Instructions for this Powerpoint are below in the Part 2 section: I will also include a copy of the Part 1 completion of this assignment which has the PICOT question and the 4 pieces of evidence found to support this topic.
In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.
To Prepare:
Part 1:
Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.
The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
Part 1 that was already completed is below:
Effects of Gastric Residual Volume Monitoring in Patients Receiving Enteral Feedings
The viability of gastric residual volume assessment in predicting aspiration has been a topic of interest in establishing its risks associated with aspiration. The following is a comparative analysis of one of the studies conducted to determine the relationship.
Full citation of the selected article
Article #1
Metheny, Norma A., et al. “Gastric Residual Volume and Aspiration in Critically Ill Patients Receiving Gastric Feedings.” American Journal of Critical Care : An Official Publication, American Association of Critical-Care Nurses, vol. 17, no. 6, 2018, pp. 512–19; quiz 520, www.ncbi.nlm.nih.gov/pmc/articles/PMC2627559/.
Why you chose this article and how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical topic of interest)
I opted for this article because it provides an empirical research method that uses analytical and quantitative data. Moreover, it seeks the relationship between two primary variables that promise to provide insight into the effects of gastric residual volume, a concept I consider to be a “best practice.” I also believe staying aware of the gastric residual volumes in patients receiving enteral feedings will allow one to identify complications related to high volumes sooner than later.
Description of the aims of the research
The article describes the link between the aspiration of gastric content and its association with gastric residual volume.
Research methodology used
A qualitative data collection method was employed where more than 200 critically ill patients were periodically monitored for three days and their GRV recorded every four hours.
Description of the strengths of the research methodologies used, its reliability, validity, and application
The research was achieved using 60-mL syringes with a timed interval, and recordings were conducted on gastric content volume. Hence, the research method identified three viable categories, focusing on volume (150mL., 200mL, and 250mL). After that, patients are categorized as either frequent or infrequent based on their 40% average-score scale score.
General Notes/Comments
The study found no viable relationship between gastric residual volumes and aspiration informed that up to 39% of the total sample size had at least 1 GRV of 150mL, and only 17% had one or more volumes of 250mL. Notably, frequent aspirations indicated an increased frequency of at least two and above volumes on the 200 mL scale and more than one on the 250mL scale.
The following is a different study conducted on the same research topic, with a broader scope of research information.
Full citation of the selected article
Article #2
Yasuda, Hideto, et al. “Monitoring of Gastric Residual Volume during Enteral Nutrition.” Cochrane Database of Systematic Reviews, May 2019, https://doi.org/10.1002/14651858.cd013335.
Why and how it relates to the clinical issue
This article provides a direct, clear insight on whether to adopt or abolish the monitoring of gastric residual volume during enteral nutrition. Thus, it presents an independent clause on the standpoint of the research topic.
Description of the aims of the research
The study aims to “investigate the clinical efficacy and safety of monitoring GRV during enteral nutrition” (Yasuda et al.).
Research methodology used
This research uses a mixed-method approach to establish the viability of the use of GRV in nutrition. Hence, it employs electronic databases such as Cochrane Central Registrar of Controlled Trials and includes adult participants as the research population (qualitative method).
Strengths of the research methodologies used, its reliability, validity, and application
Unlike most research on this topic that focuses on a specific institution, this peer review promises to perform an all-round approach to provide detailed data that thoroughly scans the phenomenon. The method is also reliable since it involves various data collection methods. Such strategies include data from the Cumulative Index to Nursing and Allied Health Literature, randomized and controlled trials, etc. the technique is also valid because it was acquired from a reputable federal website.
General Notes/Comments
While this research is relatively extensive, it provides insightful knowledge on the nature of enteral feeding. For instance, the study purports many microorganisms in the gastrointestinal tract whose mucosa offers a barrier to prevent microbial infection (Yasuda et. el.).
Article 3.
Full citation of the selected article
Article #3
Jahreis, T., Kretschmann, J., Weidner, N., Volk, T., Meiser, A., & Groesdonk, H. (2021). Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device. Journal of Clinical Medicine. https://doi.org/10.3390/jcm10214859
Why and how it relates to the clinical issue
This article provides an ICU focused preview on the otherwise negligible effects of GRV based on an extensive study that utilizes critical statistical measurements to inform results.
Description of the aims of the research
The study aims to “determine the GRV in a cohort of
enterally fed patients using a miniaturized ultrasound device to achieve knowledge about feasibility and the GRV over time during the ICU stay” (Jahreis et al., 2021).
Research methodology used
This research used quantitative data collection method to make conclusions. Specifically, it recorded results from a sample size of 217 ultrasound examinations, 651 measurements, and 18 patients.
Strengths of the research methodologies used, its reliability, validity, and application
This research is valid and reliable because it was conducted in a reputable scientific research center and published in a reliable medical journal. Further, the article was recently (2021) published. Precisely, it was conducted in Saarland University Medical Centre and published in the Journal of Clinical Medicine. Its strength lies on the precision by which GRV was measured using a statistically accurate data stipulation program, SPSS, to inform the results.
General Notes/Comments
The study provides a miniature approach to examining important information on the effect of ultrasound devices on patients while avoiding interference with the treatment procedures.
Article 4
Full citation of the selected article
Article #4
HealthManagement.org. (2022, March 16). Radiology Management, ICU Management, Healthcare IT, Cardiology Management, Executive Management. HealthManagement. https://healthmanagement.org/c/icu/issuearticle/gastric-residual-volume-monitoring-and-management
Why and how it relates to the clinical issue
This article is important to the review of enteral medical access because it gives a personal view of a medical professional on the subject. Through such input, readers get to have a personalized view and a human touch on the matter.
Description of the aims of the research
The research aims to compare enteral nutrition and parenteral nutrition for patients in the hospital who require a non-oral nutritional therapy.
Research methods
The research used mixed methodologies.
Strengths of the research methodologies used, its reliability, validity, and application
The research suggests that gastrointestinal dysfunction may be an obstacle to patients’ enteral nutrition therapy. It also advocates for management, monitoring of patients in enteral nutrition. Lastly, the article is reliable because it builds up to research previously conducted and published on the same topic.
General Notes/Comments
While this is a personal opinion article, it still provides empirical findings based on scientific knowledge and reliable methods of data collection.
Works Cited
HealthManagement.org. (2022, March 16). Radiology Management, ICU Management, Healthcare IT, Cardiology Management, Executive Management. HealthManagement. https://healthmanagement.org/c/icu/issuearticle/gastric-residual-volume-monitoring-and-management
Jahreis, T., Kretschmann, J., Weidner, N., Volk, T., Meiser, A., & Groesdonk, H. (2021). Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device. Journal of Clinical Medicine. https://doi.org/10.3390/jcm10214859
Metheny, Norma A., et al. “Gastric Residual Volume and Aspiration in Critically Ill Patients Receiving Gastric Feedings.” American Journal of Critical Care : An Official Publication, American Association of Critical-Care Nurses, vol. 17, no. 6, 2018, pp. 512–19; quiz 520, www.ncbi.nlm.nih.gov/pmc/articles/PMC2627559/.
Yasuda, Hideto, et al. “Monitoring of Gastric Residual Volume during Enteral Nutrition.” Cochrane Database of Systematic Reviews, May 2019, https://doi.org/10.1002/14651858.cd013335.
853992
2 hours ago
The PICOT question is : Does the use of gastric residual volume measurements in critically ill patients receiving enteral feedings reduce complications during hospitalization?
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