Discussion Systematic Review of Evidence

Discussion Systematic Review of Evidence

Discussion Systematic Review of Evidence

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Spirituality encompasses the search for a purpose or meaning of life found beyond physical reality. Often, spirituality will include religious beliefs and values that an individual adheres. To add on, one way that this conception of spirituality would influence the way in which I care for patients is by understanding the patient’s spirituality to help them develop healthy coping mechanisms. According to a scholarly study, more than 80% of parents reported finding comfort and using religion as a coping mechanism to help overcome the loss of a child (Puchalski 2001). This is sometimes the sad reality that a nurse will have to face; hence, it becomes important for nurses to have a way or method to direct parents to handle grief. Moreover, I do believe in spiritual power and God’s existence. I use my beliefs with morals and manners to enhance nursing care I provide to my patients. Spiritual care improves people’s spiritual well-being and performance as well as the quality of their spiritual life. Spiritual care has positive effects on individuals’ stress responses, spiritual well-being such as the balance between physical, psychosocial, and spiritual aspects of self), sense of integrity and excellence, and interpersonal relationships (Zehtab & Adib-Hajbaghery, 2014).

DQ1 Integrative versus Systematic Review of Evidence

Derived from your healthcare experience, describe the
differences between integrative versus systematic review of evidence from an
advanced nursing practice perspective.

DQ2 Comprehensive Systematic Review of Evidence

Derived from your healthcare experience, describe the impact
of the comprehensive systematic review of evidence on a selected healthcare
stakeholder (patient, family, organization, or the profession) from an advanced
nursing practice perspective.

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Evidence-based healthcare is the integration of best research evidence with clinical expertise and patient values. Green denotes, “Using evidence from reliable research, to inform healthcare decisions, has the potential to ensure best practice and reduce variations in healthcare delivery.” However, incorporating research into practice is time consuming, and so we need methods of facilitating easy access to evidence for busy clinicians.[1] Ganeshkumar et al. mentioned that nearly half of the private practitioners in India were consulting more than 4 h per day in a locality,[2] which explains the difficulty of them in spending time in searching evidence during consultation. Ideally, clinical decision making ought to be based on the latest evidence available. However, to keep abreast with the continuously increasing number of publications in health research, a primary healthcare professional would need to read an insurmountable number of articles every day, covered in more than 13 million references and over 4800 biomedical and health journals in Medline alone. With the view to address this challenge, the systematic review method was developed. Systematic reviews aim to inform and facilitate this process through research synthesis of multiple studies, enabling increased and efficient access to evidence.[1,3,4]

Systematic reviews and meta-analyses have become increasingly important in healthcare settings. Clinicians read them to keep up-to-date with their field and they are often used as a starting point for developing clinical practice guidelines. Granting agencies may require a systematic review to ensure there is justification for further research and some healthcare journals are moving in this direction.[5]

This article is intended to provide an easy guide to understand the concept of systematic reviews and meta-analysis, which has been prepared with the aim of capacity building for general practitioners and other primary healthcare professionals in research methodology and day-to-day clinical practice.

Topic 1 DQ 1

Oct 3-5, 2022

What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?

In essence, spirituality is the quest for the meaning of life (Bogue and Hogan, 2020). This vague term takes on many meanings depending on who is asked. Worldviews have a large impact on what path spirituality takes for someone. Personally, my worldview aligns with realism and optimism. Realism in the fact that what I can perceive and what is tangible in this world is what creates the majority of my experience. My optimistic worldview allows me to rely on such ideas as faith in order to maintain a positive view of my future. These play into my spirituality by allowing me to stay grounded in the present and accepting that the future is still unknown but has so much potential to be better than what I can comprehend now. My worldview allows my spirituality to be fluid and less of a daily burden mentally. The combination of my worldview and spirituality allow me to be present for my patients in their times of need, maintain positivity, be open to external experiences and worldviews, all while maintaining a tangible awareness of the physical ailments they are experiencing. Faith without realism does not benefit the patient because even if a grim prognosis exists, realism allows us to deal with the now and continue to move forward. Even if moving forward towards a terminal diagnosis, solace can be found in working through the physical realm to eventually be at peace in faith; knowing all that can be done in the now has been addressed. 


Bogue, D. W. and Hogan, M. (2020). Foundational Issues in Christian Spirituality and Ethics. Practicing dignity: An introduction to Christian values and decision making in health care. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/1 

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.

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).

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.

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

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.

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.


´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