
• The proposed intervention entails telehealth use to minimize symptom severity in depression​
• Systematic reviews provide highly reliable and accurate results ​
• The findings of systematic reviews can be translated into practice 

References  

Scott, A. M., Clark, J., Greenwood, H., Krzyzaniak, N., Cardona, M., Peiris, R., Sims, R., & Glasziou, P. (2022). Telehealth v. face-to-face provision of care to patients with depression: A systematic review and meta-analysis. Psychological Medicine, 52(14), 2852–2860. https://doi.org/10.1017/S0033291722002331​

Six, S. G., Byrne, K. A., Tibbett, T. P., & Pericot-Valverde, I. (2021). Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis. JMIR Mental Health, 8(11), e32199. https://doi.org/10.2196/32199​

Tang, Y., Gierc, M., Lam, R. W., Liu, S., & Faulkner, G. (2022). The Effectiveness of Internet-Guided Self-help Interventions to Promote Physical Activity Among Individuals With Depression: Systematic Review. JMIR Mental Health, 9(12), e38049. https://doi.org/10.2196/38049​

Zhao, L., Chen, J., Lan, L., Deng, N., Liao, Y., Yue, L., Chen, I., Wen, S. W., & Xie, R. (2021). Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis. JMIR MHealth and UHealth, 9(10), e32544. https://doi.org/10.2196/32544

Sample Answer 3 for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

Introduction

There are many reasons why it is important to study clinical issues in different healthcare organizations. For one, healthcare organizations can be very complex and understanding the clinical processes and issues within different types of organizations can help immensely in providing quality patient care. Secondly, with the vast array of different types of healthcare organizations out there, from hospitals to community health centers, private practices to research institutes, it is important to understand the strengths and weaknesses of each type of organization in order to make the best decisions for both patients and providers. And finally, by studying clinical issues within different healthcare organizations, we can learn a great deal about how effective various interventions and treatments are across a wide range of settings. This information can then be used to improve care delivery services to all the patients and facilitate clinical operational processes within healthcare organizations. On of the major clinical issues within healthcare organizations is healthcare acquired infections.

Clinical Issue of Interest

Hospital acquired infections (HAIs) are a leading cause of morbidity and mortality worldwide. In the United States, HAIs account for an estimated 1.7 million infections and 99,000 deaths each year. CDC estimates that on any given day, about one in 31 hospital patients has at least one healthcare-associated infection. Healthcare-associated infections increase length of stay, amplify the severity of illness, and lead to unnecessary suffering and death. They also drive-up healthcare costs—estimated at $20 billion annually in the United States alone. HAIs can be especially devastating for vulnerable populations such as children, the elderly, and those with chronic illnesses or weakened immune systems. Some examples of healthcare-associated infections (HCAIs) include: -methicillin-resistant Staphylococcus aureus (MRSA), -vancomycin-resistant enterococci (VRE), -Clostridium difficile (C. diff.) infection (Grayson et al., 2018).

Treating HCAIs can be difficult and expensive, as well as posing a serious risk to patients’ health and well-being. There are many different approaches have been taken to try and address this problem, including: -improving hand hygiene among healthcare workers, -using personal protective equipment (PPE) properly, and -disinfecting surfaces and equipment correctly.

Why it is important to study Clinical Issue on Hospital Acquired Infections

Hospital Acquired Infections (HAI) are infections that patients acquire while receiving treatment in a healthcare setting, such as a hospital. HAIs are a serious global public health problem and are a leading cause of death and illness. Each year, more than 2 million people in the United States develop HAIs, and about 100,000 of them die. The most common types of HAI are respiratory tract infections (such as pneumonia), urinary tract infections, and bloodstream infections (sepsis). Healthcare-associated gastrointestinal infections account for about one-third of all HAIs (Munoz-Figueroa & Ojo, 2018). There are many ways to prevent HAIs, including good hand hygiene practices, using medications properly, and safely caring for patients. Hospital acquired infections (HAIs) are a leading cause of morbidity and mortality worldwide. In the United States, HAIs account for an estimated 1.7 million infections and 99,000 deaths each year. CDC estimates that on any given day, about one in 31 hospital patients has at least one healthcare-associated infection.

Development of a PICO(T) question Based on Hospital Acquired Infections

It is important to develop a PICO(T) question based on hospital acquired infections because it will help to focus the research and determine an answer. The first step in developing a PICO(T) question is to identify the key concepts that will be explored. In this case, we are looking at hospital acquired infections. The next step is to narrow these concepts down into more specific variables that can be measured. For example, we might want to look at the rate of hospital acquired infections in different types of hospitals, or the types of infection most commonly seen in hospitals. Once we have chosen our variables, we can begin to formulate our question. A PICO(T) question asking about the development of Hospital Acquired Infections might look like this: What is the incidence of hospital-acquired infections among different types of hospitals? What are the most common types of the hospital acquired infections? In this case, the population of interest would be hospital patients who acquire infections while hospitalized. The intervention would be any measure or action taken to prevent or treat hospital acquired infections (e.g., hand hygiene protocols, antibiotics).

PICOT Question

There are several ways to prevent Hospital Acquired Infections (HAIs). One of the most important is hand hygiene. Hand hygiene includes both washing hands with soap and water and using alcohol-based hand rubs. Both soap and water and alcohol-based hand rubs are effective at killing bacteria and viruses. However, alcohol-based hand rubs are more convenient and can be used more quickly than washing hands with soap and water. For this reason, many healthcare facilities promote the use of alcohol-based hand rubs over traditional hand washing (Lim et al., 2018). However, there are certain situations where it is still best to wash hands with soap and water. This includes when hands are visibly dirty or contaminated with body fluids. The master’s prepared nurse must be aware of the need of teaching hand hygiene to healthcare professionals since doing so will help patients experience fewer healthcare-associated illnesses. HAIs are preventable damage that have an impact on patient safety and treatment not just in the United States but also internationally.

Research Databases

The best healthcare databases are PubMed, CINAHL Plus with Full Text, JBI EBP Database, and Nursing Reference Center. Each database has its own strengths and weaknesses. For example, PubMed is the best database for finding articles from medical journals, while CINAHL Plus with Full Text is the best database for finding articles from nursing journals. If one is not sure which database to use, they should start with PubMed. It is the most comprehensive healthcare database and it covers a wide range of topics. Healthcare databases are important in the research process because they allow researchers to study the health of large populations. This is important because it allows researchers to identify trends and correlations that may not be evident when studying smaller populations. Healthcare databases also contain a wealth of information on patient demographics, health history, and treatment outcomes. This information can be used to improve our understanding of how different treatments work and to develop new treatments for diseases. Finally, healthcare databases can be used to assess the value of different medical treatments. This is important because it allows us to make informed decisions about which treatments provide the most value for our healthcare system.

Relevant Peer-reviewed Articles For The PICOT Question

When embarking on research related to healthcare acquired infections, it is important to review different articles in order to get a well-rounded understanding of the topic. There are a number of reasons for this: 1) To get a sense of the range of opinions and experiences regarding healthcare acquired infections. research on this topic can be controversial, and it is important to be exposed to different perspectives before formulating your own opinion. 2) To learn about different methods that have been used to study healthcare acquired infections. This will help inform your own research design and methodology. 3) To understand what findings have been reported in previous studies on healthcare acquired infections. This will help one plan what hypotheses or Research Questions. Healthcare databases can be used to assess the value of different medical treatments. This is important because it allows us to make informed decisions about which treatments provide the most value for our healthcare system.

The Levels of Evidence

Systematic reviews are among the highest levels of evidence in clinical research. Because they employ strict, systematic methodology to search for and identify all relevant studies on a given topic, and then critically appraise and synthesize the findings of those studies, they provide the best possible evidence to inform clinical decision-making. There are several key advantages to using systematic reviews in clinical research: 1. Systematic reviews comprehensively search for and include all relevant studies on a topic, while narrative or traditional literature reviews often miss key studies or give greater weight to lower quality studies. This comprehensive approach provides a more complete picture of the available evidence on a given topic (Halm & Sandau, 2018).

2. Systematic reviews use strict inclusion/exclusion criteria. When embarking on research related to healthcare acquired infections, it is important to review different articles in order to get a well-rounded understanding of the topic. There are a number of reasons for this, for example, to get a sense of the range of opinions and experiences regarding healthcare acquired infections.

Conclusion

Hospital acquired infections, also known as nosocomial infections, are a major cause of illness and death in the United States. Each year, at least two million people in this country contract an infection while receiving hospital care and about 90,000 of them die as a direct result of the infection. A wide variety of pathogens can cause hospital acquired infections. The most common are bacteria, but viruses, fungi, and parasites can also cause these infections. Many different body sites can be affected, but the lungs (pneumonia), urinary tract (bladder or kidney infection), and bloodstream (sepsis) are the most common sites. There are several ways to prevent Hospital Acquired Infections (HAIs). One of the most important is hand hygiene. Hand hygiene includes both washing hands with soap and water and using alcohol-based hand rubs. Both soap and water and alcohol-based hand rubs are effective at killing bacteria and viruses.

References

üHalm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. American Journal of Critical Care, 27(4), 334–337. https://doi-org.ezp.waldenulibrary.org/10.4037/ajcc2018727

üMunoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. British Journal of Nursing, 27(7), 382–388. https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2018.27.7.382

üLim, K., Kilpatrick, C., Storr, J., & Seale, H. (2018). Exploring the use of entertainment-education YouTube videos focused on infection prevention and control. American Journal of Infection Control, 46(11), 1218–1223. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.05.002

üGrayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … Cruickshank, M. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. Lancet Infectious Diseases, 18(11), 1269–1277. https://doi-org.ezp.waldenulibrary.org/10.1016/S1473-3099(18)30491-2

Sample Answer 4 for NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

My clinical topic issue was opioid use disorder. There are many debates regarding how to treat opioid use from medications, CBT, counseling, group therapy, and substance abuse programs. All have an impact on people, but which shows the most effectiveness? Each day, society loses many victims to this deadly disease. Addiction strikes each family, and healthcare providers must help end this battle. One study I found reported, “In Colorado, recent reports showed that 1:10 residents live in places with no access to treatment and many in remote rural areas have to travel over 30 miles to seek treatment” (Amura, et al.,2022, p. 2).  Offering access to healthcare can change the lives of many families, individuals, and communities. Substance users in rural areas suffer due to the lack of access to medication assisting treatment programs. My PICOT question is for individuals suffering from opioid use disorder in rural areas, how does giving them access to medication-assisting treatment programs reduce opioid use and improve patients’ quality of life after the program? 

PICOT Question: P: Opioid users in rural areas, I: how does giving them access to Medication Assisting Treatment Programs, C: compared to no intervention O: reduce opioid use and improve patients’ quality of life T: after the program. 

Population: Opioid users in rural areas 

Intervention: Access to Medication Assisting Treatment Programs

Comparison: No intervention

Outcome: Reduction in opioid use with an overall improvement in quality of life

Time frame: after the program 

Search Terms and Databases Utilized for Search

I searched the Walden University Library for articles regarding my clinical topic. My initial search was for the subject, Nursing. All the nursing databases were used, including PubMed, CINAHL, ProQuest, and Medline. In the search bar, I searched for the term opioid crisis. I refined the results from 2017 through 2023, full text only, and peer-reviewed articles. Other terms I used were opioid use disorder, medication assisting programs, and rural areas or rural communities. 

Search Results, Articles Returned, and Changes from the use of Boolean Operators 

The search results went from 9.104 to 6,376. I then added the terms medication assisting treatment. It brought the number of articles down to 202. I searched each article for full text and read the beginning to see if it matched my clinical topic. “Maintaining an awareness of the different options for structuring searches broadens the potential uses of the frameworks” (Davis, 2009, p.79). I chose four peer-reviewed primary articles to help justify my PICOT question.

Database Strategies to Increase Rigor and Effectiveness

Many strategies are utilized to increase the rigor and effectiveness of nursing research. Refining your results and using Boolean operators are just a few strategies to minimize your research and give you more effective results. The Boolean Operators with keywords and terms used will help gear your articles as well. Using parentheses with keywords “and” and “or” will give you the greatest preciseness (Walden University, n.d., 2023). It is important to look at the content of the research article on the first page to see the summary of the content. I look into the aim of the research, methods, and results to see if it aligns with my topic of choice. The key to finding the best evidence is considering the components of the PICOT question (Melnyk & Fineout-Overholt, 2018, p. 18). Evidence-based guides are clinical questions and offer us standards of care to improve each patient’s overall health. 

REFERENCES:

Academic guides: Keyword searching: Finding articles on your topic: CONNECT KEYWORDS. Connect Keywords – Keyword Searching: Finding Articles on Your Topic – Academic Guides at Walden University. (n.d.). Retrieved March 22, 2023, from https://academicguides.waldenu.edu/library/keyword/Boolean

Amura, C. R., Sorrell, T. R., Weber, M., Alvarez, A., Beste, N., Hollins, U., & Cook, P. F. (2022). Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado. Substance Abuse Treatment, Prevention, and Policy, 17. https://doi.org/10.1186/s13011-021-00424-4Links to an external site.

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworksLinks to an external site.Links to an external site. for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.