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1. In patients with acute respiratory distress syndrome (P), will the implementation of a pulmonary hygiene protocol (I) compared with standard positioning care (C) improve weaning parameter metrics (O) during the next three months (T)?



Finding Evidence-Based Practice in Healthcare

· In this activity, you will choose a PICO(T) question and develop a search strategy to find the best evidence to support the intervention.

· What You Need to Know

Peer-reviewed journals contain research studies with evidence to do the following two tasks:

1) Support the identified health care challenge and the need to improve it.

2) Substantiate potential interventions and show that they are evidence-based and have been successful at closing gaps in practice or addressing health care challenges.

It is important, then, to become familiar with performing a search of the literature based on a PICO(T) question. Likewise, it is crucial to master your skills in using databases to conduct your search.

· Levels of Evidence Pyramid .

As you have learned in the readings, quantitative studies result in some of the best possible evidence that can be used in the EBP process. Qualitative studies and the evidence they produce is also an area of research that is increasing rapidly in terms of its importance, validity, and relevance. This week, you will have the opportunity to reacquaint yourself with some of the most common quantitative and qualitative research methods and designs employed in the field of public health and health care.

Quantitative research is a systematic investigation of phenomena by gathering quantifiable, numeric data and performing statistical, mathematical, or computational techniques. These types of studies collect data and information from or about a group of individuals or a sample of a population using surveys or questionnaires and with the help of existing data sources that track performance indicators and metrics and other data. There are four main types of quantitative research designs: descriptive, correlational, quasi-experimental and experimental. The differences between the four types primarily relate to the degree the researcher designs for control of the variables in the experiment.

View the following presentation to know about quantitative research designs:

· Kaiser Permanente Southern California Nursing Research. (n.d.).  Nursing research series – Part 10: Quantitative study design: Interventional  [Slide Presentation]  |  Transcript  Retrieved from http://kpnursing.org/_SCAL/research/researchseries/10_quantitativeinterventionalstudydesign/player.html

Qualitative research is significantly different from quantitative research in terms of its philosophical foundations, practical objectives, management of the investigative process, and use and interpretation of acquired data. The qualitative approach to an inquiry can provide a rich, experiential understanding of specific health care topics, greater than is generally possible with quantitative methods. Although assessing the methodological quality of qualitative studies is complex and somewhat subjective, your assessment skills in inductive reasoning, context flexibility, and theoretical analysis will grow in proportion to your use of qualitative research in your own practice and your frequency of reading this type of literature.

View the following presentation to know about qualitative research designs:

· Kaiser Permanente Southern California Nursing Research. (n.d.).  Nursing research series – Part 8: Qualitative research design  [Slide Presentation]  |  Transcript  Retrieved from http://kpnursing.org/_SCAL/research/researchseries/08_qualititativerd/player.html

One area of potential confusion when reading about research methods and research designs is differentiating the two. Research methods are generally considered to be the broad underlying philosophical and practical approaches (that is, quantitative versus qualitative or intervention versus observation) to answer a research question. A research design, on the other hand, is more like a blueprint about what steps need to be taken to answer the research question or problem. Research designs include study sample collection and recruitment strategies, the timeframe where interventions take place, the nature of instruments used for measuring efficacy or outcomes, and types of precautions used during data collection procedures.

Review the following chapter in your Evidence-Based Practice in Nursing and Healthcare textbook, to learn about both quantitative and qualitative study methods and designs:

· Write Your Discussion Post

Finding the Best Evidence to Answer Different PICO(T) Questions

Note: Remember to adhere to the requirements for initial discussion postings and responses addressed in the Discussions section of the Course Policies and Expectations presentation.


3. In patients with acute respiratory distress syndrome (P), will the implementation of a pulmonary hygiene protocol (I) compared with standard positioning care (C) improve weaning parameter metrics (O) during the next three months (T)?

For your initial post, create a four-column table with the following headings: 

1. PICO(T) component.

2. Best evidence design/method.

3. Search terms.

4. Sources of external evidence (databases). 

Use the four columns to list the following: 

· Include each component of the PICO(T) question you chose.

· Identify, using EBP evidence levels, the study design/method that would provide the best evidence to support the intervention.

· Define three different search terms you would use to begin your search for the best evidence, based on the PICO(T) question you chose. 

· Determine the most appropriate databases to perform your search.

After the table, describe your search strategy and its relation to the PICO(T) question, as shown in the table.

Response Guidelines

Read and respond to your colleagues’ posts. Try to comment on those that have had few or no responses thus far. Provide feedback about search terms, databases, and strategies.

PICOT Search Strategy Table
PICOT ComponentStudy Design/MethodSearch TermsSources of External Evidence (databases)