Nursing EBP Project

Hi there are 3 parts to this assignment.Hi the assignment is to make a short picot paper. (AN EXAMPLE IS ATTACHED). The topic in the example is clinical provider shortage. I WORK IN MATERNITY UNIT SO MY TOPIC IS â??Do pregnant women who have elective labor inductions at term (39-41 weeks) have an increased risk of unplanned cesarean sections compared to those who go into spontaneous labor?â? See attached ebp topic for clarification. The whole thing must be oriented to nursing issues and solutions THATS 1 ASSIGNMENT ———————————————————————————————————————————— NEXT PART THIS PICOT AND THE FOLLOWING PARTS OF THE ASSIGNMENT IS PART OF A FINAL PAPER TO BE PREPARED BY END OF SEMESTER SECOND PART—– I WORK IN MATERNITY UNIT SO MY TOPIC IS â??Do pregnant women who have elective labor inductions at term (39-41 weeks) have an increased risk of unplanned cesarean sections compared to those who go into spontaneous labor?â? See attached ebp topic for clarification. I NEED 8 SCHOLARLY ARTICLE SOURCES should be current within the last 5 years and closely relate to the PICOT statement developed earlier. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. —ONCE THESE 8 ARTICLES ARE ACQUIRED, USE THAT TO FILL IN THE ATTACHED LITERATURE EVALUATION TABLE, WHICH IS THE SECOND PART OF THIS ASSIGNMENT ———————————————————————————————————————————— NEXT PART— PART THREE– A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections: Title page Introduction section A comparison of research questions A comparison of sample populations A comparison of the limitations of the study A conclusion section, incorporating recommendations for further research Prepare this assignment according to the guidelines found in the APA Style THATS IT. SO YOU WILL BE SUBMITTING 3 DOCUMENTS. – PICOT PAPER LIKE IN THE ATTACHED EXAMPLE WITH MY TOPIC. – FIND ARTICLES AND FILL ATTACHED LITERATURE EVALUATION TABLE – LITERATURE REVIEW PAPER (AN EXAMPLE IS ATTACHED) Oh, just a P.S. the articles you find is needed for my final paper. so please provide working links in the literature evaluation table.
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EBP Project Abstract
Appraised by: Sevil Aliyeva, KellyDeraas, and Morgan Johnson
Clinical Question:
Do pregnant women who have elective labor inductions at term (39-41 weeks) have an increased
risk of unplanned cesarean sections compared to those who go into spontaneous labor?
Articles:
Ehrenthal,D.B., Jiang,X.,&Strobino, D.M.(2010). Labor induction and the risk of a cesarean
delivery among nulliparous women at term. Obstetrics and gynecology, 116, (1), 35-42.
Jonsson, M., Cnattingius, S., & Wikstrom, A. (2013). Elective induction of labor and the risk of
cesarean section in low-risk parous women: a cohort study. Acta Obstetricia Et
Gynecologica Scandinavica, 92(2), 198-203.
Tam, T., Conte, M., Schuler, H., Malang, S., & Roque, M. (2013). Delivery outcomes in women
undergoing elective labor induction at term. Archives of Gynecology and Obstetrics, 287,
(3), 407-11.
Synthesis of Evidence:
All three studies were a level IV retrospective cohort studies. Ehrenthal, Jiang, and Strobino,
(2010) used a total of 7804 women and labor induction was used in 43.6% of women. Elective
labor induction was the method/intervention used in 39.9% of the women. The study was
conducted over two years and seven months. Labor induction had increased the chances of
unplanned cesarean sections by 20%. Jonsson, Cnattingius, and Wikstrom, (2013) conducted a
study for parous women with no comorbidities or pregnancy complications. A total of 7973
women were used, and 343 women had elective labor induction. Out of the women who were
electively induced, 52% failed to progress and had unplanned cesarean sections. Another
complication was non-reassuring fetal heart rate which happened to 26% of electively induced
women and lead to emergent cesarean sections. Elective inductions more than doubled the risk of
unplanned cesarean sections. Tam, Conte, Schuler, Malang, and Rogue, (2013) conducted a
study for low-risk women. A total of 848 pregnant women were included, with 694 of these
women having a successful vaginal delivery and 154 having a caesarean delivery. Women who
had a favorable cervical exam and multiparity had a greater chance of having a successful
vaginal delivery. Studies showed a correlation between elective labor inductions and unplanned
cesarean sections.
Bottom Line: (findings)
The evidence suggests that elective labor inductions increased the risk of unplanned cesarean
sections.
Implications for Nursing Practice:
Nurses should be aware of the risks of elective labor inductions. The nurse educators and
practitioners need to teach the staff about these risks and implement the teaching into the
prenatal visits. Nurses and practitioners need to take the responsibility to inform the patient about
the increased risks of cesarean sections due to elective inductions. Nurses need to be the
advocate for the patient when the patient is not informed about the risks that go along with labor
inductions. The nurses and practitioners have a duty to perform thorough assessments of the
cervical condition and inform the patient if the cervix is not in favorable condition before
discussing the option of labor induction. Nurses and practitioners should be aware of risk factors
and co morbidities that can increase the risk of unsuccessful elective induction before they
consider this option.
Running head: PICOT QUESTION
1
PICOT statement
PICOT QUESTION
2
PICOT Question
A PICOT is a consistent technique for establishing subject researchable queries and a
sound PICOT makes the procedure of locating and assessing proof simpler (Northern Arizona
University, 2018). Generally, a PICOT formats stands for (P) population and problem, (I)
intervention, (c) comparison, (O) outcome, and (T) time frame.
Problem / Population
Shortage of clinical care providers in the United States causing large number of unattended
patients, which affect clinical care outcome
Intervention / Indicator
Joining hands with nursing institutions in order to train nurses while getting their services in a
mutual beneficial manner and promotion of self-care
Comparison / Control
The number of attended patients and recovery time before joining hands with nursing institutions
and promoting self-care
Outcomes
Increased number of attended patients in the shortest time possible and improved patient
recovery
Time Frame
Shortest time possible
Question
In clinical provider shortages, does self-care promotion and joining hands with nursing
institutions, compared to before implementation of the intervention, increase patient recovery
and the number of patients attended in the shortest time possible?
PICOT QUESTION
3
Reference List
Northern Arizona University, (2018). Ask: write a focused clinical question. Retrieved from:
http://libraryguides.nau.edu/c.php?g=665927&p=4682772
Literature Evaluation Table
Student Name:
Change Topic (2-3 sentences):
Criteria
Article 1
Article 2
Article 3
Author, Journal (PeerReviewed), and
Permalink or Working
Link to Access Article
Article Title and Year
Published
Research Questions
(Qualitative)/Hypothesis
(Quantitative), and
Purposes/Aim of Study
Design (Type of
Quantitative, or Type of
Qualitative)
Setting/Sample
Methods:
Intervention/Instruments
Analysis
Key Findings
Recommendations
Explanation of How the
Article Supports
EBP/Capstone Project
© 2015. Grand Canyon University. All Rights Reserved.
Article 4
Criteria
Article 5
Article 6
Article 7
Author, Journal (PeerReviewed), and
Permalink or Working
Link to Access Article
Article Title and Year
Published
Research Questions
(Qualitative)/Hypothesis
(Quantitative), and
Purposes/Aim of Study
Design (Type of
Quantitative, or Type of
Qualitative)
Setting/Sample
Methods:
Intervention/Instruments
Analysis
Key Findings
Recommendations
Explanation of How the
Article Supports
EBP/Capstone
© 2017. Grand Canyon University. All Rights Reserved.
Article 8
Literature Review
Various academic journals were explored using both Grand Canyon University Library
website and this authorâ??s place of employments healthcare library website. Various databases
searched included: CINAHL complete, Cochrane Library, Joanna Briggs Institute EBP, Nursing
and Allied Health Collection, OVID Nursing Essential Collection, PUB MED, and EBSCO Host. The
criteria used for the search were per reviewed articles from 2011 to 2017. Key words searched
included: oncology or cancer patients, neutropenia, infection, CLABSI, oral hygiene or oral care,
and mouth care.
There was a total of 23 articles researched. Some articles provided study results about
methods to reduce central line-associated blood stream infections (CLABSI), in the acute care
setting and in patients with neutropenia. Other studies focus on the impact of oral care in
oncology patients. A quantitative study was done, evaluating the purpose of a protocol for oral
care in hematology-oncology patients undergoing chemotherapy, and hematopoietic stem cell
transplant (HSCT) recipients (Elad et al., 2015). Another study was done on reducing central
line-associated bloodstream infections on an oncology unit in an academic medical center. This
study concluded that after a six-month education series, and implementing an audit system,
there was reduction in CLABSI rates in the inpatient oncology unit (Page et al., 2016).
Citation: Elad, S., Raber-Durlacher, J. E., Brennan, M. T., Saunders, D. P., et al (2015).
Basic oral care for hematology-oncology patients and hematopoietic stem cell transplantation
recipients: a position paper from the joint task force of the Multinational Association of
Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the
European Society for Blood and Marrow Transplantation (EBMT). Supportive Care Cancer, 23(1),
223-226.
Hematology-oncology and hematopoietic stem cell transplantation (HSCT) patients are
usually immunocompromised due to their disease and/or side effects from treatment (Elad et
al., 2015). Oral complications in hematology-oncology and HSCT patients can may be harmful,
causing other morbidities and even death. Basic oral care (BOC) in cancer patients should be
part of the patientsâ?? routine basic daily care to reduce the risk of infection and maintain good
oral health. The purpose of this quantitative experimental study, was to stress the significance
of BOC before, during and after chemotherapy and HSCT. The study was done by the members
of the Oral Care Study Group, Multinational Association of Supportive Care in
Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for
Blood and Marrow Transplantation (EBMT). The study was done to develop a protocol for BOC;
to prevent systemic infections, reduce discomfort and maintain oral function. Developing a
protocol for BOC could also help healthcare providers manage hematology-oncology and HSCT
patients. The protocol recommends seeing a dentist who is familiar with hematology-oncology
and HSCT patients prior to treatment. During treatment, the protocol recommends brushing
four times a day with a soft toothbrush using a toothpaste with fluoride and frequent bland
solution rinses, such as chlorhexidine. After treatment, the protocol recommends continuous
follow up with a dentist and continue to maintain good oral hygiene. The results of this study
showed that following the BOC protocol reduces the oral microbial load, reduces plaque buildup, and helps prevent infection, control oral pain, maintain oral function and improves quality
of life for hematology-oncology and HSCT patients.

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