My Topic is: WORKPLACE VIOLENCE
Hi Kim, I am required to write an Evidence-Based Paper. I figured I would try to clarify as much as possible about the direction of the paper. My first recommendation is for you to print out the grading rubric; the requirements are very specifically stated.
1. The idea behind this paper is to provide an introduction to evaluating research. So the first thing is to select a topic of interest (which I have done) which poses a nursing practice issue (My chosen topic of interest is: WORKPLACE VIOLENCE), and then you will utilize the PICOT to formulate your question (what you are proposing).
2. The next thing you will do is select relevant research articles that could help influence a practice change based on their findings. You might look through several articles to find the one that you find most fitting to address your question. For this paper, you will pick one article to evaluate. ***You will summarize the article (Include study design (quantitative/qualitative), number of subjects, data collection methods. You will briefly describe outcome(s) and study applications and/or conclusions.
3. For the next portion of the paper you will evaluate the validity of the research article.
Define Purpose
SOME USEFUL WEBSITES you may find helpful:
http://www.nlm.nih.gov/medlineplus/webeval/webeval.html
Some helpful Links with information:
http://psnet.ahrq.gov/default.aspx
http://www.ihi.org/Pages/default.aspx
http://www.jointcommission.org/standards_information/npsgs.aspx
http://www.aacn.nche.edu/faculty/qsen
The American Association of Colleges of Nursing (AACN)
The American Association of Colleges of Nursing (AACN) is the national voice for academic nursing. AACN works to establish quality standards for nursing education; assists schools in implementing those standards; influences the nursing profession to improve health care; and promotes public support for professional nursing education, research, and practice.
www.jointcommission.org (National Patient Safety Goals® | Joint Commission)
Types of Studies
Quantitative Studies (think numbers and statistics)
The table lists frequently used quantitative study designs.
Quantitative Study Designs
Randomized Control Trial (RCT)
Subjects randomly assigned to one group that receives the new intervention or to another control group that receives the old intervention or none at all. Strongest design to assess efficacy of interventions and whether some factor is the direct cause of a certain outcome — questions of treatment and assessment.
Cohort study
Long-term monitoring of a group of at-risk subjects to see who develops a particular condition – questions of prognosis.
Case-Control Study
Analysis of population with a particular condition and population free of that condition to determine causative factors – questions of etiology.
Meta-Analysis
Statistical analysis of results from multiple studies of the same question; aims to achieve more valid measurement of the effect being studied by using multiple samples.
Systematic Review
Similar to meta-analysis in that many research studies on a single issue are surveyed and quantified into databases.
Qualitative Study Designs (think quality of life issues)
Qualitative methods explore and describe the individual patient s response to health problems. The concern here is with the actual process of illness or perceived illness rather than the outcome of a particular intervention. The researcher mines data from personal interviews with subjects; thus, the sample size tends to be small. In addition, qualitative research chooses only patients experiencing a particular condition; the resulting data does not lend itself to statistical analysis. PICO format does not work well with qualitative design.
Case studies are a frequently used qualitative design.
Levels of Evidence for Qualitative Therapy Questions
Level
Evidence
Level I
Evidence from several RCTs that agree on results – Examples:
Systematic review of RCTs; or,
Clinical practice guidelines based on RCTs; or,
Meta-analysis of all relevant RCTs
Level II
At least one well-designed RCT
Level III
One well-designed non-randomized control trial
Well-designed cohort or case control study
Level IV
Systematic reviews of qualitative studies
Level V
One descriptive or qualitative study
Level VI
Expert opinion or reports of expert committees
The PICOT formatted clinical question defines the purpose of the literature search. The question drives the search.
In evidence-based practice, the purpose of a literature search is to find applicable evidence from reliable studies to answer a clinical question.
Choose Sources – The choice of source of information depends on the purpose. To increase general nursing knowledge, any health related database or internet site could be helpful. If the need for knowledge becomes more specific to an area, the choice of information source must concurrently become more discriminating.
To increase accurate knowledge of a topic, choose the most reliable source.
Begin a PubMed/MEDLINE
1. Search with the “I” (intervention of interest) of the PICO question. If too little evidence is found, use a broader term for your search. The flipside of that is, if too much evidence is found, use a narrower term. Use database tools (see MEDLINE tutorial) to refine the search.
3. One useful method for finding evidence is to work through the parts of the PICO question.
4. Once the evidence found using “I” seems appropriate, add the “C” and search again.
5. Then add “O” to continue searching; the terms may be combined at anytime.
6. “P” may be the last term added to your search.
7. Limiting the Search–If too much evidence is found, apply some limits to cut down on citations listed as results, such as; restrict the dates or search for a specific population.
Go to the PubMed Medline site: http://www.ncbi.nlm.nih.gov/pubmed/
Now try out a search using your clinical question according to the guidelines offered.
Use your PICO worksheet.
How to Use CINHAL
Use of CINAHL is by subscription only. However, it is available through online vendors like OVID or EBSCO