Nursing EBP Project

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qrnguenvfre2016

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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 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?” See attached ebp topic for clarification.

The whole thing must be oriented to nursing issues and solutions

THATS 1 ASSIGNMENT

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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 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?” 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

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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:

  1. Title page
  2. Introduction section
  3. A comparison of research questions
  4. A comparison of sample populations
  5. A comparison of the limitations of the study
  6. 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 author’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 patients’ 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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Running Head: NURSING EBP PROJECT ARTICLE REVIEW1

Literature Review
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NURSING EBP PROJECT ARTICLE REVIEW2
Literature Review
Induction of labor is usually an obstetric intervention. Its application is typically
recommended in cases where both the mother and the baby would have more health benefits in
case the delivery is initiated early enough compared to expectant management. Some of the
conditions that might lead to labor induction include the presence of a pre-eclampsia,
oligohydramnios, post-term pregnancy or any growth within the uterus that might lead to
complicated delivery. Both spontaneous and induced deliveries can generally lead to cesarean
delivery. However, there is an increased concern that induction of labor exposes pregnant
women to higher risks of undergoing cesarean delivery. The use of cesarean delivery is never
recommended because it carries some severe possible outcomes for the mother. The
complications that might develop could implicate the current pregnancy or the subsequent
pregnancies or even the newborns.
Keywords; elective labor induction, spontaneous delivery, cesarean delivery, at term.
Researchers have done quite a lot of work regarding the relationship between cesarean
delivery and labor induction. Reaching a final agreement concerning this issue of contention has
been difficult. The main reason is that of differing results and findings by different medical
researchers. Another problem that might contribute to the differing conclusions is that cesarean
delivery could be a result of a medical complication during an early delivery or that made it
necessary for the woman to undergo an induced birth. It is from such medical complications that
certain scholars argue that induction of labor should not be incriminated to be the sole cause of
caesarean delivery.

NURSING EBP PROJECT ARTICLE REVIEW3
The influence of labor induction on cesarean delivery can be better isolated using
propensity scores compared to the control of confounding using the analytical methods that have
been used traditionally. The best way for this research is, therefore, the use of propensity scores.
The scores could be used to depict the possibility of a pregnant woman being induced against the
chances of not undergoing an induction in a given gestation period.
The methods of propensity score used in this study were matching and adjustment. These
two methods were able to create a balance between the groups being treated. Creating a balance
was to ensure that no bias was depicted in the estimating the effect of labor induction on
caesarian delivery. The propensity score matching, in comparison to the traditional covariate
adjustment, enables one even to interpret the causes.
Eight articles were considered for the study with the three main sections being
retrospective cohort studies. The three research articles were of level three.7804 women were
used, and labor induction was applied in 43.6% of the women (Ethrenthal, Jiang & Strobino,
2010). The duration of the study was two years and seven months. According to the findings of
this study, labor induction contributed to an increase in the chances of cesarean sections that
were unplanned by twenty percent. The research was also done on low-risk parous women
(Jonsson, Cnnatingius & Wikstrom, 2013). The study involved 7 973 women with three hundred
and forty-three of the women having an elective labor induction. Fifty-two percent of the
induced women did not progress and had to undergo an unplanned cesarean section. Some of the
induced women had to endure a cesarean section as a result of a fetal heart rate that was not
reassuring. This research concluded that elective induction of labor almost doubled the risks of
caesarian delivery. The third study also involved low-risk women. Th study included eight
hundred and ...


Anonymous
I was struggling with this subject, and this helped me a ton!

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