Research assignment 5

Details:Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.PICOT Statement Revise the PICOT statement you wrote in the Topic 1 assignment. Topic 1 Assignment attachedThe final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).Research CritiquesIn the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions. Topic 2 and 3 assignment attachedThe completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.Proposed Evidence-Based Practice ChangeDiscuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Guideline attachedRead the lecture and incorporate it in the research paper and also follow the rubric below the attached assignment and also pay attention on the instructor feedbackCharacteristics of Nursing Research Utilization and Evidence-Based PracticeIntroductionResearch utilization and evidence-based practice (EBP) are regularly used within the nursing profession in developing positive changes for patient outcomes. Although both research methods provide results beneficial to the nursing community, each method approaches nursing research in a different manner. Research utilization focuses on implementation of the results after a study is conducted whereas EBP incorporates the research directly into the clinical decision-making process (Polit & Beck, 2006).Characteristics of Research UtilizationIn the previous lessons, the focus has been on the language and components of research. In this lesson, the focus is on how to apply research findings to improve patient outcomes. Over the past 40 years, the concept of research utilization has been described in the literature. In the nursing community, the long-held tradition has been to utilize research, through findings, to impact health changes within the profession. In order for this process to be successfully implemented into application, the research analysis would be compounded upon multiple studies within a specific nursing area. Furthermore, through the presentation of correlated findings and possibly similar results, health care professionals will have an accurate knowledge in order to influence patient and system outcomes.Over time, issues have been raised about research utilization being affected. The key to research utilization is not only the acknowledgment and review of the findings but the implementation of those results into practice. In order for this to occur, nurses need to be active participants in evaluating current research and utilizing the results within their normal practice (Polit & Beck, 2006).The majority of nurses in the United States are initially educated at the Associate Degree level. In these programs, the concepts of nursing research are often not discussed. Similarly, most registered nurses are not taught how to evaluate advanced nursing science, or how such advances will improve outcomes. Research utilization and evidenced-based practice principles put emphasis on these skills.Evidence-Based PracticeRecently, a movement has been made toward evidence-based practice (EBP) research. The purpose behind this method is to implement a solution to an evidence-based problem. To accomplish this goal, registered nurses must become experts in not only reading research articles, but also in collecting relevant research findings to help them make clinical decisions. After the fundamental information is collected about a health care topic, the researcher can utilize it in creating the design and framework for the necessary research. In essence, the search for the best possible information from top-quality research, which is integrated with clinical expertise, available resources, and the needs and desires of the patient, is the basis for EBP in nursing.The skills associated with EBP research place emphasis on diagnosis, therapy, etiology, prognosis, or prevention. EBP has been developed to provide a method for practicing nurses to understand research in a way that allows them to incorporate it into improved patient care. One skill that is helpful is the PICO method, which allows practitioners to formulate research questions. By formulating a PICO question, nurses are making the first step in preparing for their capstone project.PICOPICO is a mnemonic used to describe the four elements of a good clinical foreground question: (P) patient, (I) intervention, (C) comparison, and (O) outcome (see Table 5.1). The purpose of the PICO format is to assist clinicians in formulating clinical questions. This beginning process can be a challenge, but using the PICO format allows researchers to critically consider all of the components their research will address.PICOExample 1Example 2Example 3Example 4P (Patient or problem) Describe, as accurately as possible, the patient or group of patients of interest.In patients with acute bronchitis,In children with cancer,Among family members of patients undergoing diagnostic procedures,For pain in post operative patients,I (Intervention/Issue of Interest or cause, prognosis)What is the main intervention or therapy you wish to consider, including an exposure to disease, a diagnostic test, a prognostic factor, a treatment, a patient perception, a risk factor, etc.?do antibioticswhat are the current treatmentsdoes standard care-do relaxation and deep breathing accompanied by music therapyC (Comparison Intervention or Comparison Group)Is there an alternative treatment to compare, including no disease, placebo, a different prognostic factor, absence of risk factor, etc.?nonenonelistening to tranquil music, or audiotaped comedy routines-noneO (Outcome)What is the clinical outcome, including a time horizon, if relevant?reduce sputum production, cough, or days off?in the management of fever and infection?make a difference in the reduction of reported anxiety?change patient reported pain score by 4-5 points?Table 5.1. Example PICO QuestionsAdapted from Evidence-Based Practice: Asking the Clinical Question (Cushing/Whitney Memorial Library, n.d.).When developing a PICO question, researchers must take the time to carefully formulate it. They need to make it a topic about which they are passionate, and one that has a body of literature to support the intended outcome.ConclusionNurses’ responsibilities lie in being observant and curious, participating in quality-management activities of their units, and supporting research activities developed by others. Using expertise and professional judgment, along with quality research evidence, is essential in developing quality care and outcomes for patients.ReferencesCushing/Whitney Memorial Library. (n.d.). Evidence-based practice: Asking the clinical question. Yale University. Retrieved October 4, 2011, from…Polit, D. F., & Beck, C. T. (2006). Essentials of nursing research: Methods, appraisal, and utilization (6th ed.). Philadelphia: Lippincott.


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Nice! Great PICOT! You included both qualitative and quantitative research articles! Please remember
mechanics for your PICOT.
PICOT Statement and Literature Search
PICOT Statement
In the modern healthcare, obesity among the adolescent has become one of defining
issues. In the United States, the obesity among the youths has reached an alarming rate. As a
result, more overweight and obese peoples are being surgically treated for weight loss, thus it
makes it important for perioperative RNs to understand the effects of obesity on patient’s health,
its contribution to significant comorbidities, the perioperative care requirements, and special
needs of bariatric patients. It is important that the perioperative nurses should accurately assess
the patients undergoing the bariatric surgery to offer appropriate and safe nursing interventions
during the perioperative sequence of care.
The purpose of this paper is to examine whether “does the bariatric adolescent
undergoing gastric bypass have better continuity of care postoperatively and perioperatively
when the nurse is a primary member of the multidisciplinary team as compared to when the
nurses is a secondary member whose only role is to provide perioperative care and has no
specialized training.” The paper is basically designed to examine the important roles of nurses in
offering the perioperative and postoperative nursing care to bariatric surgical patients.
In America, obesity is the second-leading cause of preventable deaths. About 68 percent
of the Americans are considered overweight, which affects mostly the health of the patients.
Moreover, more than 30 percent of the Americans are considered obese. Therefore, obesity is
regarded as a major public health concern that needs to be addressed immediately to avoid
further serious comorbidities. Hence, perioperative RNs must understand the unique problems
this patient’s populations face to offer safe and adequate care.
Unlike when the nurses are secondary members whose only role is to offer perioperative
care, involving nurses as primary members in the multidisciplinary team approach in both
perioperative and postoperative treatment of bariatric patients enhances better continuity of care.
This is because coordination of nurses with other multidisciplinary team allows the patients to
have access to effective and timely care. Using multidisciplinary team approach is mainly
centered on the need-based of the customers as opposed to nursing acting as secondary
caregivers. Great background to your PICOT! Please seprate the components out like this:
PICOTLiterature Search
Barreca, M., Renzi, C., Tankel, J., Shalhoub, J., & Sengupta, N. (2016). Is there a role for
enhanced recovery after laparoscopic bariatric surgery? Preliminary results from a
specialist obesity treatment center. Surgery for Obesity and Related Diseases, 12(1), 119126.
The article presents a well-researched Meta-Analysis study conducted by Barreca et al
(2016) where sample population of 278 members was examined before and after undergoing a
bariatric surgery. It was established that nurse involvement in postoperative treatments as
primary care providers are more feasible as compared to when nurses are involved as secondary
care providers. Barreca et al (2016) argue that nurses’ involvement in both perioperative and
postoperative gastric bypass reduces readmission rates. The reduction in readmission rates
emanates from the fact that postoperative care gives an opportunity for the patients to access to
immediate care.
The study further established that nurses’ involvement in postoperative care after
bariatric patients underwent gastric bypass minimize acute postoperative complication that
normally delays effective discharge of care. Out of 278 sample population, only 10 percent
developed postoperative complications when nurses are involved as opposed to 28.5 percent
when nurses are not involved. From this statistic, it is clear that nurses’ involvement boosts the
recovery days of the patients as well as the satisfaction indexes.
Cooley, M. (2017). Preventing Long-term Poor Outcomes in the Bariatric Patient
Postoperatively. Dimensions of Critical Care Nursing, 36(1), 30-35.
The article provides a systematic study conducted by Cooley (2017) to examine the
critical role of nurses in postoperative gastric bypass. Cooley concluded that nurse involvement
in postoperative operations is important not in managing acute pain but also in helping to prevent
weight regain. With regular visits from nurses, they are in a position to identify the changes in
weight and looks for ways of maintaining the right weight. Cooley argues that postoperative care
is also important because it assists in early detection and prevention. The study further reveals
that direct nurse involvement after gastric bypass is essential in avoiding acute pain.
Dogan, K., Kraaij, L., Aarts, E. O., Koehestanie, P., Hammink, E., van Laarhoven, C. J., … &
Berends, F. J. (2015). Fast-track bariatric surgery improves perioperative care and
logistics compared to conventional care. Obesity surgery, 25(1), 28-35.
Dogan et al (2015) provide a randomized controlled study where two groups of 75
consecutive morbidly obese patients were subjected to LRYGB. The study reveals that nurse
involvement in both perioperative and postoperative operations reduces hospitalization time and
complication rates. The reduced hospitalization originates from the fact that nurse involvement
in a multidisciplinary team in postoperative nursing care help in rendering effective care to
patients. Since patients have direct contact when nurses are primary care providers, its health and
medical complications are minimal.
Johnston, M. J., Davis, R. E., Arora, S., King, D., Reissis, Y., & Darzi, A. (2015). Raising the
alarm: A cross-sectional study exploring the factors affecting patients’ willingness to
escalate care on surgical wards. World journal of surgery, 39(9), 2207-2213.
The article presents a cross-sectional study conducted by Johnston et al (2015) where a
total of 155 surgical patients from three hospitals were subjected to similar questionnaires to
examine their willingness to call for help from nurses as compared to doctors. The study reveals
that gastric bypass patients were more willing to solicit the support of nurses as compared to
doctors when receiving postoperative and perioperative care. As a result, nurses being a primary
participant in both postoperative and perioperative are important because it offers an opportunity
for patients to effectively solicit care. In this context, nurse’s involvement makes it easier for
patients to access care.
Shah, M. M., Hunter, B. W., Sweeney, J. F., Lin, E., Perez, S. D., Parker, C., & Davis Jr, S. S.
(2017). Operating Room Efficiency in Bariatric Surgery: The Effect of Team Member
Experience on Operative Times in Laparoscopic Roux-en-Y Gastric Bypass. Bariatric
Surgical Practice and Patient Care, 12(3), 100-106.
The article offers a randomized controlled study conducted by Shah et al (2017) where
sample population of 179 consecutive LRYGB cases was analyzed, it was concluded that
surgical times (STs) and total operation times (ORT) are reduced when nurses are involved in the
postoperative and perioperative operation. According to Shah et al (2017), nurses involvement as
a member of multidisciplinary to access to quick and timely care; hence, reduces the hospital
stay. In order for patients to get prompt care, nurses must be knowledgeable about the effects of
obesity and treatment options that are effective for the patients. Appropriate and accurate nursing
care and interventions help in reducing the hospital stay.
The study further reveals that nurse’s involvement as primary care providers helps to
reinforce the confidence of patients towards care disseminated. It is clear from this study that the
roles of nurses are not only centered on care delivery but also to motivate the patients to develop
positive attitudes towards the care. Using the multidisciplinary approach enhances effective
sharing of information that improves healthcare delivery. Therefore, the role of nurses should not
be ignored.
van der Beek, E. S., Monpellier, V. M., Eland, I., Tromp, E., & van Ramshorst, B. (2015).
Nutritional deficiencies in gastric bypass patients; incidence, time of occurrence and
implications for post-operative surveillance. Obesity surgery, 25(5), 818-823.
In a study Meta-analysis study conducted by Van der Beek et al (2015) where a group of
427 gastric bypass patients was subjected to same conditions, it was established that nurse’s
being a primary stakeholder is postoperative and perioperative care helps in minimizing
nutritional deficiencies that are normally experienced during patient’s care. According to Beek et
al, nutritional deficiencies originate from poor management of patients conditions after
undergoing gastric bypass. The study emphasizes the importance of preoperative and
postoperative assessments and treating patients with full consideration of nutritional deficiencies
of patients undergoing gastric bypass surgery. They recommend postoperative and perioperative
involvements in order to decrease the incidence of deficiencies.
Barreca, M., Renzi, C., Tankel, J., Shalhoub, J., & Sengupta, N. (2016). Is there a role for
enhanced recovery after laparoscopic bariatric surgery? Preliminary results from a
specialist obesity treatment center. Surgery for Obesity and Related Diseases, 12(1), 119126.
Cooley, M. (2017). Preventing Long-term Poor Outcomes in the Bariatric Patient
Postoperatively. Dimensions of Critical Care Nursing, 36(1), 30-35.
Dogan, K., Kraaij, L., Aarts, E. O., Koehestanie, P., Hammink, E., van Laarhoven, C. J., … &
Berends, F. J. (2015). Fast-track bariatric surgery improves perioperative care and
logistics compared to conventional care. Obesity surgery, 25(1), 28-35.
Johnston, M. J., Davis, R. E., Arora, S., King, D., Reissis, Y., & Darzi, A. (2015). Raising the
alarm: A cross-sectional study exploring the factors affecting patients’ willingness to
escalate care on surgical wards. World journal of surgery, 39(9), 2207-2213.
Shah, M. M., Hunter, B. W., Sweeney, J. F., Lin, E., Perez, S. D., Parker, C., & Davis Jr, S. S.
(2017). Operating Room Efficiency in Bariatric Surgery: The Effect of Team Member
Experience on Operative Times in Laparoscopic Roux-en-Y Gastric Bypass. Bariatric
Surgical Practice and Patient Care, 12(3), 100-106.
Van der Beek, E. S., Monpellier, V. M., Eland, I., Tromp, E., & van Ramshorst, B. (2015).
Nutritional deficiencies in gastric bypass patients; incidence, time of occurrence and
implications for post-operative surveillance. Obesity surgery, 25(5), 818-823.
PICOT Statement and Literature Search
Less than
80.0 %Content
20.0 %Nursing
A nursing
Practice Problem
statement describes
problem is not a nursing practice
problem but lacks
reliable sources.
and/or a PICOT
statement is not
describes a
problem and
includes a few
articulates a
problem using
from reliable
articulates a
problem using 30.00/30
60.0 %Qualitative
Fewer than six
and Quantitative
articles that
articles that address articles that articles that articles that
a selected nursing
address a
address a
address a
Requirements: At address the
selected nursing practice problem are selected
least six
listed in the
references with practice
the abstracts of problem are not literature search, but practice
two or more are not problem are problem are problem are
research studies identified.
research studies.
listed in the listed in the listed in the
focus on a
Abstracts are
selected nursing
search, but
search, but
search and
practice problem.
two are not
one is not a
Abstracts are Abstracts are
and Effectiveness
10.0 %Mechanics
Frequent and
Prose is
Writer is
of Writing
largely free of clearly in
(includes spelling, errors are
mechanical errors
errors or typos mechanical command of
enough that
distract the reader. are present, errors,
they impede
Inconsistencies in
but they are although a
language use)
communication language choice
not overly
few may be academic
of meaning.
(register), sentence
Inappropriate structure, or word
word choice or choice are present.
construction is
distracting to
the reader.
structure and
language are
present. A
variety of
and effective
figures of
speech are
10.0 %Format
Sources are
of sources is
of Sources
inconsistent or
documented, documented, completely
incorrect, as
as appropriate as appropriate and correctly
appropriate to
to assignment to assignment documented, 15.00/15
assignment and style, and style,
and style, and as appropriate
with numerous
although some format is
to assignment
etc., as
formatting errors.
and style, and
appropriate to
errors may be correct.
format is free
assignment and
of error.
100 %Total
Hi , You described your qualitative study nicely! Please review my comments below! Please remember
mechanics and APA formatting! Sincerely,
Information Technology in Healthcare Practice
Barriers to Adoption of Information Technology in Healthcare
Information technology in Healthcare Practice
Information technology can be a vital tool in improving quality in healthcare practice.
However, it has not been fully adopted by the healthcare system. Effective application of
information technology will be a guarantee of improved quality and safety in healthcare practice.
Healthcare is one of the fields that are important to all the societies in the world. Therefore it
means that improving the quality of healthcare services would benefit billions of people all over
the world. The study below is focused on Canada healthcare practice and evidence is retrieved
from primary and secondary sources. The article, barriers to adoption of Information Technology
in Healthcare written by Christodoulakis, Asgarian, & Easterbrook (2017), identifies two areas
of information technology, shows there barrier of adopting the technologies to health care and
the possible solutions to facilitate quality in healthcare practice. Nice intro!
The authors clearly identify the gap in nursing practice that needs to be addressed. They
show the significance of quality healthcare and how it impact the life of individuals. It presents
information of how quality healthcare can improve life as experienced in the United States and
Canada. It then brings in technology as another factor that can help improve the quality of
healthcare to be even better. The article shows that information technology can help improve
quality of healthcare services. However, the gap is the complexity of technology and healthcare
systems that hinder effective implementation of information technology in the healthcare system.
The purpose of the study is to show the different barriers to implementing information
technology into the healthcare system. The other purpose is to provide the solution to the
different barriers that will allow effective implementation of information technology into
healthcare. The study focus on two specific information technology field, the Electronic Medical
Record (EMR) and Remote Patient Monitoring (RPM). The research questions of study are how
to identify barriers to adopting information technology in health care and what are the possible
Information technology in Healthcare Practice
solutions to the barriers. The questions are well answered by the end of the study as
demonstrated in the discussion section of the research (source). Great background! Please
include in-text citations for all paragraphs.
Please include rubric headings to ensure you’re addressing each component.
The method of the study takes the approach of qualitative research approach due to the
complexity of measuring quality improvement with actual numbers. It presents information that
have been conducted from other fields and bring them together to construct meaningful study
and show how to achieve their objective of study. The study analyzes objectives that are related
to the different benefits of both the Electric Medical Record (EMR) and Remote Patient
Monitoring (RPM) in healthcare practice. The information of the benefits is an analysis of the
different research that has been done in the field of health systems and the systems thinking. In
this section of understanding the healthcare systems and their thinking, the research shows the
gap that needs to be filed and the reason why the research is important. According to the
presented information, the authors say that even though the EMR and RPM have been
implemented there is need to improve because the different research shows that it has not been
sufficiently used. Nice review of the method!
The research separates the study of the two cases being analyzed and clearly shows what
they are all about and their significance in healthcare practice. The first case that is analyzed is
the Electronic Medical Research. It deals with the recording of data in healthcare. It is something
that has been a big problem and many healthcare organizations seek to find a better strategy that
would allow effective data management up to date. The authors show why the EMR will be
crucial in healthcare practice by showing the five major benefits EMR would bring to nursing
practice. It then analyzes the results of different studies to show how effective adoption of EMR
Information technology in Healthcare Practice
has been in different researchers. It analyzes the quantitative data to show facts that the EMR has
not been effectively adopted in healthcare practice. The research then analyzes the reason why it
has been hard to adopt the EMR in healthcare. The section utilizes qualitative data analysis
which is retrieved from both primary and secondary sources to point out different barriers that
hinder full adoption of EMR in healthcare practice. The same approach is used in presenting the
case of remote patient monitoring (RPM). However, the article identifies another case of EMR,
the EMR interoperability and follows the same procedure to analyze why it is significant in
healthcare and the different barriers and the rate at which it has been adopted. Great review of
both types of research studies. Please include your source. Without a source, the reader is left to
assume this is your opinion. All points should be supported with scholarly sources.
After that, the research focusses on the solution to the different barriers. The solution
section is …
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