In pediatric patients (0-17y/o) , how does the use of tele medicine visits ( direct to consumer) for upper respiratory (URI) compared with in-person visits results in higher rates of antibiotics being given from 2015 to 2019 ?
N331 Evidence Based Practice in Nursing
Evidence Base Practice Plan Paper Guidelines
Purpose: Learn about evidence base practice process and be able to apply concepts learned into a scholarly project plan.
Directions: You will write a short paper no more than 6-7 pages (title and references not included). The paper should include all areas from the guidelines below. Be sure and include a copy of each article used.
Guidelines:
1. Write a clinical question using the PICOT format (population/patient, intervention, comparison, outcome(s), and time.
a. Should reflect uncertainty in clinical practice
b. The question is phrased using the PICOT (i.e., Patient population, Intervention, Comparison or comparison group, Outcome(s), Time period [if applicable to the question/concern]) format. The following is an example of a PICOT question:
In newborn infants in the neonatal intensive care unit (NICU), does oral sucrose administration provide better non-pharmacologic pain management than non-nutritive sucking during heel sticks?
2. Collection of the strongest, most relevant evidence to answer the question. Search the evidence and define the level of evidence found (please use the hierarchy on page 23, Polit & Beck, 2018). Select three (3) research articles that address your PICOT question.
These must be reports of single, original research studies and can be either quantitative or qualitative studies.
Do not use reviews of literature, clinical practice guidelines, or meta-syntheses. You may use mixed-methods studies if they report on a single project.
You will be marked down if your articles do not meet these criteria. You may use articles that you have selected for previous assignments (i.e. discussion forums).
3. Appraise the evidence for evidence based practice (pages 32-33, Polit & Beck, 2018). Use critical appraisal guide.
a. What is the quality of the evidence? How rigorous and reliable is it?
b. What is the evidence-magnitude of effects?
c. What is precision of estimates?
d. What evidence is there of side effects/benefits?
e. What is financial cost of applying the evidence?
f. Is the evidence relevant to my practice?
4. Extract the data. Complete the evaluation table for your two articles chosen.
5. Develop a plan for implementation
Critical Appraisal Guide
Critical Appraisal Guide for Quantitative Studies
1. Why was the study done?
• Was there a clear explanation of the purpose of the study and, if so, what was it?
2. What is the sample size?
• Were there enough people in the study to establish that the findings did not occur by chance?
3. Are the instruments of the major variables valid and reliable?
• How were variables defined? Were the instruments designed to measure a concept valid (did they measure what the researchers said they measured)? Were they reliable (did they measure a concept the same way every time they were used)?
4. How were the data analyzed?
• What statistics were used to determine if the purpose of the study was achieved?
5. Were there any untoward events during the study?
• Did people leave the study and, if so, was there something special about them?
6. How do the results fit with previous research in the area?
• Did the researchers base their work on a thorough literature review?
7. What does this research mean for clinical practice?
• Is the study purpose an important clinical issue?
(Adapted with permission from Melnyk BM, Fineout-Overholt E, editors. Evidence-based practice in nursing and health
