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The phenomenon of interest that I have chosen is “Pain Manag
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The phenomenon of interest that I have chosen is “Pain Management for the pediatric population in the ICU post cardiac/extensive surgery” Directions for EBP Guideline/Position Statement Assignment POI & EBP Guideline/Position Statement Appraisal Directions for Assignment Please review these directions for a better understanding of the assignment. You will find a video that goes over the assignment rubric and instructions for submission. There are 2 Sections to this assignment: Phenomenon of Interest (POI) and Evidence Based Practice (EBP) Guideline/Position Statement Paper. POI Selection Steps: Step 1: Choose a topic to work on throughout the ENTIRE semester. Students may seek approval on the same topic used in another course, but it is not guaranteed that approval for one course may be automatically approved in this course as the focus and requirements are unique to 608. All topics must be approved prior to beginning the Module 2 Assignment. Choose a topic that provides enough *Quantitative and Qualitative literature support to effectively research AND locate an Evidenced Based Practice Guidelines/Clinical Practice Guideline OR Position Statement (only 1 is needed) to support your papers. *You will be required to find 1 quantitative single study, 1 quantitative meta-analysis, 1 qualitative single study and 1 qualitative meta-synthesis, meta-ethnography, meta-study, meta-summary, critical interpretive synthesis or systematic review State the following in the forum area for approval: identify the problem you are interested in and why it is important to your role as an Advanced Practice Nurse or in Advanced Nursing Practice , the facility, unit or population you serve. (1-3 sentences) 2. Look for an Evidence Based or Clinical Practice Guideline or Position Statement (vetted by an agency or organization and not opinion based) to support the topic you are interested in by providing the title. Faculty will NOT pre-approve your guideline, but this step serves as a way for you to ensure that a guideline exists for your proposed POI (see examples below of clinical practice guidelines and evidence based practice guidelines and position statements to ensure you are correclty identifying one). State the title of what you found. Topic/POI Suggestions to get you started: this list serves as a place for you to get started on very generalized topics that you will have to narrow down for your approved topics. Consider the following areas of focus: What is a Phenomenon of Download What is a Phenomenon of Adult Health/Women’s Health: Stroke, Congestive Heart Failure, Diabetes Women’s Health: Breast Cancer/Screening, Prenatal Care, Prone Positioning Pediatric/Neonatal Health: Asthma, healthcare coverage, ADHD, obesity, NEC, prone positioning, Breast feeding/supplementation, Immunizations Nursing Informatics: competencies, defining the infrastructure, how to integrate informatics into the structure, implementation standards of EHR Nurse Executives: How to reduce your facility’s budget, quality and safety, patient satisfaction, staffing ratios and healthcare reform Public Health: communicable diseases, obesity, heart disease, cancer, health promotion/prevention measures Clinical Nurse Leaders: Risk anticipation, participation and identification of care outcomes, client and community advocacy, team management and collaboration with all team members General Topics Crossing All Populations:Nurse Led Rounding, Alarm Fatigue, Nurse Engagement, Discharge Processes, Nurse Burnout, Clinical Ladder Performance, Family Presence during CPR, moving from a DNR to AND (allow natural death) and SBAR versus other charting methods, Residency programs, triage protocols; readmission rates (diagnosis specific) Searching for a Guideline An excellent resource to begin your search for guidelines is a Libguide, Trey Lemley, our embedded librarian prepared on the Biomedical Library’s website, at to an external site.. Use PubMed and CINAHL. To find guidelines in these two databases, first perform a subject search and then use an appropriate limiter to restrict search results to guidelines. For instance, CINAHL has a limiter for “practice guideline” in the “Publication Type” box on the “Search Options” page, while PubMed has limiters both for “guideline” and “practice guideline” under the Article Type section on the left-hand sidebar of the search results page. TRIP Database, which stands for Translating Research into Practice is another excellent resource for finding guidelines. First, perform your subject search and then limit your results by looking for a guideline limiter on the right-hand side of the search results page. CINAHL, PubMed, and TRIP are linked to the Library Resources/Databases & Resources link on the upper left-hand side of the homepageLinks to an external site. of the Biomedical Library. The following sources are not linked to our homepage, but they are free and may be accessed via the URL provided: Canadian Medical Association, (Links to an external site.) National Institute for Clinical Excellence, . (Links to an external site.) Registered Nurses Association of Ontario, (Links to an external site.) Also, see professional societies and organizations, such as: AWHONN – the Association of Women’s Health, Obstetric and Neonatal Nurses, at (Links to an external site.). G-I-N – the Guidelines International Network, at (Links to an external site.), is another excellent place to search for guidelines; however, search results will only contain descriptive information such as the title, date, and sponsoring organization. The full-text of the guideline is restricted to paying members and organizations, but it might be useful to search G-I-N for guidelines and then search other databases like PubMed for possible full-text access. Examples of Guidelines EBP Example Clinical Practice Guideline (Update)_ Earwax (Cerumen Impaction).pdf Download EBP Example Clinical Practice Guideline (Update)_ Earwax (Cerumen Impaction).pdf EXAMPLE EBP Clinical practice guidelines for the management of rotator cuff syndrome in the workplace Clinical Practice Download EXAMPLE EBP Clinical practice guidelines for the management of rotator cuff syndrome in the workplace Clinical Practice Example of a Position Statement Download Example of a Position Statement 3. Perform a search of your topic and specifically look for single studies, both qualitative and quantitative, a meta-analysis, meta-synthesis and/or qualitative/quantitative systematic review. You must have several types of research studies (as designated in the assignments) for this course. If you are lacking ample studies in this area you may have difficulty with the next several assignments. Again this step is serving as a safeguard for you to ensure enough research exists on your proposed POI. Indicate in the discussion: Searched topic in XYZ database with ### results, (you can further narrow this to the specific types of research if desired or place in a table format). You are not required to include the titles of the research studies. In Module 3: you will need to locate a single quantitative study and a meta-analysis or quantitative systematic review. In Module 4: you will need to locate a single qualitative study and meta-synthesis or qualitative systematic review, meta-ethnography, meta-summary, meta-study, critical interpretive synthesis OR thematic synthesis. Therefore, be sure your POI topic is rich enough in research to ensure you can find these varieties of studies. 4. Address all concerns with your faculty and be sure to answer any questions asked. While this assignment is marked as complete or incomplete here, it will be part of your grade in the Module 2 Paper therefore, you must receive approval by the due date to avoid loss of points. Step 2: Obtain approval for your selected POI by the due date; once completed move to the steps below to complete the assignment. EBP Guideline/Position Statement Paper Steps: Do not start this section until you have received faculty approval for your topic. Background Information for the assignment: Health care policies are developed and implemented based on EBP. advanced practice nurses (APNs) serve a critical role in this implementation process: evaluating and critiquing EBP to inform, create and change the delivery of health care while guiding policy formation. Since policies promote the care of the patients, they are often governed by other agencies or organizations. For example, the World Health Organization describes health policy as actions that have been instituted by local, state and national government entities to influence health care outcomes. Even the International Council of Nurses feels that EBP is a problem-solving approach that influences decision making in the clinical setting (Hall & Roussel, 2017, p. 248-249). APNs must determine the strength of the recommendations and guidelines to regulate whether policy changes are warranted. Through this process the APN may begin with a clinical question in mind before searching the literature on the proposed changes needed. This question is typically presented in a PICO framework, which shapes how the question is searched, the outcomes intended, and timing of those outcomes (Hall & Roussel, 2017, Ch. 14). PICO stands for Patient or Population; Intervention; Comparison and Outcome. Step 1: Introduction A good introduction should be no more than 1 paragraph grabbing the reader’s attention providing insight to the POI and significance to the APN’s role. End with a strong thesis or purpose statement. Note: the thesis should be condensed to 1 brief purpose statement. Step 2: POI Significance: Discuss why this POI is significant to your role as an APN. How will it change practice? Why did you select this topic? Next, discuss all 3 measures: structural, process and outcomes by comparing them to one another or identifying how/what is different. What expected structural, process OR outcome measures are you hoping to see with instituting a change in practice? You must clearly identify the measure you are evaluating in this example and it should relate directly to your POI. To see a more thorough discussion on these measures, review the following information. AHRQ Structural, Process or Outcome Measures- (Links to an external site.)this link provides an overview of process, structural and outcome measures. Be sure to specify the type of measure you would expect with your implementation of EBP into practice. You must show understanding of the measure itself in your discussion. Step 3 PICO : You will include a PICO framework AND the clinical question in this section. Follow these directions as specified. Outline the PICO framework by listing (do not write in a paragraph format) P-population or patients, I-intervention, C-comparison, and O-outcomes as it relates to your POI. Then develop the clinical question by including all parts of the PICO framework in the question. Be as specific as possible in both the PICO framework development and clinical question and avoid phrases such as: “compared to the standard practice” , or “compared to the current practice” because faculty do not know what the normal practice or standard practice is at your facility. EXAMPLE: Be sure to include a heading for this section . PICO/Clinical Question. PICO -center this heading p. 48-49 APA book P: children in the acute care setting that are between 3 and 18 years of age, not including non-verbal children I: implementation of non-pharmacologic pain interventions . (art therapy, music, dim lights, etc.). C: pharmacologic interventions (Tylenol, motrin, narcotics) O: more effective at reducing pain as measured by decreased pain ratings on approved pain scales, stable vital signs, behavior Clinical Question: In pediatric patients aged 3 years to 18 years (P) is the implementation of non-pharmacologic pain interventions (I) more effective (O) than pharmacologic interventions (C ) in reducing pain as evidence by: decreased pain ratings, stable vital signs, behavior assessments? Step 4 Tool Completion: To provide an overview of the guideline OR position statement use the tool below. You will need to address each question or section of the tool as it applies to the required information; missing information may cause you to lose points. You must submit the completed tool with the assignment. Please attach the completed tool separately to the assignment area. Faculty need to see your analysis of the guideline for full credit. Evaluation tool for Guideline OR Position statement PDF Download Evaluation tool for Guideline OR Position statement PDF Evaluation Tool for Guideline OR Position Statement Word Document Download Evaluation Tool for Guideline OR Position Statement Word Document Step 5 Critique of Guideline/Position Statement: Critique the guideline or position statement by discussing ALL of the following and including appropriate support from your guideline/statement selection: (1) purpose/aim of the recommendation/postition statement-are they clear, current and relevant to your population? (2) Recommendations or objectives of the guideline/statement (3) Who (authors, groups, organizations) developed the guideline/position statement and what biases or funding did they receive? Did the authors, groups or organization have a valued interest in the guideline, why or why not? Remember to consider the author’s role professionally as part of your answer. (4) Describe if they information is credible and justify your answer. What makes information credible? Is their truth in the data, interventions recommended, or studies used to support recommendations, how do you know? (5) What levels of evidence were used to support each recommendation statement-look at the studies and resources used to develop the guideline or position statement. What levels of evidence were these resoruces/studies? Are those individual studies/resources of strong or weak on the evidence hierarchy? How do you know and does it influence the overall recommentation or guideline? (6) Based on the level of evidence used to support the recommendation statements, is the overall quality of that evidence high/low and how does that influence your decision to implement this recommendation or practice guideline into your practice? Fully support with evidence from the literature. Step 6 Quality Improvement: Explain how this guideline or position statement would impact uality improvement by addressing 2 of the bioethical principles: justice, autonomy, beneficience, or nonmalficence. Students must demonstrate full understanding of each principle discussed. Step 7 Conclusion: Conclude the entire paper by summarizing each section. Do not repeat what you did in the paper, but summarize the findings. Never include new findings in the conclusion. Step 8 Guideline/Position Statement Link or Attachment: Include a copy of the full guideline or position statement as an attachment or merged to the paper after the resources. Faculty must be able to have full and direct access to your guideline or position statement to determine if you selected and analyzed accordingly on your tool to receive full credit. If you are reviewing a guideline or position statement that has been updated, than you must be sure to provide the full and original guideline/position statement for your faculty. Therefore, you may need to submit more than 1 document for step 8 to satisfy this rubric item. Step 9 Turnitin: You are required to submit this paper to Turnitin. Review the originality report and change any phrases or sentences that you need to. You can re-submit the assignment if needed. Failure to submit to Turnitin by the due date will result in a late penalty deduction. See Rubric for specific guidelines on scholarship deductions. Page limit: 6 max pages excluding title page, references and any attachments included. Students should write in third person only for all sections of this paper. First person pronouns are not permitted. Paper should be submitted to the Assignment area. References: you should include at least 2 additional peer reviewed references other than the guideline or position statement selected. The references and guideline/position statement should be current, no older than 5 yrs. unless that guideline or position statement remains the gold standard (support with evidence).
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