Assignment: RUA Analyzing Published Research Guidelines

NR 449 Evidence-Based Practice

RUA: Analyzing Published Research Guidelines

Purpose

The purpose of this paper is to interpret the two articles identified as most important to the group topic.

Course outcomes: This assignment enables the student to meet the following course outcomes.

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CO 2: Apply research principles to the interpretation of the content of published research studies. (POs 4 and 8)

CO 4: Evaluate published nursing research for credibility and clinical significance related to evidence-based practice. (POs 4 and 8)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 200 points

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Preparing the assignment

Follow these guidelines when completing this Speak with your faculty member if you have questions.
Please make sure you do not duplicate articles within your
The paper will include the following:
1. Clinical Question (30 points/15%)
  1. Describe the problem: What is the focus of your group’s work?
  2. Significance of problem: What health outcomes result from your problem? Or what statistics document this is a problem? You may find support on websites for government or professional organizations.
  3. Purpose of the paper: What will your paper do or describe?

***Please note that although most of these questions are the same as you addressed in paper 1, the purpose of this paper is different. You can use your paper 1 for items 1 & 2 above, including any faculty suggestions for improvement provided as feedback.

Evidence Matrix Table: Data Summary (Appendix A) – (60 points/30%)

Categorize items in the Matrix Table, including proper intext citations and reference list entries for each article.

References (recent publication within the last 5 years)
Purpose/Hypothesis/Study Question(s)
Variables: Independent (I) and Dependent (D)
Study Design
Sample Size and Selection
Data Collection Methods
Major Findings (Evidence)

Description of Findings (60 points/30%)

Describe the data in the Matrix Table, including proper intext citations and reference list entries for each article.

Compare and contrast variables within each
What are the study design and procedures used in each study; qualitative, quantitative, or mixed method study, levels of confidence in each study, etc.?
Participant demographics and
Instruments used, including reliability and
How do the research findings provide evidence to support your clinical problem, or what further evidence is needed to answer your question?
Next steps: Identify two questions that can help guide the group’s

Conclusion (20 points/10%)

Review major findings in a summary paragraph.

Evidence to address your clinical
Make a connection back to all the included

NR449 Evidence-Based Practice

RUA: Analyzing Published Research Guidelines

Wrap up the assignment and give the reader something to think

Format (30 points/15%)
1. Correct grammar and spelling
2. Include a title and reference page
3. Use of headings for each section:
  - Problem
  - Synthesis of the Literature
    - Variables
    - Methods
    - Participants
    - Instruments
    - Implications for Future Work
Conclusion
Adheres to current APA formatting and guidelines
Include at least two (2) scholarly, current (within 5 years) primary sources other than the textbook
3-4 pages in length, excluding appendices, title and reference pages

For writing assistance (APA, formatting, or grammar) visit the APA Citation and Writing page in the online library.

Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned.

Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria (Points possible/% of total points available)	Highest Level of Performance	High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance	Section not present in paper
Clinical Question (30 points/15%)	30 points	26 points	24 points	11 points	0 points
Required criteria 1. Describe the problem: What is the focus of your group’s work? 2. Significance of problem: What health outcomes result from your problem? Or what statistics document this is a problem? You may find support on websites for government or professional organizations. 3. Purpose of the paper: What will your paper do or describe?	Includes 3 requirements for section.	Includes 2 requirements for section.	Includes 1 requirement for section.	Present, yet includes no required criteria.	No requirements for this section presented.
Evidence Matrix Table: Data Summary (Appendix A) (60 points/30%)	60 points	56 points	47 points	25 points	0 points
Required criteria Categorize items in the Matrix Table, including proper intext citations and reference list entries for each article. 1. References (recent publication within the last 5 years) 2. Purpose/Hypothesis/Study Question(s) 3. Variables: Independent (I) and Dependent (D) 4. Study Design 5. Sample Size and Selection 6. Data Collection Methods 7. Major Findings (Evidence)	Includes 7 requirements for section.	Includes 6 requirements for section.	Includes 5 requirements for section.	Includes 4 or less requirements for section.	No requirements for this section presented.
Description of Findings (60 points/30%)	60 points	53 points	47 points	23 points	0 points
Required criteria Describe the data in the Matrix Table, including proper intext citations and reference list entries for each article. 1. Compare and contrast variables within each study. 2. What are the study design and procedures used in each study; qualitative, quantitative, or mixed method study, levels of confidence in each study, etc.? 3. Participant demographics and information.	Includes 6 requirements for section.	Includes 5 requirements for section.	Includes 4 requirements for section.	Includes 3 or less requirements for section.	No requirements for this section presented.

Assignment Section and Required Criteria (Points possible/% of total points available)	Highest Level of Performance	High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance	Section not present in paper
4. Instruments used, including reliability and validity. 5. How do the research findings provide evidence to support your clinical problem, or what further evidence is needed to answer your question? 6. Next steps: Identify two questions that can help guide the group’s work.
Conclusion (20 points/10%)	20 points	18 points	15 points	8 points	0 points
Required criteria Review major findings in a summary paragraph. 1. Evidence to address your clinical problem. 2. Make a connection back to all the included sections. 3. Wrap up the assignment and give the reader something to think about.	Includes 3 requirements for section.	Includes 2 requirements for section.	Includes 1 requirement for section.	Present, yet includes no required criteria.	No requirements for this section presented.
Format (30 points/15%)	30 points	26 points	23 points	11 points	0 points
Required criteria 1. Correct grammar and spelling 2. Include a title and reference page 3. Use of headings for each section: o Problem o Synthesis of the Literature § Variables § Methods § Participants § Instruments § Implications for Future Work 4. Conclusion 5. Adheres to current APA formatting and guidelines 6. Includes at least two (2) scholarly, current (within 5 years) primary sources other than the textbook 7. 3-4 pages in length excluding appendices, title and reference pages	Includes 7 requirements for section.	Includes 6 requirements for section.	Includes 5 requirements for section.	Includes 4 or less requirements for section.	No requirements for this section presented.
Total Points Possible = 200 points

Appendix A

Evidence Matrix Table

Article	References	Purpose Hypothesis Study Question(s)	Variables Independent(I) Dependent(D)	Study Design	Sample Size & Selection	Data Collection Methods	Major Finding(s)
1	Smith, L. (2013). What	How do educational support	D-Dietary	Quantitative	N- 18	Focus Groups	Support and education
(SAMPLE	should I eat? A focus for	groups effect dietary modifications	modifications		Convenience		improved compliance with
ARTICLE)	those living with diabetes.	in patients with diabetes?	I-Education		sample-selected		dietary modifications.
	Journal of Nursing				from local support
	Education, 1(4), 111-112.				group in Pittsburgh,
					PA
1
2
3
4
5

Evidence Matrix Table

Article	References	Purpose Hypothesis Study Question(s)	Variables Independent(I) Dependent(D)	Study Design	Sample Size & Selection	Data Collection Methods	Major Finding(s)
1 (SAMPLE ARTICLE)	Smith, Lewis (2013), What should I eat? A focus for those living with diabetes. Journal of Nursing Education, 1 (4) 111-112.	How do educational support groups effect dietary modifications in patients with diabetes?	D-Dietary modifications I-Education	Quantitative	N- 18 Convenience sample-selected from local support group in Pittsburgh, PA	Focus Groups	Support and education improved compliance with dietary modifications.
1
2
3
4
5

A Sample Of This Assignment Written By One Of Our Top-rated Writers

RUA: Analyzing Published Research Guidelines

The group’s problem focus was complications of prolonged length of hospital stay (PLOS). PLOS is defined as the number of bed days occupied by an admitted patient that surpasses the expected length of stay for a particular disease or medical procedure. PLOS is associated with poor quality of care and inefficient use of healthcare resources. PLOS is significant because of its associated complications like hospital-acquired urinary tract infection, hospital-acquired pneumonia, pulmonary embolism, pressure ulcers, deep venous thrombosis, falls, and severe constipation (Ofori-Asenso et al., 2020). These complications are associated with high morbidity and mortality rates. Pressure ulcers are among the greatest concerns associated with PLOS and occur mostly in bedridden frail patients.

Significance of the Problem

Pressure ulcers in hospitalized patients have been established as an independent and considerable PLOS predictor. The concern with pressure ulcers is that it further prolongs hospital stay, lowers patients’ quality of life, and increase healthcare costs. The Agency for Healthcare Research & Quality (AHRQ) approximates that more than 2.5 million individuals in the US develop pressure ulcers annually (Padula & Delarmente, 2019). Besides, pressure ulcers result in increased health care utilization and lead to high healthcare costs. Medical treatment of pressure ulcers costs the US health care system $9.1 billion to $11.6 billion annually (Padula & Delarmente, 2019). Furthermore, it is a major issue for hospitals since the CMS discontinued hospital reimbursement for costs related to hospital-acquired conditions like hospital-acquired pressure ulcers. A hospital stay due to a pressure ulcer may cost additional yearly costs of up to $700 000. The purpose of this paper is to analyze and compare two peer-reviewed articles identified as most significant to the clinical problem.

Description of Findings

The articles identified as most relevant to the clinical problem were Cortés et al. (2021) and De Meyer et al. (2018). The independent variables in the Cortés et al. (2021) study included admission into the ICU and high-frequency level repositioning intervention. The dependent variables were new pressure ulcers, complications during repositioning, the emergence of pressure ulcers since admission, and length of stay in the ICU. On the other hand, the independent variable in the De Meyer et al. (2018) study was repositioning and turning of patients, while dependent variables included nurses’ compliance, patients’ body posture, pressure ulcers, incontinence-associated dermatitis, patient comfort, and budget. Both studies employed a pragmatic randomized controlled trial (RCT). However, Cortés et al. (2021) employed a pragmatic cluster RCT, while De Meyer et al. (2018) conducted a multicentre, cluster, three-arm, pragmatic RCT.

Participant Demographics and Information

The participants in both studies were patients 18 years and older recruited from different hospitals. However, participants in the Cortés et al. (2021) study were from ICU, while those in De Meyer et al. (2018) were recruited from general wards. The patient inclusion criteria in the Cortés et al. (2021) study included: Patients unable to move; Have intact skin at the time of admission into the ICU, are care-dependent for their total mobilization; and are scheduled for an admission period of at least 48 hours. The inclusion criteria for the De Meyer et al. (2018) study was patients: Hospitalized in one of the study wards; at risk of developing pressure ulcers; Free of pressure ulcers category II-IV; Admitted for a maximum of seven days; Anticipated to have an additional length of stay of at least eight days; No limitation of active and supportive therapy.

Instruments Used

Cortés et al. (2021) collected data using patient health records, which were used to record participants’ data, including demographic, health status in ICU, health history, complications in ICU, pressure ulcers and location, repositioning complications, and reason for discharge from ICU. On the other hand, De Meyer et al. (2018) used a questionnaire which collected information on nurses’ and patients perceived comfort, experiences, perceived quality, and occurrence of an adverse event. Information on the patient health records was entered every 24 hours, making the data collection instrument reliable and valid. A questionnaire was specifically designed to measure nurses’ and patients’ comfort and acceptability of the intervention, making it a reliable and valid data collection tool.

How the Research Findings Provide Evidence to Support the Clinical Problem

Cortés et al. (2021) found that frequent repositioning by nurses at least every two hours was more effective in decreasing the occurrence of pressure ulcers than other conventional repositioning. The findings support the clinical problem by establishing that frequent repositioning of patients is essential in reducing the occurrence of pressure ulcers. Similarly, De Meyer et al. (2018) found that frequent repositioning of patients led to few incidences of pressure ulcers and incontinence-associated dermatitis. The study supports the clinical problem by providing an evidence-based intervention that can reduce the incidence of pressure ulcers in hospitalized patients and the length of hospital stay.

Questions: What tools can be implemented to increase nurses’ compliance in repositioning patients?

Which other strategies can be applied to reduce the incidence of pressure ulcers among hospitalized patients?

Conclusion

Findings from Cortés et al. (2021) and De Meyer et al. (2018) establish that frequent repositioning of bedridden patients is crucial in reducing the incidence of pressure ulcers. Besides, the intervention improves comfort for patients and body posture. Thus repositioning patients can significantly address the issue of PLOS since it prevents pressure ulcers, which are independent predictors of PLOS. Therefore, nurses and healthcare organizations can adopt the approach of frequently repositioning patients to prevent the morbidities associated with pressure ulcers. However, it is important that we think about how healthcare leaders can support nurses in implementing this intervention in the healthcare setting.

References

Cortés, O. L., Herrera-Galindo, M., Villar, J. C., Rojas, Y. A., Del Pilar Paipa, M., & Salazar, L. (2021). Frequency of repositioning for preventing pressure ulcers in patients hospitalized in ICU: protocol of a cluster randomized controlled trial. BMC nursing, 20(1), 121. https://doi.org/10.1186/s12912-021-00616-0

De Meyer, D., Van Hecke, A., Verhaeghe, S., & Beeckman, D. (2019). PROTECT – Trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning to increase repositioning compliance. Journal of advanced nursing, 75(5), 1085–1098. https://doi.org/10.1111/jan.13932

Ofori-Asenso, R., Liew, D., Mårtensson, J., & Jones, D. (2020). The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia. Journal of clinical medicine, 9(9), 3055. https://doi.org/10.3390/jcm9093055

Padula, W. V., & Delarmente, B. A. (2019). The national cost of hospital‐acquired pressure injuries in the United States. International wound journal, 16(3), 634-640. https://doi.org/10.1111/iwj.13071

Appendix A: Evidence Matrix Table

Article

References

Purpose

Hypothesis

Study Question(s)

Variables

Independent(I)

Dependent(D)

Study Design

Sample

Size &

Selection

Data Collection

Methods

Major Finding(s)

The study aimed to assess the efficacy of two frequency levels of repositioning or manual posture switching in preventing ulcers caused by pressure sustained during hospitalization in adults admitted to various intensive care units in several hospitals in Colombia.

I: Admission into the ICU; High-frequency level repositioning intervention

D- Onset of new pressure ulcers; Complications during repositioning;

The emergence of pressure ulcers since admission; Length of stay in the ICU.

Pragmatic cluster randomized controlled trial

N- 22 ICUs, each having 150 patients.

Total patients in all ICUs-1650

Selection- Randomization and blinding

Patient health records

There was a low-impact decrease in pressure ulcers in ICUs that applied frequent repositioning (≤ to every 2 hours) than conventional repositioning.

De Meyer, D., Van Hecke, A., Verhaeghe, S., & Beeckman, D. (2019). PROTECT – Trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning of advanced nursing, 75(5), 1085–1098. to increase repositioning compliance. Journal https://doi.org/10.1111/jan.13932

The study aimed to examine the efficacy of tailored repositioning and a turning and repositioning system on:

Nurses’ compliance to frequencies of repositioning. Patients’ body posture after repositioning.

Incidence of pressure ulcers and incontinence-associated dermatitis.

Nurses’ and patients’ preferences, comfort and acceptability.

Impact on budget.

I- Repositioning and turning of patients.

D- Nurses’ compliance; Patients body posture; Pressure ulcers; Incontinence-associated dermatitis; Patient comfort; Budget

Multicentre, cluster, three-arm, randomized, controlled pragmatic trial.

N-227 patients

Patients were recruited from 29 wards in 16 hospitals.

Selection- simple randomization

Questionnaire

The turning and repositioning system was associated with significantly more correctly positioned patients (30-45° tilted side-lying position) (69.6% vs. 34.6%). Few pressure ulcers and incontinence-associated dermatitis incidents occurred.

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Assignment: RUA Analyzing Published Research Guidelines