NURS 81 Assignment Wk6&7

NURS 81 Assignment Wk6&7

NURS 81 Assignment Wk6&7

Systematic Reviews: Searching and Analysis of the Literature

This Assignment expands upon the work you have been conducting for this week’s Discussion.) you will conduct a search for literature on your selected practice problem. A Literature Review Matrix template will be used to identify gaps in the literature.

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To prepare:

Consider the practice problem you addressed in this week’s Discussion. (You may select a new issue if necessary, but it is not recommended): Practice problem chosen: Health literacy and self-care activities, self-efficacy, and health related outcome of patients with type 2 Diabetes.

Review the guidelines in the Literature Review Matrix, included in the Learning Resources.

Formulate a research question around your issue as indicated in Part I. Then

complete Part II of the Matrix, identifying the resources you will use, search terms and criteria, and Boolean search strings.

Using the Walden Library, locate 10 articles related to your research question. At least one article must be a systematic review.

All of the articles should be primary sources. NOTE: If appropriate, you may use the four articles you reviewed for this week’s Discussion. NURS 81 Assignment Wk6&7

Actual Assignment:

Complete Part I and Part II of the Literature Review Matrix template.

Begin working on Part III.

Review Part III of the Literature Review Matrix and notice which middle range theories were used most frequently in the articles you reviewed.

Consider the appropriate use of the theoretical frameworks in each article.

Review the information on empiricism presented in Chapter 1 of Theoretical Basis for Nursing and Chapter 6 in The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence as you consider your response to Part IV.

Complete Part III of the Literature Review Matrix.

In your analysis of the strengths and weaknesses of the existing literature, note the appropriate use of the theoretical frameworks.

Complete Part IV addressing the influence of empiricism on quantitative methodology.

REFERENCES

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

Chapter 10, “Introduction to Middle Range Nursing Theories”

Chapter 11, “Overview of Selected Middle Range Nursing Theories”

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 3, “Introduction to Quantitative Research”

Chapter 4, “Introduction to Qualitative Research”

Chapter 6 guides nurses through the process of identifying research objectives, developing research questions, and creating research hypotheses.

Chapter 7 examines the process of preparing for a literature review to support research efforts. NURS 81 Assignment Wk6&7

Chapter 13, “Outcomes Research”

Moran, K., Burson, R., & Conrad, D. (2017). The doctor of nursing practice scholarly project: A framework for success (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Review Chapter 6, “Developing the Scholarly Project”

Armola, R., Bourgault, A., Halm, M., Board, R., Bucher, L., Harrington, L., & … Medina, J. (2009). AACN levels of evidence: What’s new? Critical Care Nurse, 29(4), 70–73. doi: 10.4037/ccn2009969

Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59–60. doi: 10.1097/01.NURSE.0000369871.07714.39

Fawcett, J., & Garity, J. (2009). Chapter 6: Evaluation of middle-range theories. Evaluating Research for Evidence-Based Nursing. Philadelphia, Pennsylvania: F. A. Davis.

DeSanto-Madeya, S., & Fawcett, J. (2009). Toward Understanding and Measuring Adaptation Level in the Context of the Roy Adaptation Model. Nursing Science Quarterly, 22(4), 355–359.

Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part I an introduction to gathering, evaluating, and recording the evidence… fifth in a series. American Journal of Nursing, 110(7), 47–52. doi: 10.1097/01.NAJ.0000383935.22721.9c

Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5

_NURS_8110PICOLITERATUREREVIEWPLAIN.doc

Literature Review Matrix

Part I: PICO Analysis of Research Topic

P: Patient or Population

I: Anticipated Intervention

C: Comparison group or Current standard

O: Outcome desired

Source: Adapted from Elkins (2010)

Step 1: Frame your clinical question using the PICO method.

P:

I:

C:

O:

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Part II: Search Strategy

Using the Walden Library and other appropriate databases, locate ten scholarly articles that pertain to a practice issue of interest to you and that is appropriate for an evidence-based practice project.

Step 1: Identify the resources you will utilize, or utilized, to find articles that pertain to your topic

Electronic Databases Research or Professional Organizations Experts in the field to consult Books, encyclopedias, handbooks
       
       
       
       
       
       
       
       
       

Step 2: Identify search terms and criteria

Key words & phrases Major authors Inclusion criteria Exclusion criteria
       
       
       
       
       
       
       
       
       

Step 3: Identify Boolean search strings

Part III: Analysis of Literature

Step 1: Summarize the ten (10) articles you select from your search efforts completing the table below.

Summary Table of Analyzed Articles (you may determine your own headings)
Citation Conceptual Framework/ Theory Main finding Research method Strengths of study Weaknesses Level of Evidence
             
             
             
             
             
             
             
             
             
             

Step 2: Briefly summarize the history and purpose of your research question.

Step 3: Analysis of strengths and weaknesses of existing literature.

Strengths Weaknesses
   
   

Step 4: What gap exists in the current literature? Explain.

Part IV: Identify the influence of empiricism on quantitative research methodology. Discuss its applicability to evidenced-based practice projects.

NURS8110 Week 6 and 7 ASSIGNMENT SAMPLE PAPER.doc

PAGE

4

Literature Review Matrix

Name

Walden University

Theoretical and Scientific Foundations for Nursing

Nursing 8110

Date

Literature Review Matrix

Part I: PICO Analysis of Research Topic

P: Patient or Population

I: Anticipated Intervention

C: Comparison group or Current standard

O: Outcome desired

Source: Adapted from Elkins (2010)

Step 1: Frame your clinical question using the PICO method.

P: Patients supported by a Mechanical Circulatory Support Device

I: who participate in an online educational and skills review training program

C: compared to patients who do not participate in the online training

O: are more likely able to recall critical skills necessary in care of the MCS device.

Part II: Search Strategy

Using the Walden Library and other appropriate databases, locate ten scholarly articles that pertain to a practice issue of interest to you and that is appropriate for an evidence-based practice project. NURS 81 Assignment Wk6&7

Step 1: Identify the resources you will utilize, or utilized, to find articles that pertain to your topic

Electronic Databases Research or Professional Organizations Experts in the field to consult Books, encyclopedias, handbooks
Walden Library Databases ISHLT MyLVAD.com  
Google Scholar ICCAC Device Manufacturers  
  HFSA    

Step 2: Identify search terms and criteria

Key words & phrases Major authors Inclusion criteria Exclusion criteria
Online training Kolb Primary research Medical Education
Online education   Systematic Reviews Nursing education
Virtual education      
Virtual training      
MCS or Mechanical Circulatory Support      
LVAD or Left ventricular assist device      
Skills verification knowledge verificaiton      
Patient education      
MCS patient or LVAD patient      

Step 3: Identify Boolean search strings

To obtain research articles involving online patient education Boolean search strings included “Online or virtual <and> Patient education or patient training <and> Skills.” Terms excluded from the search strings included:

· Not virtual patient;

· Not medical;

· Not nursing;

· Not surgery or surgical training;

· Not pharmacy.

Dates were limited to 2009 to present to obtain recent literature and the search was limited to peer reviewed scholarly journals. NURS 81 Assignment Wk6&7

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Part III: Analysis of Literature

Step 1: Summarize the ten (10) articles you select from your search efforts completing the table below.

Summary Table of Analyzed Articles (you may determine your own headings)
Citation Conceptual Framework/ Theory Main finding Research method Strengths of study Weaknesses Level of Evidence
Attai (2015) Patient centered care Proof of concept – participant’s knowledge of disease specific information and self care was increased

· Convenience Sample

· Online twitter survey – Likert scale

· Increased reach to various patients geographically

 

· Survey not validated

· Recall bias

· No control group

· Similar demographic characteristics of respondents

· Unclear if results can be generalized

· Lurking un-trackable

 

VI
Calvillo (2015) Patient Empowerment

· Four levels of patient empowerment exist.

· Any current online interface supports patient empowerment

· Technology already exists

· Attitude change needed to fully engage technology

Systematic review of literature

· Comprehensive search across multiple specialties

· Distinct definition and plan for inclusion and exclusion of articles

· Strong theoretical basis

· English articles only reviewed I
Song (2009) Patient self care – (empowerment) · Web based programs have potential as an alternative to live diabetes patient education

· Quasi-experimental

· Non equivalent control group

· Pre/post test design

· No statistical difference in group characteristics

· High drop out

· Non randomization

· Short duration of data collection

 

III
Finkelstein (2013) Adult learning theories

· Intervention group had significantly higher knowledge score

· Better experience with guided learning

· Mixed methods

· Randomized control trial

· Intervention group – CO-ED system

· Control group – internet search

· Pre and post test knowledge assessments

· Semi structured interviews for experience

· Randomized controlled intervention

· Similar knowledge level at baseline

· Mixed method to evaluate experience as well as intervention effect.

· Only used white English speaking population

 

II
Bol (2015) Cognitive theory of multimedia learning

· Adding illustrations is beneficial to all

· Older patients benefited with cognitive or affective illustrations

· Older patients recall better with cognitive illustrations.

· Randomized assignment to 3 separate experimental groups

· Text only, text plus illustrations younger, text plus illustrations older

· Randomized sampling.

· Adequate sample size.

· Exposed patients to online cancer information without context of needs

· Underrepresentation of older and female patients

III
Wiecha (2015) Social cognitive theory and eHealth theoretical models · Digital applications have potential to support multiple aspects of health care and health behavior

· Prospective randomized pilot trial

· Subjects assigned to one of three groups control with two separate levels of online intervention

· Strong design

· Randomization

· Small sample size limited statistical power

· Consolidation of intervention groups resulting in asymmetrical groups

III
Fraval (2015)

Patient education/ information

(empowerment)

· Patient knowledge improved with website use · Randomized controlled trial

· Large sample

· Multiple clinical sites

· Lack of longitudinal follow up. II
Ganier (2014) Learning transfer theory · Performance was the same with virtual and live group training · Randomized controlled trial · Randomized distribution of participants

· Training of control group done as group, virtual training done individually

· Limited sample size

IV

Bernardino (2015)

(Spanish)

Patient self care – (empowerment) · Patients who participated in the video group had better knowledge of self care · Prospective randomized multicenter trial

· Study design

· Sample size

 

· Author bias – same author created video and questionnaire –

· Timing of questionnaire completion

· Only knowledge measured – no functional outcomes

· Questionnaire not validated

II
Tuong (2015) Patient self care – (empowerment)

· Internet based patient education appears to be effective

· Increasing interactivity enhances effectiveness of patient education.

· Randomized trial – 1:1 randomization to standard website group or automated counseling group

· Strong design

 

· Only involved adolescents

· Repeat access to site was self reported

· Questionnaire not validated

II

Step 2: Briefly summarize the history and purpose of your research question.

The mechanical circulatory support (MCS) field began in the mid-1990’s with the first FDA approval of a ventricular assist device (VAD). Those devices were large and required the patient to stay in the hospital while waiting for a cardiac transplant. By 2001 the first devices were portable enough to allow patient discharge from the hospital. Patient education surrounding MCS device therapy has been largely dictated by the manufacturers with adjustments for institutional practices, but very little research has been conducted related to patient education, training, and retraining. Patients are required to maintain a minimal level of competency to perform emergency procedures should their device malfunction. These skills are taught at implant but rarely reviewed in follow-up clinic visits. Other fields have used virtual or online training as a successful means of patient teaching reporting a higher recall of subject matter with participation in online training (Tuong, 2015, Bernardino, 2015, Fraval 2015, Song 2009). Creation of an online training module to reinforce emergency procedures related to MCS self-care should help to fill this practice gap, giving patients a monitored review of lifesaving MCS skills. NURS 81 Assignment Wk6&7

Step 3: Analysis of strengths and weaknesses of existing literature.

Strengths Weaknesses
Multiple disciplines with similar outcomes. No research involving MCS technology.
Patient empowerment is an underlying trend in theory base. Un-validated questionnaires
Randomized interventions. Lack of longitudinal follow up
  Limited sample sizes

Step 4: What gap exists in the current literature? Explain.

The current literature regarding MCS education and re-education is non-existent. The entire realm of what and how MCS patients are taught and learn has not been systematically described or explored through research. Training of patients and caregivers between institutions is inconsistent with some centers providing written material developed by the manufacturers, some providing written material adapted from the manufacturers, and some using video to help aid in training. The most consistent method of teaching is using a hands-on approach to practice connections and expose patients and caregivers to alarms. There are a few anecdotal descriptions of single institutional training methods in the literature, but no investigation as to most effective means for providing training. Research needs to be done to determine content, timing, and methods of instruction as well as optimal ways of providing retraining for maintaining skills related to emergency procedures for MCS devices.

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Part IV: Identify the influence of empiricism on quantitative research methodology. Discuss its applicability to evidenced-based practice projects.

Empiricism has had a major influence on quantitative research methodology. Empirical methods allow researchers to break down questions into small bytes of knowledge that can be studied individually (McEwen & Wills, 2014). Extraneous variables are controlled by isolating the research subject and manipulating one variable to determine the effect of the intervention (McEwen & Wills, 2014). Empirical research does not consider phenomena within the context of its environment. Not all research questions can be looked at from an empirical perspective, especially those that involve human subjects. There is variation in human nature and humans, and their environments are actively integrated. Therefore, research surrounding human phenomena has to take into account the environment in which they are a part. Study design must allow for those variations. Evidence-based research revolves around human interventions and human phenomena. Some things can be controlled, but removing all extraneous influences is impossible. Removal of the subject from its environment can bias study results as well (McEwen & Wills, 2014). It is for that reason an empirical methodology is not adequate when doing evidenced based research. Research involving mixed methods incorporating quantitative and qualitative aspects can help to characterize evidence-based research in a more accurate dimension (McEwin & Wills, 2014). NURS 81 Assignment Wk6&7

References

Attai, D. J., Cowher, M. S., Al-Hamadani, M., Schoger, J. M., Staley, A. C., & Landercasper, J. (2015). Twitter Social Media is an Effective Tool for Breast Cancer Patient Education and Support: Patient-Reported Outcomes by Survey. Journal of Medical Internet Research17(7), e188.

Bol, N., Smets, E., Eddes, E., DeHaes, J., Loos, E., Van Weert, J. (2015). Illustrations enhance older colorectal cancer patients’ website satisfaction and recall of online cancer information. European journal of cancer care, 24, 213-223.

Calvillo, J., Román, I., & Roa, L. M. (2015). lHealth Expectations: An International Journal of Public Participation in Health Care and Health Policy18(5), 643–652.

Cooper, H., Cooper, J., & Milton, B. (2009). Technology-based approaches to patient education for young people living with diabetes: a systematic literature review. Pediatric Diabetes10(7), 474–483.

Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59-60.

Fraval, A., Chandrananth, J., Chong, Y., Tran, P., Coventry, L. (2015). Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial. BMC Musculoskeletal disorders, 16:14. DOI 10.1186/s12891-015-0466-9.

Ganier, F., Hoareau, C., & Tisseau, J. (2014). Evaluation of procedural learning transfer from a virtual environment to a real situation: a case study on tank maintenance training. Ergonomics57(6), 828–843.

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th. ed.). Philadelphia, PA: Wolters Kluwer Health.

Molano Bernardino, C., Maestro Fernández, A., Seijas Vázquez, R., Cintado Avilés, M., Edelaar, P., & Pérez Carro, L. (2015/8). Eficacia de Internet audiovisual para educación de pacientes con artroscopia de rodilla. Revista Española de Artroscopia Y Cirugía Articular22(2), 85–92.

Rose, F. D., Attree, E. A., Brooks, B. M., Parslow, D. M., Penn, P. R., & Ambihaipahan, N. (2000). Training in virtual environments: transfer to real world tasks and equivalence to real task training. Ergonomics43(4), 494–511.

Song, M., Choe, M.-A., Kim, K. S., Yi, M. S., Lee, I., Kim, J., … Shim, Y. S. (2009). An evaluation of Web-based education as an alternative to group lectures for diabetes self-management. Nursing & Health Sciences11(3), 277–284.

Schnetter, V. A., Lacy, D., Jones, M. M., Bakrim, K., Allen, P. E., & O’Neal, C. (2014). Course development for web-based nursing education programs. Nurse Education in Practice14(6), 635–640.

Tuong, W., Wang, A. S., & Armstrong, A. W. (2015). Comparing the effectiveness of automated online counseling to standard web-based education on improving acne knowledge: a randomized controlled trial. American Journal of Clinical Dermatology16(1), 55–60.

Wiecha, J., Adams, W., Rybin, D., Rizzodepaoli, M., Keller, J., Clay, J. (2015). Evaluation of a web-based asthma self management system: a randomized controlled pilot trial. BMC Pulmonary medicine, 15:17. DOI: 10.1186/s12890-015-0007-1

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  • Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

  • Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

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Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

  • Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

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Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. NURS 81 Assignment Wk6&7

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