Evidenced Base Practice

Formulate
a PICO question based on the clinical topic of interest identified. Table
19.1 has an example of PICO; Chapters 2-3 explicitly cover PICO
development.
Search
the literature for a systematic review or meta-analysis relating to your
PICO question. Chapter 11 gives you a background in systematic
reviews/meta-analysis.
Identify
the strengths and weaknesses of the systematic review/meta-analysis using
the PRISMA checklist. There is link in Week 14 Module to the
Prisma website. In the upper-right corner, there is a link to the
checklist. The checklist is not questions to be answered but rather a
guide for what kind of criteria is used to report a new systematic review
of the literature. Chapter 11 has a box of Critical Appraisal Criteria for
Systematic Reviews that you can use along with the PRISMA checklist to
identify the strengths and weaknesses of your review.
Discuss
how the above could be applied to practice. Chapters 19 and 20
will help you with this. Boxes 20.2 and 20.3 offer ideas to think about. This
is your analysis of the “so what” of the critique of your article. What
does this information mean in relation to your specific population? What
is the relevance of your finding related to your specific population? What
is the strength of evidence? Would the application of the finding be
feasible (Overall or in your setting)? What would be the cost vs benefit?
After examining these things,
make a concluding statement or 2 on what your recommendation would be to senior
management if you were on the QI committee. Does this information suggest you:
continue the current practice, make minor changes, make major changes or create an
entirely new process to address the issue?
5. Conclusion.
Why is this process important for RNs to know and utilize? Summarize your
findings. Make a concluding recommendation: “This systematic
review/meta-analysis examined……. The critique showed that……. So/However (state
your recommendation for application).

Minimum of 5 substantial, complete paragraphs: An
introductory paragraph (to include your clinical topic of interest, your PICO
question, key search terms and parameters used for your search, the databases
you searched in, and the title of your meta-analysis or systematic review), a
substantial paragraph summarizing strengths, a substantial paragraph
summarizing weaknesses, a paragraph discussing how this information could be
applied to a practice situation, and a conclusion. Be sure to include your reference
list.
Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
website
PICO Question: In mechanically ventilated ICU patients, does positioning the patient in semi-fowlers result in a lower incidence of healthcare-associated pneumonia when compared to the supine position? (Please feel free to change the PICO question if no systemic review is found on this).

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