NURS 8114 INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

Sample Answer for NURS 8114 INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW Included After Question

The Assignment

Part 1: Literature Review (10+ scholarly articles)

Using the Walden Library as your source, search to select at least 10 scholarly articles that represent current literature (i.e., published within the previous 5 years) with evidence that addresses your critical question and could inform a practice change initiative for quality improvement. Using the Individual Evidence Summary Tool template document, complete all sections for each article.

Part 2: Critical Assessment (7+ pages)

In a paper of at least 7 pages, plus cover page and references page, include the following:

  • Write a critical assessment of your search outcomes that synthesizes the evidence from your literature review.
  • Demonstrate clear connections between the practice problem that informs your critical question, your appraisal of evidence that addresses the critical question, and resulting clarification on the need for a practice change initiative focusing on quality improvement. Be specific and provide examples.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

 Complete Parts 1 and 2 of your Assignment:

  • Part 1: Literature Review: Be sure you have completed all required sections of the template (PDF) document.
  • Part 2: Critical Assessment paper: Reflect on comments from colleagues in response to your Week 10 Discussion post. Apply feedback of value to you in completing your synthesis of evidence to inform a practice change initiative focusing on quality improvement.

A Sample Answer For the Assignment: NURS 8114 INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

Title: NURS 8114 INVESTIGATING A CRITICAL PRACTICE QUESTION THROUGH A LITERATURE REVIEW

  Date: 8/6/2023  EBP Question: Can medical personnel be trained to effectively facilitate interdisciplinary care, resulting in exceptional patient-centered care and fewer emergency room or hospital readmissions[BB1] ?
  Article Number    Author and Date    Evidence Type  Sample, Sample Size, Setting  Findings That Help Answer the EBP Question  Observable Measures    Limitations  Evidence Level, Quality
1Fortin, M., Stewart, M., Ngangue, P., Almirall, J., Bélanger, M., Brown, J. B., … & Zwarenstein, M. (2021). Scaling up patient-centered interdisciplinary care for multimorbidity: a pragmatic mixed-methods randomized controlled trial. The Annals of Family Medicine19(2), 126-134. https://doi.org/10.1370/afm.2650Randomized controlled trialMedical personnel such as nurses, nutritionists, and kinesiologists were trained to offer care to 284 patients who were randomized into an intervention group (144) and a control group (140)    Various findings help answer the EBP question. The patient care offered by the trained medical personnel improved care outcomes. The patient could engage more in healthy behaviors, such as physical exercise and nutrition, which led to better care outcomes.Physical activity, healthy eating, self-efficacy, and self-management.-short intervention duration, which may lead to the inability to demonstrate substantial effects. -Lack of generalizability as the intervention was not demonstrated for patients with multimorbidity.Level I- High quality
2Uslu-Sahan, F., & Terzioglu, F. (2020). Interprofessional simulation-based training in gynecologic oncology palliative care for students in the healthcare profession: A comparative randomized controlled trial. Nurse Education Today95, 104588. https://doi.org/10.1016/j.nedt.2020.104588Randomized control trialThe study was conducted in a university setting, where a total of 84 participants were recruited to take part. The sample was interprofessional, consisting of individuals from social work, nutrition-dietician, medical, and nursing)    Upon the use of high-fidelity simulation and hybrid simulation, the personnel showed improved teamwork attitudes, interdisciplinary perception, and palliative care knowledge, which are key to improved patient outcomes.Palliative care knowledge, teamwork attitudes, interdisciplinary education perception-The training conducted was a one-time event which may not be sufficient for causing significant changes. There was a challenge conducting the study due to the intense program.Level 1- High quality.
3Jeon, Y. H., Krein, L., Simpson, J. M., Szanton, S. L., Clemson, L., Naismith, S. L., … & Brodaty, H. (2020). Feasibility and potential effects of interdisciplinary home-based reablement program (I-HARP) for people with cognitive and functional decline: a pilot trial. Aging & Mental Health24(11), 1916-1925. Doi: 10.1080/13607863.2019.1642298Randomized controlled trialEighteen dyads were randomly assigned into two groups, and care was done through up to 12 home visits by psychologists, occupational therapists, and registered nurses.One of the short-term outcomes was that the intervention group showed improved functional independence. The care offered by the personnel also led to improved physical functioning among patients. Individuals in the intervention group recorded no falls during the study. These outcomes showed the important role played by the trained medical personnel.Functional independence, physical functioning, patient falls.-The number of study participants was low, which could have led to biasLevel 1- high
4Liu, X., Song, L., Xiao, S., & Wang, Y. (2023). Comprehensive Geriatric Assessment, Multidisciplinary Treatment, and Nurse-Guided Transitional Care in Hospitalized Older Adults: A Randomized Controlled Trial. Research in Gerontological Nursing, 1-7. https://doi.org/10.3928/19404921-20230606-03Randomized controlled trialThe study was conducted in a hospital setting where 100 hospitalized older adults were recruited to take part in the study. They were offered a multidisciplinary treatment followed by a nurse-guided transitional care program offered by trained medical personnel.      The care offered to the patients led to improved care outcomes. The intervention group showed improved independence in activities of daily living and reduced unplanned hospital readmission rates.-Readmission rates and independence in activities of daily living.-There was no evaluation of longer term impacts of the multidisciplinary treatment on the participantsLevel 1-High quality.
5Schapira, M., Outumuro, M. B., Giber, F., Pino, C., Mattiussi, M., Montero-Odasso, M., … & Perman, G. (2022). Geriatric co-management and interdisciplinary transitional care reduced hospital readmissions in frail older patients in Argentina: results from a randomized controlled trial. Aging Clinical and Experimental Research34(1), 85-93. Doi: 10.1007/s40520-021-01893-0Randomized controlled trialThe study was conducted in Argentina in a hospital setting where a total of 120 patients were recruited to take part in the study.    The use of the intervention offered by a co-management team led to a significant reduction in hospital readmissions among patients in the intervention group. They also experience reduced rates of emergency room visits.-Emergency room visits and hospital readmissions.-Bias cannot be ruled out since the medical personnel team offering the treatment was not blinded. -It was a single-center study; hence the findings may lack generalizability.Level I-high quality evidence.
6Spies, C. D., Paul, N., Adrion, C., Berger, E., Busse, R., Kraufmann, B., … & Weiss, B. (2023). Effectiveness of an intensive care telehealth programme to improve process quality (ERIC): a multicentre stepped wedge cluster randomised controlled trial. Intensive Care Medicine49(2), 191-204. Doi: 10.1007/s00134-022-06949-xRandomized Controlled TrialThe study was conducted at the Intensive Care Units in Brandenburg and Berlin. A total of one thousand four hundred and sixty-three patients were recruited to take part in the study.  The implementation of the intervention led to improved quality indicators, especially related to delirium. This showed the effectiveness of the use of trained medical personnel in interdisciplinary care to improve patient outcomes.Weaning from ventilation, infection management, and early mobilization-Potential selection bias since the cluster-level participation was on a voluntary basis. -The clinical sites already showed a high level of performanceLevel I-high quality evidence.
7.Yan, H., Du, Y. X., Wu, F. Q., Lu, X. Y., Chen, R. M., & Zhang, Y. (2022). Effects of nurse-led multidisciplinary team management on cardiovascular hospitalization and quality of life in patients with atrial fibrillation: Randomized controlled trial. International Journal of Nursing Studies127, 104159. https://doi.org/10.1016/j.ijnurstu.2021.104159Randomized controlled trialThe study was conducted in a cardiology unit in China. The researchers recruited a total of two hundred and thirty-five patients who were randomized into the control and intervention groups.      -Upon the use of the intervention, the patients in the intervention group showed fewer cases of cardiovascular hospitalizations. -Both groups showed improved quality of life; however, the intervention group showed more.-Quality of life and cardiovascular hospitalizations.-potential lack of generalizabilityLevel I-high quality evidence
8Lewis, K. A., Ricks, T. N., Rowin, A., Ndlovu, C., Goldstein, L., & McElvogue, C. (2019). Does simulation training for acute care nurses improve patient safety outcomes: a systematic review to inform evidence‐based practice. Worldviews on Evidence‐Based Nursing16(5), 389-396. https://doi.org/10.1111/wvn.12396Systematic reviewThis is a systematic review of 12 selected articles ranging from pilot studies, experimental studies. The total number of patients considered were 844-The training done to the nurses sing simulation led to significant results as they were able to offer more efficient care services which helped improve care outcomesClinical patient safety outcomes, acute respiratory failure-related outcomes, pressure ulcers-The review considered study article available in English, which potentially leaves out some evidenceLevel II-High quality.
9Cheung, K. L., Schell, J. O., Rubin, A., Hoops, J., Gilmartin, B. J., & Cohen, R. A. (2021). Communication Skills Training for Nurses and Social Workers: An Initiative to Promote Interdisciplinary Advance Care Planning and Palliative Care in Patients on Dialysis. Nephrology Nursing Journal48(6). https://europepmc.org/article/pmc/pmc9936385Mixed method designThe study was conducted in the University of Vermont Medical inpatient and outpatient dialysis unit where nurses and social workers were recruited to take part in the study. These professionals were trained-The training led to the professionals having improvement in various aspects such as empathic behaviors, response to end-of-life and emotion concerns as well as discussion of spiritual concerns with patients which all led to improved care outcomes.Empathic behaviors, response to end-of-life and emotion concerns-The study was a single center, hence potential lack of generalizability. -There may be implementation barrier as there is a need for dedicated time to train the nurses and social workers.Level II-High quality
10Strauven, G., Anrys, P., Vandael, E., Henrard, S., De Lepeleire, J., Spinewine, A., & Foulon, V. (2019). Cluster-controlled trial of an intervention to improve prescribing in nursing homes study. Journal of the American Medical Directors Association20(11), 1404-1411. https://doi.org/10.1016/j.jamda.2019.06.006Randomized controlled trialThe study was conducted at a Belgian nursing home were a total 1804 nursing home residents were recruited to take part in the study.-The training of medical personnel on patient care to deliver a multifaceted intervention led to a successful improvement on prescriptions which led to improved patient outcomesAppropriateness of prescribing, criterion-specific prevalence and medication use-The explicit tools used do not consider individual aspects. -Potential selection bias since NHs who freely applied were includedLevel I-high quality

Attach a reference list with full citations of articles reviewed for this EBP question.

References

Cheung, K. L., Schell, J. O., Rubin, A., Hoops, J., Gilmartin, B. J., & Cohen, R. A. (2021). Communication Skills Training for Nurses and Social Workers: An Initiative to Promote Interdisciplinary Advance Care Planning and Palliative Care in Patients on Dialysis. Nephrology Nursing Journal48(6). https://europepmc.org/article/pmc/pmc9936385

Fortin, M., Stewart, M., Ngangue, P., Almirall, J., Bélanger, M., Brown, J. B., … & Zwarenstein, M. (2021). Scaling up patient-centered interdisciplinary care for multimorbidity: a pragmatic mixed-methods randomized controlled trial. The Annals of Family Medicine19(2), 126-134. https://doi.org/10.1370/afm.2650

Jeon, Y. H., Krein, L., Simpson, J. M., Szanton, S. L., Clemson, L., Naismith, S. L., … & Brodaty, H. (2020). Feasibility and potential effects of interdisciplinary home-based reablement program (I-HARP) for people with cognitive and functional decline: a pilot trial. Aging & Mental Health24(11), 1916-1925. Doi: 10.1080/13607863.2019.1642298

Lewis, K. A., Ricks, T. N., Rowin, A., Ndlovu, C., Goldstein, L., & McElvogue, C. (2019). Does simulation training for acute care nurses improve patient safety outcomes: a systematic review to inform evidence‐based practice. Worldviews on EvidenceBased Nursing16(5), 389-396. https://doi.org/10.1111/wvn.12396

Liu, X., Song, L., Xiao, S., & Wang, Y. (2023). Comprehensive Geriatric Assessment, Multidisciplinary Treatment, and Nurse-Guided Transitional Care in Hospitalized Older Adults: A Randomized Controlled Trial. Research in Gerontological Nursing, 1-7. https://doi.org/10.3928/19404921-20230606-03

Schapira, M., Outumuro, M. B., Giber, F., Pino, C., Mattiussi, M., Montero-Odasso, M., … & Perman, G. (2022). Geriatric co-management and interdisciplinary transitional care reduced hospital readmissions in frail older patients in Argentina: results from a randomized controlled trial. Aging Clinical and Experimental Research34(1), 85-93. Doi: 10.1007/s40520-021-01893-0

Spies, C. D., Paul, N., Adrion, C., Berger, E., Busse, R., Kraufmann, B., … & Weiss, B. (2023). Effectiveness of an intensive care telehealth programme to improve process quality (ERIC): a multicentre stepped wedge cluster randomised controlled trial. Intensive Care Medicine49(2), 191-204. Doi: 10.1007/s00134-022-06949-x

Strauven, G., Anrys, P., Vandael, E., Henrard, S., De Lepeleire, J., Spinewine, A., & Foulon, V. (2019). Cluster-controlled trial of an intervention to improve prescribing in nursing homes study. Journal of the American Medical Directors Association20(11), 1404-1411. https://doi.org/10.1016/j.jamda.2019.06.006

Uslu-Sahan, F., & Terzioglu, F. (2020). Interprofessional simulation-based training in gynecologic oncology palliative care for students in the healthcare profession: A comparative randomized controlled trial. Nurse Education Today95, 104588. https://doi.org/10.1016/j.nedt.2020.104588

Yan, H., Du, Y. X., Wu, F. Q., Lu, X. Y., Chen, R. M., & Zhang, Y. (2022). Effects of nurse-led multidisciplinary team management on cardiovascular hospitalization and quality of life in patients with atrial fibrillation: Randomized controlled trial. International Journal of Nursing Studies127, 104159. https://doi.org/10.1016/j.ijnurstu.2021.1041

 [BB1]Good star with question development. Keep in mind DNP students cannot involve patients in project. If this is your project topic the question may require tweaking based on the approach,