NURS 6052 Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

Walden University NURS 6052 Assignment 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 Assignment 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 Assignment 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 Assignment 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 Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

The introduction for the Walden University NURS 6052 Assignment 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 Assignment 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 Assignment 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 Assignment 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 Assignment 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 Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

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.

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.

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.

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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).

Hospital acquired infections, also known as nosocomial infections, are a major cause of illness and death in the United States. 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.

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.

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.

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).

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.

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

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Sample Answer 2 for NURS 6052 Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

Introduction

This presentation will discuss:
A clinical issue of interest- CLABSI
Developing my PICOT question
Research Databases used
Peer-reviewed articles
Strengths of Systematic Reviews

The following presentation will discuss a clinical issue of interest that I have identified. I will describe how I developed my PICOT question. In addition, I will state the databases I used to conduct my search for the peer-reviewed articles and list the articles used. Besides, I will describe the level of evidence for each article and explain the strengths of using systematic reviews for clinical research.

Clinical Issue of Interest

Clinical issue- Central line bloodstream infection
A lab-confirmed bloodstream infection
It affects patients with central line catheters
CDC estimate about 41,000 CLABSI annually
Contributes to: prolonged hospital stays
High patient care costs & mortality
Prevention: Aseptic techniques, surveillance, & management

Central line bloodstream infection (CLABSI) is my chosen clinical issue of interest. It is a laboratory-confirmed bloodstream infection not associated with an infection at another site, which occurs within 48 hours of a central line placement (Bell & O’Grady, 2017). CLABSI affects hospitalized patients with central line catheters. It occurs when microorganisms enter a patient’s central line and then into their bloodstream.

CLASI is an issue of interest since the CDC estimates that about 41,000 bloodstream infections are caused by contaminated central lines in U.S. hospitals annually (Bell & O’Grady, 2017). Besides, it contributed to prolonged hospital stays and increased patient care costs and mortality. Nevertheless, most CLABSI cases can be prevented through appropriate aseptic techniques, surveillance, and management interventions (Bell & O’Grady, 2017). The CDC and Infectious Diseases Society of America (IDSA) have developed CLABSI prevention guidelines during central line insertion and maintenance.

PICO

In hospitalized patients with central lines, does daily chlorhexidine baths compared with daily bath with regular soap and water decrease the incidence of CLABSI infections during the hospital stay?

Developing the PICO Question

Identified population of interest- patients with central line
Researched for an EBI from peer-reviewed articles
Intervention- use of daily chlorhexidine baths
Comparison intervention- bath with regular soap and water
Indentified outcome- decreasing CLABSI infections

Research Databases

I used several research databases to search peer-reviewed articles on interventions effective in addressing CLABSI among hospitalized patients. The databases include:

PubMed, MEDLINE, Cochrane Library, and CINAHL Plus.

Peer-Reviewed Articles

Musuuza, J. S., Guru, P. K., O’Horo, J. C., Bongiorno, C. M., Korobkin, M. A., Gangnon, R. E., & Safdar, N. (2019). The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis. BMC infectious diseases, 19(1), 1-10. https://doi.org/10.1186/s12879-019-4002-7

Reyes, D. C. V., Bloomer, M., & Morphet, J. (2017). Prevention of central venous line-associated bloodstream infections in adult intensive care units: a systematic review. Intensive and Critical Care Nursing, 43, 12-22. https://doi.org/10.1016/j.iccn.2017.05.006

Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., … & Granger, B. B. (2021). Results of the Chlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line-associated bloodstream infections Study (Changing Baths): a stepped wedge cluster randomized trial. Implementation Science, 16(1), 1-16. https://doi.org/10.1186/s13012-021-01112-4

Scheier, T., Saleschus, D., Dunic, M., Fröhlich, M. R., Schüpbach, R., Falk, C., … & Schreiber, P. W. (2021). Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection, 110, 26-32. https://doi.org/10.1016/j.jhin.2021.01.007

Sample Answer 3 for NURS 6052 Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

Levels of Evidence

Musuuza et al. (2019)- Level I evidence
Reyes et al. (2017)- Level I evidence
Reynolds et al. (2021)- Level II evidence
Scheier et al. (2021)- Level III evidence

Musuuza et al. (2019) is a level I evidence article. It employs a systematic review and meta-analysis of randomized controlled trials, cluster-randomized trials, and quasi-experimental studies.

Reyes et al. (2017) is a level I evidence. It conducted a systematic review of Randomized controlled trials and observational studies.

Reynolds et al. (2021) is a level II evidence article since it uses evidence from a stepped wedge cluster randomized trial.

Scheier et al. (2021) is a level III evidence article since it uses evidence obtained from well-designed controlled trials but without randomization.

Strengths of Using Systematic Reviews for Clinical Research

Minimizes bias- reliable & accurate conclusions
Information is easier for the reader to understand
Produce reliable estimates on interventions’ impact
Disclose where knowledge is lacking
Save time for research discoveries & implementation
Increase generalizability & consistency of outcomes

Systematic reviews concentrate on a specific clinical question and carry out an extensive literature search to discover studies with sound methodology (Møller et al., 2018).

Advantages of using systematic reviews in clinical research include:

The method employed to find and select the studies minimizes bias and thus highly likely to lead to reliable and accurate conclusions (Møller et al., 2018).

Systematic reviews sum up findings from multiple studies, making the information easier for the reader to understand.

They abide by a strict scientific design founded on explicit, pre-specified, and reproducible methods. Consequently, they produce reliable estimates about the impact of interventions to make defensible conclusions (Møller et al., 2018).

They disclose where knowledge is lacking, which guides future clinical research.

They save time used in research discoveries and implementation (Møller et al., 2018).

Systematic reviews also increase the generalizability and consistency of outcomes.

References

Bell, T., & O’Grady, N. P. (2017). Prevention of Central Line-Associated Bloodstream Infections. Infectious disease clinics of North America, 31(3), 551–559. https://doi.org/10.1016/j.idc.2017.05.007

Møller, M. H., Ioannidis, J. P., & Darmon, M. (2018). Are systematic reviews and meta-analyses still useful research? We are not sure. Intensive Care Medicine, 44(4), 518-520. https://doi.org/10.1007/s00134-017-5039-y

Sample Answer 4 for NURS 6052 Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

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.

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

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.

References

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.

Sample Answer 5 for NURS 6052 Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews

Clinical Issue of Interest: Nursing Shortage

Nursing shortage is a common problem in different healthcare settings. Most healthcare organizations are often involved in the development of strategies to solve the problem of nursing shortage. Nursing shortages usually interferes with the general quality healthcare delivery and also increase the cost of healthcare. Nursing shortage is not necessarily attributed to the lack of enough trained nurses (Marć et al., 2019). Sometimes, the perceived shortages is experienced simultaneously with the increase in the rates of patient admission. For instance, in some cases, the outbreak of diseases or global pandemics may cause an instant shortage in nursing professionals. The shortage of nurses may also be attributed to the simultaneous increase in the rates of admissions of nursing students into different nursing schools. The potential factors to nursing shortage include lack of adequate staffing ratios in various clinical centers and hospitals. Also, lack of permanent programs for the placement of replacement of retired nurses with the newly trained healthcare professionals contributes to the nursing shortage (MacLean et al., 2016).

Consequences of the clinical issue (Nursing Shortage)

With the lack of enough nurses in the healthcare systems, there is always increased errors which is attributed to the nurse-burnout. Few nurses cannot accurately take care of the increased number of patients, especially during a pandemic. Also, with the nursing shortage, patients cannot obtain quality care as nurses often become overwhelmed with the increased responsibilities. Nurse staffing has impacts on different nursing areas. Appropriate staffing enhances the quality of care among the patients in the hospital (Haddad et al., 2020). Good staffing in the hospital, therefore, increases values and expectations of the customers or the patients from different medical facilities (Martin, 2015). Medical facilities with a low number of medical professionals or nurses often have poor patient outcomes or higher incidence. An inadequate number of nurses or poor nurse-patient ratio not only affect the patient but also the entire employees as well. In most cases, the low or insufficient number of nurses increase the nurse’s workload as well as the job dissatisfaction (Snavely, 2016). Overall, an insignificant number of nurses compared to the number of patients reduces the total patient care.

Development of a PICOT Question

While developing the PICOT question, there was the identification of the reason or need for the whole process of the study. The PICOT question aimed at establishing there reason or the causes of nursing shortage in different healthcare settings. There were different steps involved in the formulation of the PICOT question. Both the number of patients and the number of nurses were put into consideration in the process of developing the PICOT question. Nursing shortage is a common problem that often form basis of investigation in the research processes. PICOT question is often used to guide the research process. It describe the population that ought to be considered in the research processes, as well as the control groups or the comparisons and other interventions that ought to be considered in the research processes. The control groups are important in the research processes as they form the basis of making comparisons to determine the success in the research process.

While developing the PICOT question and statement, well-informed question made it relatively easier to elicit and combine the required or appropriate terms needed to present the needs for the information required in the general research process. In this cases, there was the consideration of different aspects of nursing shortage in different healthcare systems. Inadequate nurse staffing increases the nurse burnout as well as the adverse patient outcomes. When there is an inadequate number of nurses compared to the number of patients, the capability to work ethically often become questionable. The ethical question under the discussion refers to the nonmaleficence, a scenario which requires a nurse or medical professional to act in a manner which aids at avoiding harm to patients. The above factors were critical in the formulation of the PICOT question. They helped in the definition of the population under the study and the approaches that ought to be undertaken to define the comparison groups in the entire process of research.

Research Databases

Databases are important in enhancing the success of the research processes. They are sources of numerous forms of information that are ideal in facilitating the entire process of the research. The three databases highlighted above proved to be the ideal sources of information. They were helpful in the determination of the research problems and the formulation of the PICOT question. Investigating the problems associated with the nursing shortage requires the application of different sources of information. In the process of determining the factors associated with the nursing shortage, there was the consideration of the nurse-patient ratios. Appropriate nurse-patient ratio leads to the enhancement of the delivery of medical care in different hospitals and medical settings. The correct nurse-patient ratio in the medical facility encourages team work as well as the learning processes that increase experience and technical-knowhow in different work environments. The above information was obtained from the three databases listed above.

Peer Reviewed Articles

These peer reviewed sources provides ideal information required in the analysis of the nursing shortage in the healthcare settings. According to the articles, Every hospital or medical facility needs to ensure the correct nurse-patient ratio stipulated by the government as well as the international standards. An inadequate number of nurses impacts the patients, current and future nursing staff, their loved ones, as well as the hospitals or medical facilities where they are attached to or employed. As a result, the time worked; the total hours worked as well as the overtime work in a given period often has significant effects on errors. A high nurse-to-patient ratio is related to job dissatisfaction or job satisfaction. In most cases, through ensuring suitable nurse to patient ratio, many healthcare facilities can avoid the preventable patient mortality as well as the low nurse retention rates. In other words, adequate staffing in hospitals often saves the life of many people. ). Higher rates of patient outcomes, as well as the poor nurse staffing, are related directly. Even though the above observation has been proven in different studies, little has changed about nurse staffing. Many people lose their lives in hospitals due to low nurse-to-patient ratios.

Levels of Evidence

From the four articles selected, there were different levels of evidence. Level one evidence involves the meta-analysis or the systematic reviews of the entire relevant randomized controlled trials. Level I evidence may also involve the evidence-based clinical practices guideline based on the systematic reviews of the randomized control studies. Level four evidence in the research process involves evidence from well-designed cohort or case control studies. On the other hand, level five evidence involve a single qualitative or descriptive study. Finally, level six evidence involve evidence obtained from at least one of the well-designed randomized control trials. Levels of evidence are significant when it comes to the identification of sources of information in the research process. In this cases, the selection of the research articles, peer-reviewed sources, involved the determination of the levels of evidence and how these prices of evidence influence the study process. Investigating the problem of nursing shortage should involve the identification of authentic sources of information (Abhicharttibutra et al., 2017).

References

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. In StatPearls [Internet]. StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/sars-cov-2/
Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International nursing review, 66(1), 9-16. Retrieved from: https://doi.org/10.1111/inr.12473
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98-101. Retrieved from: https://go.gale.com/ps/anonymous?id=GALE%7CA452050018&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=07461739&p=AONE&sw=w
Abhicharttibutra, K., Kunaviktikul, W., Turale, S., Wichaikhum, O. A., & Srisuphan, W. (2017). Analysis of a government policy to address nursing shortage and nursing education quality. International nursing review, 64(1), 22-32. Retrieved from: https://doi.org/10.1111/inr.12257
MacLean, L., Hassmiller, S., Shaffer, F., Rohrbaugh, K., Collier, T., & Fairman, J. (2016). Scale, causes, and implications of the primary care nursing shortage. Annual Review of Public Health, 35, 443-457. Retrieved from: https://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-032013-182508